METABOLISM IN DISEASES OF BONES AND JOINTS 777 



TABLE 35 



METABOLISM OF A PATIENT WHO HAD RECOVERED FROM ATROPHIC ARTHRITIS 



The amount of phosphate in the feces is likewise high about the 

 same as, or a little more than, that in the urine. Again, as in hypertrophic 

 arthritis, the urine contains, on the average, only about half as much 

 phosphate as the food. The loss of phosphate is in all cases less than the 

 loss of calcium, and, as in the cases of hypertrophic arthritis, is probably 

 secondary to the loss of calcium. 



A comparison of Tables 31 and 35 is particularly instructive in this 

 connection. These tables show the metabolism in the same patient during 

 the active stage of atrophic arthritis (Table 31) and after recovery (Table 

 35). With the return to normal, as judged by the clinical condition, there 

 is a return to the normal metabolism. Table 31 shows negative calcium 

 balance and positive magnesium balance ; Table 35 shows positive calcium 

 balance and negative magnesium balance. Table 31 shows 95 per cent 

 as much calcium in the feces as in the food; Table 35 shows only 78 per 

 cent. Table 31 shows 18 per cent less phosphate in the urine than in the 

 feces; Table 35 shows 60 per cent more phosphate in the urine than in the 

 feces. Table 31 shows only 36 per cent as much phosphate in the urine 

 as in the food; Table 35 shows 76 per cent. 



The metabolic changes in both hypertrophic arthritis and atrophic 

 arthritis are like those found in osteomalacia and similar bone diseases, 

 and are probably due to the bone softening and atrophy found in the bones 

 in these arthropathies. 



According to Pemberton of Philadelphia, chronic arthritis, without 

 distinction of clinical type, apparently, is a disease in which the body 

 cannot metabolize the normal amount of carbohydrate and protein (Pem- 

 berton(Z>) (c) (d) (e) ). This etiology is based on the good clinical results 



