B507:) “. Dietetics in Tuberculosis. 155 
Observations on Tubercular Patients treated with Very Large Nets. 
Careful observations have been made upon tubercular patients treated 
on the very large diets prescribed in many sanatoria, for instance, on diets 
with a daily proteid value of 200 grammes or more, and a total calorie value 
of 4000 or more. 
Clinical Results of these Observations.—Patients made much less satisfactory 
all round progress on the very large diets than on diets of considerably 
smaller nutritive value. Weight was gained in nearly every case, in some 
to a very large extent, and very rapidly, but this gain of body-weight was 
not associated with any more satisfactory progress in the tubercular lesions 
than was obtained with the smaller diets; on the other hand, general health 
suffered considerably, as evidenced by failure of appetite and marked digestive 
and intestinal derangements. 
Metabolism.—(1) The absorption of fat in the case of patients below their 
normal weight was higher than normal, even when very large quantities 
were ingested, eg., a patient taking 231 grammes of fat daily absorbed 
96-4 per cent. The great majority of patients absorbed over 90 per cent., 
and in no case was the absorption below 87 per cent. 
(2) The absorption of nitrogen was also high in all cases, viz., 90 per 
cent., or over, but, when very large quantities were ingested, an increase in 
the amount excreted in the urine invariably occurred, and only a very small 
percentage of the increased amount of nitrogen ingested remained in the 
body. It was noticeable that the absorption, both of fat and nitrogen, was 
high, even in the cases suffering from acute dyspepsia. 
(3) The percentage of nitrogen excreted as urea decreased, and, conse- 
quently, the percentage excreted in less oxidised form increased, indicating 
less complete elaboration. 
Table I1—Diets and Metabolism of Three Patients treated by Forced 
Feeding. 
BSEORCI OU, 600), abe aencceness no 232 °5 Piffal al 251 °4 
BRM t aeiciees ode PSE ew doe 183 ‘9 231-2 208 3 Nutritive value of 
Carbohydrate ..:............ | 321 °3 392 ‘1 297 °2 diet. 
Motal) calories ..:...6.66..05. 4126 °O 5026 -O 4187 °0 J 
PEIN os 288 eae Sb caiwa cae ney 2810 ‘0 3444 °O 3234 °O 
PSM PIEING och ecce cers s obs 30 “8 23 °8 18 *1 
IGE (DE a ere cee 85 °5 40 °6 28 *4 
INDRA EE COS. oo eces ces. 1. vou 7 4°3 2 °4 Metabolism figures 
(average of 4 days’ 
observation). 
LODUE ae Ne a 3°8 7°8 4, °4; 
| N absorbed (per cent.) ,.. 94 °2 89 9 93 9 
| eh (seratet or 97 ‘9 96 4 She 
