Part 6

The chair calorimeter was designed for experiments to last not more than 6 to 8 hours, as a person can not remain comfortably seated in a chair much longer than this time. For longer experiments (experiments during the night and particularly for bed-ridden patients) a type of calorimeter which permits the introduction of a couch or bed has been devised. This calorimeter has been built, tested, and used in a number of experiments with men and women. The general shape of the chamber is given in fig. 26. The principles involved in the construction of the chair calorimeter are here applied, _i. e._, the use of a structural-steel framework, inner air-tight copper lining, outer zinc wall, hair-felt insulation, and outer asbestos panels. Inside of the chamber there is a heat-absorbing system suspended from the ceiling, and air thermometers and thermometers for the copper wall are installed at several points. The food-aperture is of the same general type and the furniture here consists simply of a sliding frame upon which is placed an air-mattress. The opening is at the front end of the calorimeter and is closed by two pieces of plate glass, each well sealed into place by wax after the subject has been placed inside of the chamber. Tubes through the wall opposite the food-aperture are used for the introduction of electrical connections, ingoing and outgoing water, the air-pipes, and connections for the stethoscope, pneumograph, and telephone.

The apparatus rests on four heavy iron legs. Two pieces of channel iron are attached to these legs and the structural framework of the calorimeter chamber rests upon these irons. The method of separating the asbestos outer panels is shown in the diagram. In order to provide light for the chamber, the outer wall in front of the glass windows is made of glass rather than asbestos. The front section of the outer casing can be removed easily for the introduction of a patient.

In this chamber it is impossible to weigh the bed and clothing, and hence this calorimeter can not be used for the accurate determination of the moisture vaporized from the lungs and skin of the subject, since here (as in almost every form of respiration chamber) it is absolutely impossible to distinguish between the amount of water vaporized from bed-clothing and that vaporized from the lungs and skin of the subject. With the chair calorimeter, the weighing arrangements make it possible to weigh the chair, clothing, etc., and thus apportion the total water vaporized between losses from the chair, furniture, and body of the man. In view of the fact that the water vaporized from the skin and lungs could not be determined, the whole interior of the chamber of the bed calorimeter has been coated with a white enamel paint, which gives it a bright appearance and makes it much more attractive to new patients. An incandescent light placed above the head at the front illuminates the chamber very well, and as a matter of fact the food-aperture is so placed that one can lie on the cot and actually look outdoors through one of the laboratory windows.

Special precaution was taken with this calorimeter to make it as comfortable and as attractive as possible to new and possibly apprehensive patients. The painting of the walls unquestionably results in a condensation of more or less moisture, for the paint certainly absorbs more moisture than does the metallic surface of the copper. The chief value of the determination of the water vaporized inside of the chamber during an experiment lies, however, not in a study of the vaporization of water as such, but in the fact that a certain amount of heat is required to vaporize the water and obviously an accurate measure of the heat production must involve a measure of the amount of water vaporized. So far as the measurement of heat is concerned, it is immaterial whether the water is vaporized from the lungs or skin of the subject or the clothing, bedding, or walls of the chamber; since for every gram of water vaporized inside of the chamber, from whatever source, 0.586 calorie of heat must have been absorbed.

The apparatus as perfected is very sensitive. The sojourn in the chamber is not uncomfortable; as a matter of fact, in an experiment made during January, 1909, the subject remained inside of the chamber for 30 hours. With male patients no difficulty is experienced in collecting the urine. No provision is made for defecation, and hence it is our custom in long experiments to empty the lower bowel with an enema and thus defer as long as possible the necessity for defecation. With none of the experiments thus far made have we experienced any difficulty in having to remove the patient because of necessity to defecate in the cramped quarters. It is highly probable that, with the majority of sick patients, experiments will not extend for more than 8 or 10 hours, and consequently the apparatus as designed should furnish most satisfactory results.

In testing the apparatus by the electrical-check method, it has been found to be extremely accurate. When the test has been made with burning alcohol, as described beyond, it has been found that the large amount of moisture apparently retained by the white enamel paint on the walls vitiates the determination of water for several hours after the experiment begins, and only after several hours of continuous ventilating is the moisture content of the air brought down to a low enough point to establish equilibrium between the moisture condensed on the surface and the moisture in the air and thus have the measured amount of moisture in the sulphuric acid vessels equal the amount of moisture formed by the burning of alcohol. Hence in practically all of the alcohol-check experiments, especially of short duration, with this calorimeter, the values for water are invariably somewhat too high. A comparison of the alcohol-check experiments made with the bed and chair calorimeters gives an interesting light upon the power of paint to absorb moisture and emphasizes again the necessity of avoiding the use of material of a hygroscopic nature in the interior of an apparatus in which accurate moisture determinations from the body are to be made.

The details of the bed calorimeter are better shown in fig. 4. The opening at the front is here removed and the wooden track upon which the frame, supporting the cot, slides is clearly shown. The tension equalizer (see page 71) partly distended is shown connected to the ingoing air-pipe, and on the top of the calorimeter connected to the tension equalizer is a Sonden manometer. On the floor at the right is seen the resistance coil used for electrical tests (see page 50). A number of connections inside the chamber at the left are made with electric wires or with rubber tubing. Of the five connections appearing through the opening, reading from left to right, we have, first, the rubber connection with the pneumograph, then the tubing for connection with the stethoscope, then the electric-resistance thermometer, the telephone, and finally a push button for bell call. The connections for the pneumograph and stethoscope are made with the instruments outside on the table at the left of the bed calorimeter.

MEASUREMENTS OF BODY-TEMPERATURE.

While it is possible to control arbitrarily the temperature of the calorimeter by increasing or decreasing the amount of heat brought away, and thus compensate exactly for the heat eliminated by the subject, the hydrothermal equivalent of the system itself being about 20 calories--on the other hand the body of the subject may undergo marked changes in temperature and thus influence the measurement of the heat production to a noticeable degree; for if heat is lost from the body by a fall of body-temperature or stored as indicated by a rise in temperature, obviously the heat produced during the given period will not equal that eliminated and measured by the water-current and by the latent heat of water vaporized. In order to make accurate measurements, therefore, of the heat-production as distinguished from the heat elimination, we should know with great accuracy the hydrothermal equivalent of the body and changes in body temperature. The most satisfactory method at present known of determining the hydrothermal equivalent of the body is to assume the specific heat of the body as 0.83.[14] This factor will of course vary considerably with the weight of body material and the proportion of fat, water, and muscular tissue present therein, but for general purposes nothing better can at present be employed. From the weight of the subject and this factor the hydrothermal equivalent of the body can be calculated. It remains to determine, then, with great exactness the body temperature.

Recognizing early the importance of securing accurate body-temperatures in researches of this kind, a number of investigations were made and published elsewhere[15] regarding the body-temperature in connection with the experiments with the respiration calorimeter. It was soon found that the ordinary mercurial clinical thermometer was not best suited for the most accurate observations of body-temperature and a special type of thermometer employing the electrical-resistance method was used. In many of the experiments, however, it is impracticable with new subjects to complicate the experiment by asking them to insert the electrical rectal thermometer, and hence we have been obliged to resort to the usual clinical thermometer with temperatures taken in the mouth, although in a few instances they have been taken in the axilla and the rectum. For the best results the electrical rectal thermometer is used. This apparatus permits a continuous measurement of body temperature, deep in the rectum, unknown to the subject and for an indefinite period of time, it being necessary to remove the thermometer only for defecation.

As a result of these observations it was soon found that the body temperature was not constant from hour to hour, but fluctuated considerably and underwent more or less regular rhythm with the minimum between 3 and 5 o'clock in the morning and the maximum about 5 o'clock in the afternoon. In a number of experiments where the mercurial thermometer was used under the tongue and observations thus taken compared with records with the resistance thermometer, it was found that with careful manipulation and avoiding muscular activity, mouth breathing, and the drinking of hot or cold liquid, a fairly uniform agreement between the two could be obtained. Such comparisons made on laboratory assistants can not be duplicated with the ordinary subject.

It is assumed that fluctuations in temperature measured by the rectal thermometer likewise hold true for the average temperature of the whole body, but evidence on this point is unfortunately not as complete as is desirable. In an earlier report of investigations of this nature, a few experiments on comparison of measurements of resistance thermometer deep in the rectum and in a well-closed axilla showed a distinct tendency for the curves to continue parallel. A research is very much needed at present on a topographical distribution of body temperature, and particularly on the course of the fluctuations in different parts of the body. A series of electric-resistance thermometers placed at different points in the colon, at different points in a stomach tube, in the well-closed axilla, possibly attached to the surface of the body, and in women in the vagina, should give a very accurate picture of the distribution of the body-temperature and likewise indicate the proportionality of the fluctuations in different parts of the body. Until such a research is completed, however, it is necessary to assume that fluctuations in body-temperature as measured by the electric rectal thermometer are a true measure of the average body-temperature of the whole body. Indeed it is upon this assumption that it is necessary for us to make corrections for heat lost from or stored in the body. It is our custom, therefore, to compute the hydrothermal equivalent by multiplying the body-weight by the specific heat of the body, commonly assumed as 0.83, and then to make allowance for fluctuations in body-temperature.

When it is considered that with a subject having a weight of 70 kilos a difference in temperature of 1 deg. C. will make a difference in the measurement of heat of some 60 calories, it is readily seen that the importance of knowing the exact body-temperature can not be overestimated; indeed, the whole problem of the comparison of the direct and indirect calorimetry hinges more or less upon this very point, and it is strongly to be hoped that ere long the much-needed observations on body-temperature can be made.

CONTROL EXPERIMENTS WITH THE CALORIMETER.

After providing a suitable apparatus for bringing away the heat generated inside the chamber and for preventing the loss of heat by maintaining the walls adiabatic, it is still necessary to demonstrate the ability of the calorimeter to measure known amounts of heat accurately. In order to do this we pass a current of electricity of known voltage through a resistance coil and thus develop heat inside the respiration chamber. While, undoubtedly, the use of a standard resistance and potentiometer is the most accurate method for measuring currents of this nature, thus far we have based our experiments upon the measurements made with extremely accurate Weston portable voltmeter and mil-ammeters. Thanks to the kindness of one of our former co-workers, Mr. S. C. Dinsmore, at present associated with the Weston Electrical Instrument Company, we have been able to obtain two especially exact instruments. The mil-ammeter is so adjusted as to give a maximum current of 1.5 amperes and the voltmeter reads from zero to 150 volts. The direct current furnished the building is caused to pass through a variable resistance for adjusting minor variations in voltage and then through the mil-ammeter into a manganin resistance-coil inside the chamber, having a resistance of 84.2 ohms. Two leads from the terminals of the manganin coil connect with the voltmeter outside the chamber, and hence the drop in potential can be measured very accurately and as frequently as is desired. The current furnished the building is remarkably steady, but for the more accurate experiments a small degree of hand regulation is necessary.

The advantage of the electrical method of controlling the apparatus is that the measurements can be made very accurately, rapidly, and in short periods. In making experiments of this nature it is our custom first to place the resistance-coil in the calorimeter and make the connections. The current is then passed through the coil, and simultaneously the water is started flowing through the heat-absorbing system and the whole calorimeter is adjusted in temperature equilibrium as soon as possible. When the temperature of the air and walls is constant and the thermal-junction system in equilibrium, the exact time is noted and the water-current deflected into the meter. At the end of one hour, the usual length of a period, the water-current is deflected from the meter, the meter is weighed, and the average temperature-difference of the water obtained by averaging the results of all the temperature differences noted during the hour. Usually during an experiment of this nature, records of the water-temperatures are made every 4 minutes; occasionally, when the fluctuations are somewhat greater than usual, records are made every 2 minutes.

The calculation of the heat developed in the apparatus is made by means of the formula C x E x _t_ x 0.2385 = calories, in which C equals the current in amperes, E the electromotive force, and _t_ the time in seconds. This gives the heat expressed in calories at 15 deg. C. This procedure we have followed as a result of the recommendation of Dr. E. B. Rosa, of the National Bureau of Standards. In order to convert the values to 20 deg., the unit commonly employed in calorimetric work, it has been necessary to multiply by the ratio of the specific heat of water at 15 deg. to that of water at 20 deg. Assuming the specific heat of water at 20 deg. to be 1, the specific heat at 15 deg. is 1.001.[16]

Of the many electrical check-tests made with this type of apparatus, but one need be given here, pending a special treatment of the method of control of the calorimeter in a forthcoming publication. An electrical check-experiment with the chair calorimeter was made on January 4, 1909, and continued 6 hours. The voltmeter and mil-ammeter were read every few minutes, the water collected in the water-meter, carefully weighed, and the temperature differences as measured on the two mercury thermometers were recorded every 4 minutes.

The heat developed during the experiment may be calculated from the data as follows: Average current = 1.293 amperes; average E. M. F. = 109.15 volts; time = 21,600 seconds; factor used to convert watt-seconds to calories = 0.2385. (1.293 x 109.15 x 21600 x 0.2385) x 1.001 = 727.8 calories produced.

During the 6 hours 237.63 kilograms of water passed through the absorbing system.

The average temperature rise was 3.04 deg. C., the total heat brought away was therefore (237.63 x 3.04) x 1.0024[17] = 724.1 calories.

Thus in 6 hours there were about 3.7 calories more heat developed inside the apparatus than were measured by the water-current, a discrepancy of about 0.5 per cent.

Under ideal conditions of manipulation, the withdrawal of heat from the calorimeter should be at just such a rate as to exactly compensate for the heat developed by the resistance-coil. Under these conditions, then, there would be no heat abstracted from nor stored by the calorimeter and its temperature should remain constant throughout the whole experiment. Practically this is very difficult to accomplish and there are minor fluctuations in temperature above and below the initial temperature during a long experiment and, indeed, during a short experimental period. If a certain amount of heat has been stored up in the calorimeter chamber or has been abstracted from it, there should be corrections made for the variations in the temperature of the chamber. Such corrections are impossible unless a proper determination of the hydrothermal equivalent has been made. A number of experiments to determine this hydrothermal equivalent have been made and the results are recorded beyond, together with a discussion of the nature of the experiments. As a result of these experiments it has been possible to make correction for the slight temperature changes in the calorimeter.

It is interesting to note that these fluctuations are small and there may therefore be a considerable error in the determination of the hydrothermal equivalent without particularly affecting the corrections applied in the ordinary electrical check-test. The greatest difficulty experienced with the calorimeter as a means of measuring heat has been to secure the average temperature of the ingoing water. The temperature difference between the mass of water flowing through the pipes and the outer wall of the pipe is at best considerable. The use of the vacuum-jacketed glass tubes has minimized the loss of heat through this tube considerably, but it is advisable that the bulb of the thermometer be placed exactly in the center of the water-tube, as otherwise too high a temperature-reading will be secured. When the proper precautions are taken to secure the correct temperature-reading, the results are most satisfactory.

In testing both calorimeters a large number of electrical check experiments have led to the conclusion that discrepancies in results were invariably due, not to the loss of heat through the walls of the calorimeter, but to erroneous measurement of the temperature of the water-current.

DETERMINATION OF THE HYDROTHERMAL EQUIVALENT OF THE CALORIMETER.

While the temperature control of the calorimeter is such that in general the average temperature varies but a few hundredths of a degree between the beginning and the end of an experimental period, in extremely accurate work it is necessary to know the amount of heat which is absorbed with any increase in temperature. In other words, the determination of the hydrothermal equivalent is essential.

The large majority of the methods for determining the hydrothermal equivalent of materials are at once eliminated when the nature of the calorimeter here used is taken into consideration. Obviously, in warming up the chamber there are two sources of heat: first, the heat inside of the chamber; second, the heat in the outer walls. As has been previously described, the zinc wall is arbitrarily heated so that its temperature fluctuations will follow exactly those of the inner wall, hence it is impossible to compute from the weight of the metal the hydrothermal equivalent. By means of the electrical check experiments, however, a method for determining the hydrothermal equivalent is at hand. The general scheme is as follows.

During an electrical check experiment, when thermal equilibrium has been thoroughly established and the heat brought away by the water-current exactly counterbalances the heat generated in the resistance-coil inside the chamber, the temperature of the calorimeter is allowed to rise slowly by raising the temperature of the ingoing water and thus bringing away less heat. At the same time the utmost pains are taken to maintain the adiabatic condition of the metal walls. Since the temperature is rising during this period, it is necessary to warm the air in the outer spaces by the electric current. By this method it is possible to raise the temperature of the calorimeter 1 degree or more in 2 hours and establish thermal equilibrium at the higher level. The experiment is then continued for 2 hours at this level, and the next 2 hours the temperature is gradually allowed to fall by lowering the temperature of the ingoing water so that more heat is brought away than is generated, care being taken likewise to keep the walls adiabatic. Under these conditions the heat brought away by the water-current during the period of rising temperature is considerably less than that actually developed by the electric current and the difference represents the amount of heat absorbed by the calorimeter in the period of the temperature rise. Conversely, during the period when the temperature is falling, there is a considerable increase in the amount of heat brought away by the water-current over that generated in the resistance-coil and the difference represents exactly the amount of heat given up by the calorimeter during the fall in temperature. It is thus possible to measure the capacity of the calorimeter for absorbing heat during a rise in temperature and the amount of heat lost by it during cooling. A number of such experiments have been made with both calorimeters and it has been found that the hydrothermal equivalent of the bed calorimeter is not far from 21 kilograms. For the chair calorimeter a somewhat lower figure has been found, _i. e._, 19.5 kilograms.

GENERAL DESCRIPTION OF RESPIRATION APPARATUS.