PHOSPHORUS STARVATION: II. 107 



taste for this food and therefore, when we first saw him, in the beginning 

 of January, he was practically on a diet of rice, together with a certain 

 quantity of fish and meat, milk and bread. The results of the examina- 

 tion are as follows: 



A Filipino of small stature, 42 kilos in body weight, lying in the bed, unable 

 to raise himself or to stand without assistance. If .placed on his feet, he collapses 

 as soon as support is released. Muscles of the leg and arms very weak, knee 

 reflexes absent; dynamometric test of the left hand 30 to 35, right hand 55 to 60. 

 The sesthesiometrie test shows that the ability to feel, the sense of touch and 

 reaction to pricking, as well as his ability to distinguish two different spots 

 simultaneously touched, is reduced to a great extent on the legs, to a less degree 

 on the arms and that it is about normal for a Filipino on the forehead. The 

 apex beat in the mammary line, fifth intercostal space, right border of heart on 

 the right line of sternum. Heart sounds normal, pulse 70. The man is somewhat 

 constipated, but digestion and appetite are otherwise apparently normal. Diag- 

 nosis: beriberi. 



On January 6, the man was put in the isolation room which we have 

 described, and kept on a diet of rice, together with a quantity of fish. 

 He was taught to collect his urine and fasces, to consume his food entirely, 

 and the other details of the regimen necessary for experiments on metab- 

 olism. The diet to be given in the first set of experiments should be 

 one which would cause beriberi; in the next period, organic phosphorus 

 should be added; then a third period, like the first, should follow. In 

 the next period after this, we intended to study the result of an increase 

 of the intake of nitrogen alone without increasing the phosphorus, and 

 in the last we desired to employ a diet more or less like that given to the 

 first man, and which one of us has termed a typical Filipino diet, con- 

 sisting of rice and fish. It was our further intention to double the two 

 most important periods, namely, those with the diet poor and rich in 

 phosphorus, so as to have a better control. Seven periods were therefore 

 planned, each intended to cover four days, so that twenty-eight days 

 would be necessary for the experiment. 



The experiment originally began on January 9, but because of a failure in 

 taking the faeces, we were compelled again to begin on January 10, so that the 

 experiment covered twenty-nine instead of twenty-eight daj'S. ■ The arrangements 

 were in all particulars exactly like those described above. The food used was 

 again analyzed in respect to the rice, bacon, and fish; the bread and coffee were 

 made in the same way as before and the values obtained in the first series were 

 taken. As in the foregoing "normal" periods, we added bacon to the food of this 

 patient so as to make it as deficient in phosphorus as possible. Three samples of 

 bacon were employed: A was somewhat lean, containing some muscle fiber, 

 whereas B and G consisted entirely of fat. The number of calories given, when 

 reduced to the kilo of body weight (44 calories) was at least identical with the 

 calories given to the first prisoners and therefore the food was quite sufficient to 

 sustain a man who was not able to perform any muscular exertion. Phytin was 

 added to the food during the two periods when a diet rich in phosphorus was 

 administerd, so that we might study the result of the ingestion of this organic 



