568 SAMUEL H. HURWITZ 



recorded may be attributed to lack of uniform and adequate precautions 

 in regard to food, muscular activity and apparatus, factors which are 

 known to influence greatly the results obtained by calorimetric methods. 



Pettenkofer and Voit(c) were among the first to apply clinical calo- 

 rimetry to the study of blood conditions in man. They investigated the 

 respiratory metabolism of a patient suffering from severe leukemia and 

 found the gaseous exchange almost identical with that of a healthy indi- 

 vidual taking the same diet. This pioneer experiment stimulated the later 

 studies on this subject. Notable contributions on basal heat production 

 in anemia and leukemia have been made by Magnus-Levy (c) (gr), Kraus 

 (&), Bohland(a), Thiele and Nehring, Grafe(e) (/) (i), Roily, Meyer and 

 Du Bois, Murphy, Means and Aub, and Tompkins, Brittingham and 

 Drinker. 



A comparison of the results of these different workers is rendered 

 difficult on account of lack of uniformity in the experimental conditions, 

 and in the normal standards of comparison used. Kraus and also Bohland, 

 for instance, studied their patients under conditions which are now 

 known to increase metabolism. The former neglected to have his patients 

 at rest, and the latter disregarded the metabolism-accelerating influence of 

 food. Notwithstanding such sources of error, some comparison of results 

 has been made possible by Meyer and Du Bois and by Murphy, Means 

 and Aub, who have recalculated the basal metabolism on certain clinical 

 anemias and leukemias studied prior to their work on the basis of Meeh's 

 formula for surface area and the normal of 34.7 calories per square 

 meter per hour. 



The respiratory metabolism of secondary anemia and chlorosis has 

 been studied by Kraus, Magnus-Levy (g), and Thiele and Nehring. When 

 the figures for oxygen absorption which Kraus found in secondary anemia 

 and chlorosis are expressed in terms of calories, the metabolism is abnor- 

 mally high. This increase in calorific output may have been due, as 

 previously mentioned, to the fact that these investigators permitted their 

 patients to sit during the observation. 



Magnus-Levy's results, do not exceed the normal limits ; whereas 

 Thiele and Nehring report a normal metabolism for secondary anemia, 

 but diminished or on the lower border of normal for chlorosis. 



The results of various workers are more in agreement, however, as 

 regards the basal heat production in pernicious anemia. Magnus-Levy and 

 Kraus both found the metabolism increased in this type of anemia, the 

 degree above normal varying from four to seventeen per cent. Basing 

 their computations on modern standards (linear formula), Meyer and 

 Du Bois found in their patients with pernicious anemia a metabolism on 

 the upper limits of normal in mild cases, while in two severe cases the 

 demand for oxygen was from seven to thirty-three per cent above the 

 normal average. Greater irregularity in results was found by Tompkins, 





