THE FOOD REQUIREMENT OF THE SICK 25 



The question most discussed has been whether the effects of cold and 

 heat decidedly increase the processes of combustion in the body. That remain- 

 ing in a cold atmosphere produces a great loss of heat will scarcely be doubted, 

 and in the endeavor of the body to maintain its own temperature a decided 

 loss in heat in consequence of cooling cannot be prevented, at any rate not 

 without an increased consumption of its combustible material. The ques- 

 tion to be chiefly considered is, whether the irritation of cold upon the sur- 

 face of the body produces chemical changes in the interior, and thus directly 

 increases the intensity of combustion. Speck disputes this, and considers 

 that some physical regulation is responsible for the preservation of body tem- 

 perature by limiting the loss of heat to the slightest amount. In his opinion, 

 the involuntary muscular contractions which result as the effect of cold are 

 the cause of the increase in the interchange of gases which has been observed. 



As a matter of fact, Loewy,^ in his investigations of the influence of cold 

 upon the respiratory metabolism, was unable to determine an increase of Oj 

 consumption in all cases of intelligent persons who understood their bodily 

 functions and who maintained completely flaccid muscles during the investi- 

 gations. This corresponds with the experience of Wolpert, which is of prac- 

 tical importance, that " the temperature of the air of the work-room, during 

 work within the limits of 5° C. and 25° C, exerts no especial influence upon 

 the degree of COj excretion, either during rest or during strenuous corporeal 

 labor." (In contrast to this are the views of Liebermeister, according to 

 whom the heat loss from the effect of cold causes directly an increase of heat 

 production.) 



Eegarding the increase of oxidation processes which are generated by the 

 action of heat upon the body, when the conduction of heat by evaporation is 

 prevented, we have some interesting figures obtained in the experiments on 

 the respiratory metabolism which v. Mering had performed in his clinic by 

 Winternitz,^ Lohse,' and others. In contrast to the decided increase of oxida- 

 tion produced by the hot-water hath, as shown by these investigations, the 

 effect of a hot-air hath upon metabolism is quite insignificant in consequence 

 of a prompt physical regulation (sweating) (Salomon).* 



According to the few researches at hand ( Schattenf roh,^ Wolpert") we 

 may assume that the influence of heat and cold in the metabolism of the sich 

 is quite different from that in the healthy. In the obese, for example, at least 



1 A. Loewy, " Ueber den Einfluss der Abkiihlung auf den Gaswechsel des Menschen.'' 

 Pfluger's Arch., Bd. xlvi, p. 189. 



^ E. Winternitz, " Ueber den Einfluss heisser Bader auf den respiratorischen Stoff- 

 weehsel." Klin. Jahrbuch, 1899, Bd. vii. — " Ueber die Wirlcung verschiedener Bader 

 auf den Gaswechsel." Hab.-Schrift, 1902, Nauenburg. 



3 Lohse, " Ein Beitrag zur Lehre von der Einwirlfung des heissen Bades auf den 

 menschlichen StoflFwechsel." Diss., Halle, 1900. 



* Salomon, " Ueber die Wirkung der Heissluftbader und elektrischen Lichtbader." 

 Zeitschr. f. diiit. u. physik. Therap., Bd. v, Heft 3. 



6 Sohattenfroh, " Respirationsversuche an einer fetten Versuehsperson." Arch. f. 

 Hyg., Bd. xxxviii, p. 93. 



« Wolpert und Broden, " Respiratorische Arbeitsversuche bei wechselnder Luft- 

 feuchtigkeit an einer fetten Versuehsperson." Arch. f. Hyg., Bd. xxxix, p. 298, 



