Part 5
For the first six months the average daily excretion amounted to 5.82 grams of nitrogen, while from April 12 to June 28 the average daily excretion of nitrogen was 5.40 grams, thus showing a slight tendency downward. On the whole, however, there is shown a somewhat remarkable uniformity in the daily excretion. Thus, the average daily excretion for the month of November was 5.79 grams of nitrogen, for the month of March 5.66 grams, thus showing very little difference in the output of nitrogen through the kidneys in these two periods, three months apart. In other words, the extent of proteid katabolism was essentially the same throughout the entire nine months, implying that the amount of proteid food eaten must have been fairly constant, and that the body had adapted itself to this new level of nutrition from which there was no tendency to deviate. There was no weighing out of food and no attempt to follow any specified diet. The greatest possible variety of simple foods was indulged in, and the dictates of the appetite were followed with the single precaution that excess was avoided. In other words, it was temperance in diet, and not prohibition. Yet it is equally true, in the writer’s case at least, that the appetite itself unconsciously served as a regulator, since there was, as a rule, no necessity to hold the appetite in check to avoid excess. Doubtless, the writer’s knowledge of the general composition of food-stuffs has had some influence in the choice of foods, and thereby aided in bringing about this somewhat remarkable uniformity in the daily output of nitrogen for such a long period of time on an unrestricted diet.
What now do the nitrogen figures show regarding the amount of proteid material metabolized each day? It will be remembered that the Voit standard calls for 118 grams of proteid or albuminous food daily, of which 105 grams should be absorbable, in order to maintain the body in a condition of nitrogen equilibrium, and in a state of physical vigor and general tone. This would mean a daily excretion through the urine of at least 16 grams of nitrogen. The daily output of nitrogen in the case under discussion, however, was 5.699 grams for a period of nearly nine months. This amount of nitrogen excreted through the urine means only 35.6 grams of proteid metabolized, or about one-third the amount called for by the Voit standard, or the standards generally adopted as expressing man’s daily requirement of proteid food. But was the body in nitrogenous equilibrium on this small amount of proteid food? Naturally, this question might be answered in the affirmative, on the basis of the constancy in body-weight for the period from October to June, but more decisive proof is needed. The question was therefore settled by a careful comparison of the income and output, in which all the food eaten was carefully weighed and analyzed, while the nitrogen of the urine and fæces was determined with equal accuracy. The first experiment of this character to be quoted is for the week commencing March 20, a period of six days.
Following are the diets made use of each day, the weights of the various food-stuffs being given in grams. Likewise is shown the nitrogen content of the several food-stuffs for each day, and also a comparison of the nitrogen intake with the output of nitrogen through the urine:
_Sunday, March 20, 1904._
Breakfast, 7.45 A. M.—One cup coffee, _i. e._, coffee 137.5 grams, cream 30.5 grams, sugar 9 grams.
Dinner, 1.30 P. M.—Stewed chicken 50 grams, mashed potato 131 grams, biscuit 49 grams, butter 13 grams, chocolate pudding 106 grams, one small cup coffee, _i. e._, coffee 64 grams, sugar 12 grams, cheese crackers 29 grams.
Supper, 6.30 P. M.—Lettuce sandwiches 56 grams, biscuit 35 grams, butter 6 grams, one cup tea, _i. e._, tea 170 grams, sugar 7 grams, sponge cake 47 grams, sliced oranges 82 grams.
Food. Grams. Per cent Nitrogen. Total Nitrogen.
Coffee 64 + 137 = 201.5 × 0.042 = 0.085 gram. Cream 30.5 × 0.41 = 0.125 Sugar 12 + 9 + 7 = 28.0 × 0.00 = 0.000 Chicken 50.0 × 4.70 = 2.350 Mashed potato 131.0 × 0.30 = 0.393 Biscuit 35 + 49 = 84.0 × 1.49 = 1.251 Butter 13 + 6 = 19.0 × 0.10 = 0.019 Chocolate pudding 106.0 × 0.86 = 0.911 Cheese crackers 29.0 × 2.54 = 0.737 Lettuce sandwich 56.0 × 0.92 = 0.515 Tea 170.0 × 0.048 = 0.082 Sponge cake 47.0 × 0.98 = 0.461 Sliced orange 82.0 × 0.073 = 0.060 ------ Total nitrogen in food 6.989 grams. Total nitrogen in urine 5.910
Fuel value of the food 1708 calories.[32]
_Monday, March 21, 1904._
Breakfast, 7.45 A. M.—Coffee 119 grams, cream 30 grams, sugar 9 grams.
Lunch, 1.30 P. M.—One shredded wheat biscuit 31 grams, cream 116 grams, wheat gems 33 grams, butter 7 grams, tea 185 grams, sugar 10 grams, cream cake 53 grams.
Dinner, 6.30 P. M.—Pea soup 114 grams, lamb chop 24 grams, boiled sweet potato 47 grams, wheat gems 76 grams, butter 13 grams, cream cake 52 grams, coffee 61 grams, sugar 10 grams, cheese crackers 16 grams.
Food. Grams. Per cent Nitrogen. Total Nitrogen.
Coffee 119 + 61 = 180 × 0.042 = 0.076 gram. Cream 30 + 116 = 146 × 0.41 = 0.600 Sugar 9 + 10 + 10 = 29 × 0.00 = 0.000 Shredded wheat biscuit 31 × 1.62 = 0.502 Tea 185 × 0.048 = 0.089 Wheat gems 33 + 76 = 109 × 1.46 = 1.591 Butter 7 + 13 = 20 × 0.10 = 0.020 Cream cake 53 + 52 = 105 × 0.97 = 1.018 Pea soup 114 × 1.00 = 1.140 Lamb chop 24 × 4.54 = 1.090 Sweet potato 47 × 0.18 = 0.085 Cheese crackers 16 × 2.54 = 0.410 ------ Total nitrogen in food 6.621 grams. Total nitrogen in urine 5.520
Fuel value of the food 1713 calories.
_Tuesday, March 22, 1904._
Breakfast, 7.45 A. M.—Coffee 97 grams, cream 26 grams, sugar 9 grams.
Lunch, 1.30 P. M.—Baked potato 83 grams, fried sausage 36 grams, soda biscuit 39 grams, butter 12 grams, tea 137 grams, sugar 10 grams, cream meringue 59 grams.
Dinner, 6.30 P. M.—Chicken broth 146 grams, bread 52 grams, butter 15 grams, creamed potato 76 grams, custard 76 grams, coffee 50 grams, sugar 11 grams, cheese crackers 10 grams.
Food. Grams. Per cent Nitrogen. Total Nitrogen.
Coffee 97 + 50 = 147 × 0.042 = 0.060 gram. Cream 26 × 0.42 = 0.109 Sugar 9 + 10 + 11 = 30 × 0.00 = 0.000 Baked potato 83 × 0.40 = 0.332 Fried sausage 36 × 3.06 = 1.101 Soda biscuit 39 × 1.66 = 0.647 Butter 12 + 15 = 27 × 0.10 = 0.027 Tea 137 × 0.048 = 0.066 Cream meringue 59 × 0.92 = 0.543 Chicken broth 146 × 0.78 = 1.138 Bread 52 × 1.66 = 0.863 Creamed potato 76 × 0.42 = 0.319 Custard 76 × 0.82 = 0.623 Cheese crackers 10 × 2.54 = 0.254 ------ Total nitrogen in food 6.082 grams. Total nitrogen in urine 5.940
Fuel value of the food 1398 calories.
_Wednesday, March 23, 1904._
Breakfast, 7.45 A. M.—Coffee 103 grams, cream 30 grams, sugar 10 grams.
Lunch, 1.30 P. M.—Creamed codfish 64 grams, potato balls 54 grams, biscuit 44 grams, butter 22 grams, tea 120 grams, sugar 10 grams, wheat griddle cakes 133 grams, maple syrup 108 grams.
Dinner, 6.30 P. M.—Creamed potato 85 grams, biscuit 53 grams, butter 15 grams, apple-celery-lettuce salad 50 grams, apple pie 127 grams, coffee 67 grams, sugar 8 grams, cheese crackers 17 grams.
Food. Grams. Per cent Nitrogen. Total Nitrogen.
Coffee 103 + 67 = 170 × 0.042 = 0.071 gram. Sugar 10 + 10 + 8 = 28 × 0.00 = 0.000 Cream 30 × 0.43 = 0.129 Potato balls 54 × 0.68 = 0.367 Creamed codfish 64 × 1.26 = 0.806 Biscuit 44 + 53 = 97 × 1.66 = 1.610 Butter 22 + 15 = 37 × 0.10 = 0.037 Tea 120 × 0.048 = 0.058 Wheat griddle cakes 133 × 1.32 = 1.760 Maple syrup 108 × 0.019 = 0.021 Creamed potato 85 × 0.53 = 0.450 Cheese crackers 17 × 2.54 = 0.431 Apple-celery salad 50 × 0.20 = 0.100 Apple pie 127 × 0.75 = 0.953 ------ Total nitrogen in food 6.793 grams. Total nitrogen in urine 5.610
Fuel value of the food 1984 calories.
_Thursday, March 24, 1904._
Breakfast, 7.45 A. M.—Coffee 100 grams, cream 25 grams, sugar 8 grams.
Lunch, 1.30 P. M.—Shredded wheat biscuit 29 grams, cream 118 grams, wheat gems 60 grams, butter 8 grams, tea 100 grams, sugar 7 grams, apple pie 102 grams.
Dinner, 6.30 P. M.—Milk-celery soup 140 grams, bread 15 grams, butter 1 gram, lettuce sandwiches 62 grams, tea 100 grams, sugar 10 grams, lemon pie 109 grams.
Food. Grams. Per cent Nitrogen. Total Nitrogen.
Coffee 100 × 0.042 = 0.042 gram. Cream 25 + 118 = 143 × 0.43 = 0.615 Sugar 8 + 7 + 10 = 25 × 0.00 = 0.000 Shredded wheat biscuit 29 × 1.76 = 0.510 Wheat gems 60 × 1.17 = 0.702 Butter 8 + 1 = 9 × 0.10 = 0.009 Tea 100 + 100 = 200 × 0.048 = 0.096 Apple pie 102 × 0.75 = 0.765 Milk-celery soup 140 × 0.42 = 0.588 Bread 15 × 1.36 = 0.204 Lettuce sandwich 62 × 1.02 = 0.632 Lemon pie 109 × 0.82 = 0.894 ------ Total nitrogen in food 5.057 grams. Total nitrogen in urine 4.310
Fuel value of the food 1594 calories.
_Friday, March 25, 1904._
Breakfast, 7.45 A. M.—Coffee 100 grams, cream 25 grams, sugar 9 grams.
Lunch, 1.30 P. M.—Halibut with egg sauce 108 grams, mashed potato 89 grams, biscuit 48 grams, butter 10 grams, chocolate-cream cake 90 grams, tea 100 grams, sugar 9 grams.
Dinner, 6.30 P. M.—Milk-celery soup 121 grams, lettuce sandwiches 61 grams, creamed potato 65 grams, lettuce-apple-celery salad 74 grams, coffee 70 grams, sugar 10 grams.
Food. Grams. Per cent Nitrogen. Total Nitrogen.
Coffee 100 + 70 = 170 × 0.042 = 0.071 gram. Cream 25 × 0.40 = 0.100 Sugar 9 + 9 + 10 = 28 × 0.00 = 0.000 Halibut, etc. 108 × 3.02 = 3.262 Mashed potato 89 × 0.26 = 0.231 Biscuit 48 × 1.52 = 0.730 Butter 10 × 0.10 = 0.010 Tea 100 × 0.048 = 0.048 Chocolate-cream cake 90 × 0.99 = 0.891 Celery-milk soup 121 × 0.52 = 0.629 Lettuce sandwich 61 × 0.98 = 0.598 Lettuce-apple salad 74 × 0.21 = 0.155 Creamed potato 65 × 0.37 = 0.241 ------ Total nitrogen in food 6.966 grams. Total nitrogen in urine 5.390
Fuel value of the food 1285 calories.
NITROGEN BALANCE.—_Chittenden._
Nitrogen Output. Taken in. Nitrogen in Urine. Weight of Fæces[33] (dry).
March 20 6.989 grams. 5.91 grams. 3.6 grams. 21 6.621 5.52 0.0 22 6.082 5.94 12.0 23 6.793 5.61 18.5 24 5.057 4.31 23.0 25 6.966 5.39 16.9 ------ ------ ------ 74.0 grams contain 6.42% N. 38.508 32.68 + 4.75 grams nitrogen. ------ ---------------------- 38.508 grams nitrogen. 37.43 grams nitrogen.
Nitrogen balance for six days = +1.078 grams. Nitrogen balance per day = +0.179 gram.
Average Intake.
Calories per day 1613. Nitrogen per day 6.40 grams.
Examination of the results shown in the foregoing balance makes it quite clear that the body was essentially in nitrogenous equilibrium. Indeed, there was a slight plus balance, showing that even with the small intake of proteid food the body was storing up nitrogen at the rate of 0.16 gram per day. The average daily intake of nitrogen for the six days’ period was 6.40 grams, equal to 40.0 grams of proteid or albuminous food. The average daily output of nitrogen through the urine and fæces was 6.24 grams. The average daily output of nitrogen through the urine for the six days’ period was 5.44 grams, corresponding to the metabolism of 34 grams of proteid material. When these figures are contrasted with the usually accepted standards of proteid requirement for the healthy man, they are certainly somewhat impressive, especially when it is remembered that the body at that date had been in essentially this same condition for at least six months, and probably for an entire year. The Voit standard of 118 grams of proteid, with an equivalent of at least 18 grams of nitrogen and calling for the metabolism of 105 grams of proteid, or 16.5 grams of nitrogen per day, makes clear how great a physiological economy had been accomplished. In other words, the consumption of proteid food was reduced to at least one-third the daily amount generally considered as representing the average requirement of the healthy man, and this with maintenance of body-weight at practically a constant point for the preceding ten months, and, so far as the writer can observe, with no loss of vigor, capacity for mental and physical work, or endurance. Indeed, the writer is disposed to maintain that he has done more work and led a more active life in every way during the period of this experiment, and with greater comfort and less fatigue than usual. His health has certainly been of the best during this period.
In this connection it may be well to call attention to the completeness of the utilization of the daily food in this six days’ experiment, as shown by the small amount of refuse discharged per rectum, indicating as it does the high efficiency of the digestive processes and of the processes of absorption. The refuse matter for the entire period of six days amounted when dry to only 74 grams, and when it is remembered how large a proportion of this refuse must of necessity be composed of the cast-off secretions from the body, it will be seen how thorough must have been the utilization of the food by the system. The loss of nitrogen to the body per day through the fæces amounted to only 0.79 gram, and this on a mixed diet containing considerable matter not especially concentrated, and on some days with noticeable amounts of food, such as salads, not particularly digestible.
Finally, emphasis should be laid upon the fact that this economy of proteid food, this establishment of nitrogen equilibrium on a low proteid intake, was accomplished without increase in the daily intake of non-nitrogenous foods. In fact, the amount of fats and carbohydrates was likewise greatly reduced, far below the minimal standard of 3000 calories as representing the potential energy or fuel value of the daily diet. Indeed, during the balance period of six days just described the average fuel value of the food per day was only a little over 1600 calories.
As the experiment continued and the record for the months of April and May was obtained, it became evident from the nitrogen results that the rate of proteid katabolism was being still more reduced. A second balance experiment was therefore tried with a view to seeing if the body was still in nitrogen equilibrium, and also to ascertain whether the fuel value of the food still showed the same low calorific power. For a period of five days, June 23 to 27, the intake of food and the entire output were carefully compared, with the results shown in the accompanying tables.
_Thursday, June 23, 1904._
Breakfast.—Coffee 123 grams, cream 50 grams, sugar 11 grams.
Lunch.—Omelette 50 grams, French fried potatoes 70 grams, bacon 10 grams, wheat gems 43 grams, butter 9 grams, strawberries 125 grams, sugar 20 grams, cream cake 59 grams.
Dinner.—Beefsteak 34 grams, peas 60 grams, creamed potato 97 grams, bread 26 grams, butter 17 grams, lettuce-orange salad 153 grams, crackers 43 grams, cream cheese 15 grams, coffee 53 grams, sugar 12 grams.
Food. Grams. Per cent Nitrogen. Total Nitrogen.
Coffee 123 + 53 = 176 × 0.045 = 0.079 gram. Cream 50 × 0.35 = 0.175 Sugar 11 + 20 + 12 = 43 × 0.00 = 0.000 Omelette 50 × 1.32 = 0.660 French fried potatoes 70 × 0.37 = 0.259 Bacon 10 × 3.43 = 0.343 Wheat gems 43 × 1.49 = 0.641 Butter 9 + 17 = 26 × 0.13 = 0.034 Strawberries 125 × 0.11 = 0.138 Cream cake 59 × 0.98 = 0.578 Beefsteak 34 × 4.14 = 1.408 Peas 60 × 0.97 = 0.582 Creamed potato 97 × 0.34 = 0.330 Bread 26 × 1.23 = 0.320 Lettuce-orange salad 153 × 0.15 = 0.230 Crackers 43 × 1.40 = 0.602 Cream cheese 15 × 1.62 = 0.243 ------ Total nitrogen in food 6.622 grams. Total nitrogen in urine 5.260
Fuel value of the food 1863 calories.
_Friday, June 24, 1904._
Breakfast.—Coffee 96 grams, sugar 8 grams, milk 32 grams.
Lunch.—Creamed codfish 89 grams, baked potato 95 grams, butter 10 grams, hominy gems 58 grams, strawberries 86 grams, sugar 26 grams, ginger snaps 47 grams.
Dinner.—Cold tongue 14 grams, fried potato 48 grams, peas 60 grams, wheat gems 30 grams, butter 11 grams, lettuce-orange salad with mayonnaise dressing 155 grams, crackers 22 grams, cream cheese 14 grams, ginger snaps 22 grams, coffee 58 grams, sugar 10 grams.
Food. Grams. Per cent Nitrogen. Total Nitrogen.
Coffee 123 + 53 = 176 × 0.045 = 0.079 gram. Sugar 8 + 26 + 10 = 44 × 0.00 = 0.000 Milk 32 × 0.51 = 0.163 Creamed codfish 89 × 1.78 = 1.584 Baked potato 95 × 0.29 = 0.276 Butter 10 + 11 = 21 × 0.13 = 0.027 Hominy gems 58 × 1.20 = 0.696 Strawberries 86 × 0.11 = 0.095 Ginger snaps 47 + 22 = 69 × 1.15 = 0.794 Cold tongue 14 × 4.87 = 0.682 Fried potato 48 × 0.37 = 0.178 Peas 60 × 0.94 = 0.564 Wheat gems 30 × 1.45 = 0.435 Lettuce-orange salad, etc. 155 × 0.15 = 0.233 Crackers 22 × 1.40 = 0.308 Cream cheese 14 × 1.62 = 0.227 ------ Total nitrogen in food 6.331 grams. Total nitrogen in urine 5.300
Fuel value of the food 1506 calories.
_Saturday, June 25, 1904._
Breakfast.—Coffee 101 grams, milk 36 grams, sugar 13 grams.
Lunch.—Omelette 50 grams, bacon 9 grams, French fried potato 23 grams, biscuit 29 grams, butter 8 grams, cream cheese 17 grams, iced tea 150 grams, sugar 15 grams, ginger snaps 42 grams.
Dinner.—Wheat popovers 57 grams, butter 10 grams, lettuce-orange salad with mayonnaise dressing 147 grams, cream cheese 21 grams, crackers 22 grams, cottage pudding 82 grams, coffee 48 grams, sugar 11 grams.
Food. Grams. Per cent Nitrogen. Total Nitrogen.
Coffee 1201 + 48 = 149 × 0.045 = 0.067 gram. Milk 36 × 0.46 = 0.166 Sugar 13 + 15 + 11 = 39 × 0.00 = 0.000 Omelette 50 × 1.42 = 0.710 Bacon 9 × 2.66 = 0.239 French fried potato 23 × 0.57 = 0.131 Biscuit 29 × 1.35 = 0.392 Butter 8 + 10 = 18 × 0.13 = 0.023 Iced tea 150 × 0.018 = 0.027 Ginger snaps 42 × 1.15 = 0.483 Cream cheese 17 + 21 = 38 × 1.62 = 0.616 Wheat popovers 57 × 1.64 = 0.935 Lettuce-orange salad 147 × 0.15 = 0.221 Crackers 22 × 1.40 = 0.308 Cottage pudding 82 × 0.76 = 0.623 ------ Total nitrogen in food 4.941 grams. Total nitrogen in urine 4.430
Fuel value of the food 1392 calories.
_Sunday, June 26, 1904._
Breakfast.—Coffee 122 grams, cream 31 grams, sugar 8 grams.
Dinner.—Roast lamb 50 grams, baked potato 52 grams, peas 64 grams, biscuit 32 grams, butter 12 grams, lettuce salad 43 grams, cream cheese 21 grams, toasted crackers 23 grams, blanc mange 164 grams.