OCCURRENCBl AND CONSEQUENCES OF OVER-NUTRITION 61 



the nervous system. Meat and eggs are withdrawn and the patients are put 

 upon a vegetable diet. To this no special objection can be raised, provided 

 it is carefully chosen ; but too frequently it is lacking in nourishment. This 

 has been so abundantly proven as to need no further consideration at this point. 



4. OCCURRENCE AND CONSEQUENCES OF OVER-NUTRITION 



If the food (i. e., its combustion value) exceeds what is necessary for 

 maintenance we have the condition of liy per nutrition. In over-nutrition the 

 organism does not increase its processes of combustion, or, at least, does so 

 to a very slight extent. Perhaps the increase of oxidation which arises from 

 over-nutrition has been for a time underestimated, as the latest investiga- 

 tions of Fr. Miiller appear to prove. Theoretically this increase is interest- 

 ing, but it is too slight to be of practical importance. 



The increase of oxidation is not due to a stimulation of the cells to a greater 

 katabolic activity, in other words, to a greater rapidity of metabolism, but 

 only to the greater labor which is put forth by the mechanism of mastication, 

 the stomach and intestines, the digestive glands, the organs of circulation and 

 respiration, etc., in order to work up and utilize the greater mass of food. 

 After deducting the slight amounts spent upon the increased labor of diges- 

 tion, etc. (about 7 per cent, to 20 per cent, of the energy supplied by the 

 food), a large residue from the superfluous food remains, which accumulates 

 as reserve material, and serves to increase the body mass. We call this " food 

 surplus " ( = the difference between food ingested and food used up in metab- 

 olism). 



Aside from slight differences it is of no importance to the processes of 

 metabolism whether the surplus of food occurs from- excess of albuminates . or 

 of N-free food, or whether the increased supply comes from one source only 

 (the albumin or the fat or the carbohydrates). A surplus of carbohydrate 

 nourishment favors almost exclusively the production of adipose tissue, pro- 

 vided special circumstances do not promote the increase of protoplasm (see 

 above). 



In an especial case (B. Krug's experiment upon himself carried out under 

 my direction) the following calculations were made: 



Dr. Krug (perfectly well and in a moderately good state of nutrition), 

 after a period in which he had been abundantly nourished, took for fif feen days 

 in addition to his ordinary food a daily total of 1,710 calories, consisting of 

 fat and carbohydrates. This sum represented " surplus nourishment " ; for 

 the fifteen days it amounted to 25,650 calories. Of these 23,051 calories were 

 utilized by the body. 



1,720 calories = 7.46 per cent, albumin accumulation, and 

 21,331 calories = 92.54 per cent, accumulation of fat. 



Whether the production of albumin was equivalent to accumulation of flesh 

 could not be decided. 



It follows from the preceding statements that after the ingestion of a 

 surplus amount of food only an accumulation of fat can certainly be counted 



