570 



SAMUEL H. HURWITZ 



not unlikely that in these instances the increased metabolism may be 

 attributed, in part at least, to influences other than the anemia. 



It is evident from this review that the results recorded in the litera- 

 ture concerning the metabolism in anemia show some variations. On the 

 whole, however, experimental and clinical observations support the view 

 that, an anemic individual requires and consumes at least the same quan- 

 tity of oxygen, and consequently produces the same number of calories 

 as a healthy person ; and that in certain of the severe anemias an increase 

 of the respiratory metabolism and basal heat production may be observed. 



The literature contains only a few observations 011 the basal metab- 

 olism of patients suffering from leukemia. Of the studies recorded 

 those of Kraus, Magnus-Levy (c), Grafe(e), and Murphy, Means and Aub 

 merit discussion. All these workers are agreed that in both forms of leu- 

 kemia there is invariably a marked rise in the basal metabolism expressed 

 in terms of body surface area. This elevation in basal heat production has 

 been found about equal in both the lymphatic and splenomyelogenous 

 types of the disease. Murphy, Means and Aub have calculated the aver- 

 age increase over the normal in eight cases of lymphatic leukemia recorded 

 in the literature to be 52 per cent ; and in five patients of myelogenous 

 type, 44 per cent. Their own patient with chronic lymphatic leukemia 

 showed a rise of 44 per cent above the average figure for normal men 

 of that age. 



Compensatory Factors in Anemic States. The finding of a nor- 

 mal or augmented metabolism in anemic states has led to considerable 

 speculation concerning the manner in which the body requirements of 

 oxygen are met in the presence of a reduction of hemoglobin. Normally 



TABLE 3 

 BASAL METABOLISM IN CASES OF PERNICIOUS ANEMIA COLLECTED FROM THE LITERATURE 



Rearranged from Table by Meyer, A. L., and Dubois, E. F. Arch. Int. Med., 1916, 

 xvii, 974. 



