Studies of Basal Metabolism. 



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Studies of the basal metabolism and its relation to the body 

 surface in obesity, myxedema, and pituitary disease. 



By J. H. Means. 1 



[From the Medical Service of the Mass. General Hospital.] 



The following determinations of basal metabolism were cal- 

 culated by indirect calorimetry from the oxygen absorption and 

 the R. Q., these factors being obtained by means of Benedict's 

 unit apparatus (mouthpiece and spirometer). At least three 

 ten-minute periods were run, and the average taken for that day's 

 basal metabolism. In case I the calculation included the esti- 

 mation of calories due to non-protein metabolism and to this 

 was added that due to protein. In the other cases the protein 

 metabolism was ignored. None of these cases had over 6-7 grams 

 urinary nitrogen per day, so that the protein element would not 

 affect the total calorie calculation by more than 1 to 2 per cent. 



The body surface has been calculated by Meeh's formula and 

 also by DuBois's. 



The results are given in the table. 



Cases studied were: 



Case 1. Simple obesity of many years duration. 

 Case 2. Very marked obesity, also of many years dura- 

 tion. 



Case 3. Sudden gain in weight in last year and a half. 

 Sugar tolerance abnormally low. Thought to be hypo- 

 pituitary. Said to have a polyuria, not noticed in ward. 



Case 4. Acromegaly of long standing. Sugar tolerance 

 now high. Thought to be going over into a hypo- 

 pituitary stage. 



Case 5. Typical myxedema. Never treated with thy- 

 roid. 



Subject Dr. P. Normal control. Large muscular man. 

 In the cases studied the surface area by Meeh's formula was 

 from 10 to 30 per cent, below that by DuBois's. In two cases of 

 marked obesity the metabolism per square meter (DuBois) was 



' Walcott Fellow in Clinical Medicine, Harvard University. 



