Metabolism during Convalescence. 
3i 
it seemed of some moment to investigate the creatin and crea- 
tinine excretion during convalescence from acute febrile dis- 
ease. Patients convalescent from typhoid fever were selected be- 
cause during the course of this disease there is considerable loss 
of muscle tissue, and on that account if creatin or creatinine take 
part in the synthetic processes of muscle regeneration, their utili- 
zation for this purpose might be more easily detected than in 
conditions where the metabolism is less active. Young adults 
and children were used exclusively, since it is reasonable to suppose 
that in such subjects anabolism occurs at its height. 
The diet in all cases consisted of milk, eggs and cereals ex- 
clusively. 
The following tables are compiled from the records of analyses 
which were made during two weeks of convalescence in each of 
these cases. 
From these tables it may be noted that when creatinine is 
ingested under the conditions of these experiments a large part of 
the material is recovered in the urine, but there is always a loss 
which remains to be accounted for. When creatin is fed it can 
not be recovered as creatin in the urine, unless the patient is on a 
diet very rich in protein and the amounts of administered creatin 
are large. A slight increase in creatinine excretion which at times 
follows the ingestion of creatin is too small to warrant any con- 
clusion. 
The occasional presence of creatin in the urine of these patients 
is not to be explained by any observation made clinically. All 
of the patients were without fever during the convalescence and 
relapses occurred in no instance. The presence of even traces 
of creatin in urine under these circumstances is of interest in its 
bearing upon the earlier observations of Munk. 1 
1 Deutsche Klinik, 1862, p. 300. 
