52 ANALYSIS OF DISTURBANCES OF METABOLISM 



of albumin (nitrogen retention) during forced muscular labor. Is it possi- 

 ble that the muscular machine acts so wonderfully that it is not subject to 

 wear and tear, but actually develops during this condition, while it transfers 

 the energy supplied by the carbohydrates into living force? Or are the con- 

 ditions in reality quite different, and are nitrogen-free substances really 

 burned in the muscle during its work, or, on the contrary, does it decompose 

 the specific albuminous protoplasm of the muscle cell so that the nitrogen 

 also at once decomposes like the albumin of the muscle, and is utilized for 

 the reconstruction of muscular albumin ? Verworn assumes that in muscular 

 activity the biogen molecule which represents living albumin decomposes into 

 atom groups containing nitrogen and non-nitrogenous atoms, of which only 

 the latter are excreted in metabolism, whereas the former regenerate to com- 

 plete biogens. That we must recognize synthetic processes if we are to make 

 such an assumption, cannot be thought remarkable after what has been said. 

 For does not the animal organism evolve from inorganic iron such a highly 

 complicated molecule as is represented by hemoglobin? It produces syn- 

 thetically nuclear albumin from its components, etc. 



If we dismiss the view that each molecule of food which is absorbed, and 

 is required by the organism to maintain its vital functions, is at once in all 

 its constituents decomposed into end-products of metabolism and quantita- 

 tively excreted, then many other points in the pathology of metabolism for- 

 merly difficult to understand will be made clear. 



When nuclein decomposition occurs in the body, the phosphoric acid ex- 

 cretion is frequently not uniform with the excretion of alloxur bodies; appar- 

 ently because phosphorus is retained for the purpose of nuclein synthesis, for 

 the regeneration of the nuclein which has been lost. 



After complete withdrawal of carbohydrates, the amount of sugar excreted 

 in severe cases of diabetes (as has lately been frequently observed) may 

 exceed the quantity which may be assumed to be formed from albumin. Be- 

 fore we speak of a sugar formation from fat, we should think of a renegera- 

 tion of the K-containing part of the albumin molecule after splitting off the 

 carbohydrate group, perhaps with the aid of the atom groups taken from 

 the fat molecule. This is, however, quite different from a direct sugar' forma- 

 tion from fat expressed in chemical equation. It is simultaneous splitting 

 and synthesis, a work of the living cell, whose effort toward regeneration 

 becomes greater the more its protoplasm is involved in decomposition. 



In the study of the pathology of metabolism, we must escape from the 

 narrow confines of views which, in the discipline of student days, were of 

 certain value to us, but which must no longer be a barrier to development. 



The opinion must probably be discarded that the amount of decomposi- 

 tion of animal protoplasm (living substance), that is, the amount of metabo- 

 lism necessary to maintain life, is equal in all individuals and at all times. 



Of course the common estimation of the amount of total energy consump- 

 tion m clinical metabolism investigations is not decisive in Judging this 

 question. Slight, and even scarcely noticeable differences in the activity of 

 different individuals (greater muscular exertion, etc.) may produce vary- 

 ing degrees. Hence the difference of two values obtained under similar con- 



