It will be seen by a study of the analytical data that Dr. Underhill had an average daily excretion of nitrogen through the kidneys from October 26, 1903, to June 23, 1904, of 7.43 grams. From October 26 to April 13, a period of nearly six months, the average daily excretion was 7.81 grams of nitrogen, while from the latter date to June 23 the average daily excretion amounted to 6.68 grams of nitrogen. Taking the body-weight at 65 kilos, the lower nitrogen figure would mean a metabolism of 0.102 gram of nitrogen per kilo of body-weight, closely akin to the figures obtained with the two preceding subjects.
An excretion of 6.68 grams of nitrogen corresponds to the metabolism of 41.75 grams of proteid matter, while the excretion of 7.43 grams of nitrogen implies the metabolism of 46.4 grams of proteid, being less than one-half the ordinarily accepted requirement for the healthy adult.
During this long period of eight months the body-weight was stationary, carrying with it the assumption that the body was in a condition of nitrogen equilibrium. It should be emphasized in connection with Dr. Underhill’s case, that throughout the entire period of eight months, and more, there was perfect freedom in the choice of food. Further, it will be noticed by a study of the dietary made use of in the balance experiments that Dr. Underhill did not reduce his nitrogen intake by any exclusion of meat. He practically made use of his ordinary diet, such as he had always been accustomed to, but with a decided diminution of the amount of proteid food, accompanied by a gradual reduction in the total amount of food consumed each day. His diet, therefore, was in no sense a vegetable diet. Meat was conspicuous in his daily food, but naturally in reduced quantities.
On February 9 a nitrogen balance was attempted, in which a careful comparison of the nitrogen content of all intake and output was made for a period of six days. By a study of the results of this balance period, shown in the accompanying tables, it will be noticed that not only was there no deficiency of nitrogen, but the body was laying on nitrogen at the rate of 0.158 gram per day. Further, it will be observed that the fuel value of the food per day averaged only a little over 2000 calories. Yet this amount of food, with its comparatively low fuel value, carried with it only 8.83 grams of nitrogen per day. Upon this quantity of food the body was able to maintain itself, with a little nitrogen to spare and with sufficient fuel value in the food to supply all the energy required for muscular contraction, mental effort, and the maintenance of body temperature.
Tuesday, February 9, 1904.
Breakfast.—Bread 22 grams, tea 146 grams.
Lunch.—Macaroni 129 grams, fried sweet potato 85.5 grams, bread 59 grams, butter 15 grams, fig cake with wine sauce 115 grams, sugar 15 grams, coffee 210 grams.
Dinner.—Bread 27.9 grams, beef 48 grams, potato 207.5 grams, butter 19 grams, pie 272 grams, coffee 210 grams, sugar 10 grams.
Wednesday, February 10, 1904.
Breakfast.—Bread 33 grams, tea 146 grams.
Lunch.—Bread 71 grams, butter 10.5 grams, apple fritters 119 grams, coffee 210 grams, sugar 21 grams.
Dinner.—Roast pork 80 grams, bread 55.7 grams, butter 27.8 grams, cranberry sauce 150 grams, coffee 210 grams, sugar 21 grams.
Thursday, February 11, 1904.
Breakfast.—Bread 38.7 grams, tea 146 grams.
Lunch.—Bread 97.5 grams, butter 31.5 grams, sweet potato 108.7 grams, spaghetti 82.5 grams, peaches 89.4 grams, coffee 210 grams, sugar 21 grams.
Dinner.—Bread 75 grams, butter 21.5 grams, roast beef 116 grams, lemon pie 188.5 grams, coffee 210 grams, sugar 21 grams.
Friday, February 12, 1904.
Breakfast.—Bread 34 grams, tea 146 grams.
Lunch.—Bread 42 grams, butter 20 grams, codfish cake 72 grams, potato 100 grams, custard 100 grams, coffee 210 grams, sugar 21 grams.
Dinner.—Bread 46 grams, butter 25.5 grams, veal 53 grams, potato 75 grams, lima beans 50 grams, apple dumpling 120 grams, coffee 210 grams, sugar 21 grams.
Saturday, February 13, 1904.
Breakfast.—Bread 35 grams, tea 146 grams.
Lunch.—Bread 57.5 grams, butter 28 grams, sweet potato 100 grams, coffee 210 grams, sugar 21 grams, quince 105.5 grams, apple turnovers 153 grams.
Dinner.—Bread 35.5 grams, butter 11 grams, peas 70 grams, roast beef 50 grams, pie 169 grams, coffee 210 grams, sugar 21 grams.
Sunday, February 14, 1904.
Breakfast.—Bread 31 grams, tea 146 grams.
Lunch.—Bread 70.5 grams, butter 29 grams, potato 123 grams, apple sauce 127.5 grams, coffee 210 grams, sugar 21 grams.
Dinner.—Bread 20.5 grams, butter 23 grams, chicken 101.5 grams, potato 80 grams, succotash 80 grams, chocolate cake 103 grams, ice cream 125.8 grams, coffee 210 grams, sugar 21 grams.
NITROGEN BALANCE.—Underhill.
Average Intake.
On June 1, near the close of the experiment, a second nitrogen balance was attempted, with a view to seeing if under the existing conditions of life and activity it was possible to reduce the fuel value of the food, and at the same time diminish in still greater measure the quantity of proteid food taken. The results of this trial are seen in the accompanying tables, where for four days a careful comparison of output and intake is shown. It will be observed from these tables that the average fuel value of the food per day was reduced to 1785 calories, and that the average intake of nitrogen was restricted to 6.73 grams per day. The balance shown is a minus balance, although the deficiency per diem is not large. It is very obvious that both the nitrogen and fuel value of the food can be reduced considerably below the average maintained during the period of the first balance, but not to the degree attempted in the second balance, and secure nitrogen or body equilibrium. It will be noted in this last nitrogen balance, that the average daily output of nitrogen through the urine amounted to 6.46 grams, while the average nitrogen intake was 6.73 grams. The fuel value of the food, however, averaged only 1785 calories per day. It is quite evident, if the non-nitrogenous food had not been reduced quite so much, that a plus nitrogen balance would have been obtained. Still, it is obvious that under the conditions of life and activity, this subject needed to metabolize only about 40 grams of proteid per day, with the total fuel value of his food equal to about 2000 calories, in order to secure both body and nitrogen equilibrium. Here, again, we have an illustration of the possibility of physiological economy which shows itself in a reduction of the daily proteid food more than 50 per cent, with a reduction of the non-nitrogenous food fully 30 per cent, and with maintenance of health, strength and vigor equal, if not superior, to that which the subject has ever experienced.
Wednesday, June 1, 1904.
Breakfast.—Champagne wafer 21.5 grams, tea 146 grams, sugar 15 grams.
Dinner.—Bread 67.4 grams, butter 15.1 grams, beefsteak 55.5 grams, potato 128 grams, asparagus 103.5 grams, tea 146 grams, sugar 15 grams, banana 83.5 grams.
Supper.—Bread 15.7 grams, butter 11.8 grams, banana and nuts 106 grams, crullers 90.2 grams, coffee 145 grams, sugar 15 grams.
Thursday, June 2, 1904.
Breakfast.—Bread 30 grams, tea 146 grams, sugar 15 grams.
Dinner.—Clam chowder 270.5 grams, bread 64 grams, butter 14.5 grams, lobster 36.5 grams, Saratoga chips 15 grams, caramel custard 79 grams, tea 146 grams, sugar 15 grams.
Supper.—Bread 35.2 grams, butter 13.8 grams, pineapple 148.7 grams, crullers 84.8 grams, tea 140 grams, sugar 15 grams.
Friday, June 3, 1904.
Breakfast.—Bread 31 grams, tea 146 grams.
Dinner.—Fried ham 61 grams, asparagus 124.2 grams, baked potato 85 grams, bread 29 grams, butter 23.5 grams, tea 140 grams, sugar 15 grams, pineapple 74.8 grams.
Supper.—Bread 34 grams, butter 17.8 grams, pineapple 158.5 grams, tomato 132.5 grams, cup cake 121 grams, tea 140 grams, sugar 15 grams.
Saturday, June 4, 1904.
Breakfast.—Bread 32 grams, tea 140 grams.
Dinner.—Hash 133 grams, peas 151.5 grams, bread 61.4 grams, butter 16.1 grams, custard 150 grams, sugar 15 grams, tea 140 grams.
Supper.—Bread 62.5 grams, butter 17 grams, tea 140 grams, sugar 15 grams.
NITROGEN BALANCE.—Underhill.