THE FOOD REQUIREMENT OF THE SICK 41 



With such an amount of IST-retention there is no possibility that we are 

 producing only a temporary retention of N-containing products of metabo- 

 lism (proteid destruction). Further such an enormous increase cannot take 

 wholly the form of circulating albumin (in Voit's sense). Neither can we 

 call it "reserve albumin" (v. Noorden), if this term is meant to imply that 

 the albumin accumulated during convalescence is a different kind of albu- 

 min from, and subject to other laws of destruction than, the ordinary albumin 

 of the organs. 



In the person experimented upon by Liithje, whose diet for twenty days 

 averaged 62.5 grams of N",^ after a reduction to 16.7 grams N, K-equilibrium 

 was attained, not at once indeed, but within three or four days ; and even after 

 eight days, when the research was stopped, but small losses of nitrogen were 

 shown.= In view of the obvious tendency toward F-equilibrium in this case 

 there is no reason to assume that, in the subsequent period, all the nitrogen 

 (166.78 grams) which had accumulated during twenty days of the albumin 

 period was again lost. At any rate, there was no loss in weight, although 

 the patient after leaving the clinic and while living on a freely chosen diet 

 probably did not consume a very large quantity of albumin. 



Apparently then the amount of his living cell substance probably remained 

 large. Consequently, in later investigations in the same person larger quan- 

 tities of albumin were required to bring about a large IST-retention, a phe- 

 nomenon quite in accord with the views of Pfliiger, according to which the 

 degree of the albumin metabolism is dependent upon the amount of living 

 cell substance of the body. 



We are, therefore, justified in holding the view that the N-retention in 

 convalescents is not due to the retention of JST-containing urinary products 

 of metabolism, but to an actual accumulation of albumin which is equivalent 

 to an increase of living protoplasm and, in a certain sense, to an increase in 

 the activity of the body. Moreover, we must not always consider the muscles 

 of the body alone, and for this reason the designation, "muscle-food," had 

 better be avoided. Eichness in albumin (increase of the juices of the flesh) 

 is only the necessary pre-requisite for great power in the musculature, and it is 

 exercise and only exercise which increases power, on which capacity for work 

 is directly dependent. 



On the other hand a decided retention of nitrogen, which -does not mean 

 an accumulation of albumin (or an increase of living protoplasm), is fre- 

 quently met with in renal diseases. Disturbance of the nitrogen-equilibrium 

 is usual in these affections. 



It is evident without further elucidation that in nephritis which is a con- 

 sequence of disease of the excretory organs urinary substances are prone to 

 remain in the body, and we are therefore not far wrong, when we find rela- 

 tively small amounts of nitrogen in the urine (in comparison with the 



' Corresponding to the enormous administration of 390 grams of albumin per day. 

 2 For which the further decrease of N-administration to 15.6 grams N is to be made 

 partly responsible. 



