This paper records some observations made on a patient who suffered from repeated attacks of recurrent vomiting. In recent years much has been written concerning this disease, but we are still ignorant of its exact etiology. The whole subject has been reviewed recently by Marfan.1 It is worth while to call attention to the fact that among all the investigators, two, Hilliger 2 and Knoepfelmacher,3 have attacked the problem from a particular point of view, namely, the relationship of the ketosis to the metabolism of fat and carbohydrates. It was first demonstrated by Marfan, and has been abundantly confirmed by others, that attacks of this disease are regularly accompanied by an early and excessive excretion of acetone bodies in the urine. The early appearance of the bodies seems to show that they are not the result of ordinary inanition from vomiting or anorexia. Our intention was to study the appearance of the ketone bodies in relation to the blood sugar, and to see how rapidly and readily the ketosis might be produced by artificial means, also how amenable it was to measures directed against it.The investigation was divided into two parts: first, a ketosis was induced by fasting for a short period ; secondly, a ketosis was produced by a diet in which the ratio of fat to carbohydrate was high. So far as possible, comparable studies were carried out on children with apparently normal metabolism as controls.
METHODS USEDFor blood sugar, the Fitz modification of the Bang method was used because of the convenience in making a large number of determi¬ nations on a single person. Blood for determinations was obtained by pricking the finger. A 0.1 per cent, glucose solution was used to standardize these results. This was made fresh each day and the sugar determined on a few drops, using a technic identical with that for blood
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