AETIFICIAL METHODS OF FEEDING 817 



is better and more satisfactory. It must also he said that for short periods 

 the intravenous route is better for giving glucose solutions also. 



Intravenous Feeding. The intravenous method of giving medication 

 for varying conditions has come into vogue more and more, and is now an 

 established method of practice. The application of this principle to 

 supplying nourishment to the body is of very recent date, and a field of 

 usefulness has been opened that may be fruitful of very definite results, 



There are certain dangers connected with this method that do not 

 obtain in other forms of artificial feeding and must be taken into account. 

 Embolism is a possibility, but is probably of slight moment with anything 

 like surgical cleanliness and is certainly a rare occurrence in giving medica- 

 tion. Overfilling of the blood vessels is another potential danger, and 

 with a weakened heart muscle must be kept in mind, and the amount in- 

 jected into the vein carefully regulated as to speed of introduction and 

 total quantity used. 



INDICATIONS. The chief indications for this form of feeding may be 

 summoned up as follows: 1. When all other routes are closed. 2. In 

 conditions of severe acidosis. 3. In severe acute infections. 4. To pro- 

 duce massive diuresis. The last three indications are to meet medical 

 rather than nutritional demands. 



Protein. The use of protein by the intravenous route, except in the 

 form of serum, is still in the experimental stage and no reference can be 

 found in recent literature bearing on the subject. Woodyat reports that 

 he and his collaborators have been doing experimental work with proteins 

 but is not yet ready to publish it. It would seem a simple matter to supply 

 protein in a limited way intravenously by using human serum, but the 

 difficulty would naturally arise in securing a supply to carry on the food 

 requirements. Horse serum could be used for a short time, provided the 

 individual was not sensitive to it. The process is still in a speculative and 

 experimental stage with as yet no definite solution of the problem of 

 supplying easily the protein requirements of the body by this method. 



Fat. From what is known of fat embolism it would seern that the 

 giving of fat by the intravenous route was pretty definitely precluded, and 

 although a 3 per cent lard emulsion has been used experimentally in ani- 

 mals, it is not without danger and should not be used in man. 



Carbohydrates. Again, as in the rectal and subcutaneous methods of 

 feeding, carbohydrate in the form of dextrose is the most easily used and 

 readily absorbed and forms, so far, the only important constituent of this 

 method of artificial nutrition. 



Woodyat, Sansum and Wilder, by means of a special apparatus, de- 

 scribed in the Journal of Biological Chemistry, tested glucose tolerance- by 

 intravenous injection, and showed that by delivering it at a uniform rate 

 of speed in 10 to 50 per cent solutions, a rate closely corresponding to 0.85 

 gin. of glucose per kilo of body weight and hour of time, for from six to 



