PHOSPHORUS STARVATION: II. 109 



The amount of nitrogen was increased during the next period (F) by 

 the addition of egg albumen, in quantity so as to contain 8.34 grams 

 instead of about 6.5 grams of nitrogen daily. In the normal man, the 

 loss in nitrogen was reduced correspondingly by this addition, but in 

 the individual suffering from beriberi, the same quantity of nitrogen 

 as before was lost daily. It is still more remarkable that the excess of 

 nitrogen did not appear almost entirely in the urine, but a large proper- 

 tion was excreted in the faeces. Egg albumen, under normal conditions, 

 should be absorbed almost to the extent of 98 per cent as was the case in 

 period VI, but in this instance at least 25 per cent was lost. 



The addition of 100 grams of fish, in period G, finally increased the 

 nitrogen intake to 10.06 grams a day, or 0.25 gram per kilo of body 

 weight. The nitrogen balance now registered only — 0.6 gram, which did 

 not represent full nitrogen equilibrium, although the shortage was small. 



The phosphorus intake was at the same time increased to 1.91 grams 

 per day, or 0.048 gram P 2 5 per kilo of body weight. 'While this amount 

 of P 2 is far below that given during periods C and D, when phytin 

 was added to the diet, the phosphorus balance now showed a daily loss 

 of only 0.13 gram P 2 5 . Therefore, the man was nearly in phosphorus 

 equilibrium. While during this period there was less P 2 5 taken in, 

 there still was a better retention of this element, probably because of the 

 fact that, during this period, the loss of nitrogen was very small as 

 compared with that in the foregoing periods C and D. It must be 

 assumed that the destruction of the materials of the body containing 

 nitrogen also brings with it the destruction of those containing phosphorus, 

 and that therefore a loss in nitrogen should necessarily also be accom- 

 panied by one of phosphorus, regardless of the excess of phosphorus 

 which may be taken in. Of course, as experiment VII has shown, we 

 may find a favorable retention of phosphorus together with a loss of 

 nitrogen, but in this instance the loss in phosphorus had taken place 

 during a short period, whereas in the patient suffering with beriberi the 

 loss of both nitrogen and phosphorus had continued for many weeks. 



This view is strengthened by certain differences to be observed between 

 cases of beriberi. A patient just beginning to show symptoms of nervous 

 disorder and of weakness will often recover if his diet is changed in the 

 course of one or two weeks; whereas, on the other hand, in instances 

 where the disease has lasted several months, a long period of treatment 

 is necessary before improvement sets in. 



After finishing the metabolism experiment, we kept the patient on 

 practically the same diet as he had received in period G after February 

 7, and, in addition, he received 4 grams of phytin daily, in two powders. 

 He was maintained in isolation and under close observation. He was 

 able to get up without help on or about February 20, toward the middle 



