306 STRONG AND CROWELL. 



impulse not visible nor distinctly palpable; heart sounds feeble 

 but clear ; second aortic sound accentuated at the base ; no oedema 

 of the legs, and no tenderness of the calves ; says he feels weaker 

 than before taking the diet, but he weighs 0.9 kilogram (2 

 pounds) more than before the experiment. The urine contained 

 no albumin nor casts. Twelve days after his return to the 

 regular prison ration he had gained 1.3 kilograms (3 pounds) 

 more. 



CASE NO. 6 (GROUP l). 



Diet: White rice + rice polishings for 13 days 

 followed by white rice + extract of polish- 

 ings for 95 days, together with the special 

 diet common to all the groups. 



Dried codfish and potatoes were added to the diet on the 97th day. 



Total period of experi- 

 ment, 108 days. 



Following is a summary of the notes of the case : Examination 

 shows a well-developed and well-nourished man; percussion and 

 auscultation of the lungs reveals nothing abnormal ; examination 

 of the heart shows the point of maximum impulse not distinctly 

 visible; just palpable 6 centimeters to the left of the median 

 line and 3 centimeters below the nipple line ; there is no increase 

 in the area of cardiac dulness ; the heart sounds are clear ; there 

 is no epigastric pulsation ; the pulse is 80, and the systolic blood 

 pressure 114 millimeters Hg; the liver and spleen are not en- 

 larged ; the knee j erks are active. 



He lost 4.08 kilograms (9 pounds) in weight during the time 

 he was fed on rice mixed with the polishings, but when the 

 extract of polishings was added to the rice instead of the polish- 

 ings, he regained about 0.9 kilogram (2 pounds) . The earliei* 

 notes in regard to him are otherwise unimportant. The knee 

 jerks remained active. On the eighty-fifth day the systolic blood 

 pressure was 95 millimeters. On the ninety-ninth day epigastric 

 pulsation was visible, but there was no throbbing over the cardiac 

 area; the point of maximum impulse was not visible, but was 

 just palpable within the nipple line; the heart sounds were clear, 

 and the pulse slow and regular ; there was no oedema of the legs ; 

 the knee jerks were active. The prisoner made no complaints 

 except of small erosions on the edge of the lips and on the tongue. 

 On the one hundred fifth day there was no particular change 

 in his condition. The erosions about the mouth had improved by 

 application of a 5-per-cent solution of silver nitrate. On the 

 one hundred eighth day the note made was as follows: Fairly 

 well nourished; pulse 100, and of good volume; some epigastric 



