GENERAL THERAPEUTICS OF THE DISEASES OF 

 METABOLISM 



Physiology. — The treatment of the so-called metabolic dis- 

 eases (diabetes mellitus, obesity, gout, chronic disturbances of 

 nutrition) must be based upon the physiology of metabolism. 

 Metabolism can be influenced principally in a dietetic way. The 

 chief nutritive materials used for this purpose are albumin, fat and 

 the carbohydrates, in addition to water and salts. 



In reference to albumin, physiology teaches that the more 

 albumin that is introduced into the body the more is decomposed. 

 Feeding albumin in abundance therefore only increases the total 

 albumin decomposition and does not increase the amount stored up. 

 A real strengthening of the body, i.e., an increase in the amount of 

 organic albumin, does not result from a pure albumin diet, con- 

 trary to the usual assumption. Such a diet only temporarily in- 

 creases the amount of circulating albumin in the blood. If organic 

 albumin is to be stored up in the body, which is the object aimed at 

 in the treatment of chronic disturbances of nutrition, then fats 

 or carbohydrates must be given with the albumin. The presence 

 of fats and carbohydrates limits the albumin decomposition in 

 both healthy and diseased animal bodies. 



The fat taken into the body is partly stored up and partly 

 decomposed. The fat deposited in the body is derived principally 

 from the fat in the food and only to a slight degree from the al- 

 bumin. In emaciation, therefore, the deposition of fat can be 

 attained only by feeding an increased amount of fat and not by 

 increasing the albumin in the diet. On the contrary, reduction 

 can be obtained in obesity by an exclusively albuminous diet (Bant- 

 ing treatment) or by withdrawing fat and carbohydrates from the 

 ration. 



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