Russian Research On Undernutrition: V. V. Pashutin, Albitsky, And I. A. Pashutin, 1887-1902

While prolonged fasting and complete starvation have received experimental attention in a great many physiological laboratories, surprisingly little attention has been paid to chronic undernutrition, except in Russia. Russians fast frequently during the year and chronic undernutrition is common among the poor classes. It is probable, however, that in the religious fasting seasons the Russians do not fast in the strictest sense of the word, as they are said to continue their work with apparent vigor and sustained vitality, although they lose in weight, indicating that the nutrition must be insufficient.1 As a result of the frequent occurrence of incomplete nutrition among the Russian people, we find that the metabolism during undernutrition was studied in the laboratory of Professor V. V. Pashutin by Albitsky and later by I. A. Pashutin. In these well-planned investigations studies were made of the metabolism of animals during insufficient feeding and subsequent realimentation.

The series of experiments made by Albitsky was extensively discussed by the senior Pashutin in his course on general and experimental pathology.2 The experiments made by the younger Pashutin are reported in a dissertation published in 1895, which gives one of the best general discussions of undernutrition printed as early as that date.3 In this dissertation Pashutin raises the question as to whether the vital processes would be affected if the normal diet were reduced one-fourth, one-third, or one-half.

The primary object of Albitsky's experiments was to study the influence of repeated periods of complete fasting (with or without water) and subsequent realimentation. One of the tables in Pashutin's book shows the carbon-dioxide excretion and oxygen consumption for Albitsky's rabbit No. 4, in four successive fasts, and the first and third realimentation periods. For comparison, the table also gives an average normal value which was determined during 4 days of normal feeding prior to the third fasting period. Unfortunately no normal value for the gaseous exchange, either in the post-absorptive state or with food, was obtained before the beginning of the first fasting period. During the first few days of the first and third realimentation periods, the rabbit, confined in the Pashutin respiration chamber, received food for only a few hours daily. Since it is the custom of these animals to eat intermittently the greater part of the 24 hours, the rabbit received an insufficient amount of food on these first days, the intake being roughly proportional to the length of time in which the rabbit had access to food. The values obtained during these realimentation periods supply the only data which have an interest in our discussion of the influence of undernutrition.

1 I. A. Pashutin, The metabolism of animals during insufficient feeding and subsequent realimentation. Diss., St. Petersburg, 1895. See introduction.

2 V. V. Pashutin, General and experimental pathology (Pathological Physiology), St. Petersburg, 1902,2 (1), p. 177 (Russian). So far as we know, the full details of these experiments are given in no other place, although mention is made of the fact that the experiments were published in part in the report of a convention in Moscow in 1887.

31. A. Pashutin, loc. cit.

In the first 3 days of the first realimentation period, the solid matter eaten was but 13, 34, and 36 per cent, respectively, of the amount eaten during the normal period; on the corresponding days in the third realimentation period, it was 62, 49, and 33 per cent, respectively. Since the intake of solid material did not reach the normal amount until the seventh day in the first realimentation period and the sixth day in the third realimentation period, the animal was distinctly undernourished in the earlier days of these periods. On the first day of the first realimentation period, the oxygen consumption per kilogram of body-weight per 24 hours was a little more than one-half the normal value (15.81 grams as compared with 27.58 grams). In the third realimentation period, the oxygen consumption for the first day was 25.08 grams. The carbon-dioxide excretion on the first days of these realimentation periods was 17.79 and 32.16 grams, respectively, and thus much lower than the normal value of 42.41 grams. The oxygen consumption and carbon-dioxide excretion, particularly in the third period, did not return to normal until the food intake was essentially that prior to fasting. During these two periods of undernutrition, therefore, the metabolism per kilogram of body-weight was considerably lower than normal, the oxygen being from 43 to 9 per cent less and the carbon dioxide from 58 to 15 per cent less in the first and third realimentation periods, respectively. While the difference in the carbon-dioxide excretion may naturally be accounted for, in part, by the difference in character of the carbonaceous material in the food, the values would indicate that during chronic undernutrition there is at first a distinct lowering of the metabolism per kilogram of body-weight when measured by either the oxygen consumption or the carbon-dioxide excretion, as compared with the metabolism with a normal amount of food. The fact, however, that the oxygen consumption increases from 43 to ^ only 9 per cent below normal in the third realimentation period would indicate that with the larger diet in the third period the metabolism immediately tended to follow the higher plane of nutrition.

This finding is substantiated by a comparison of the metabolism during the realimentation periods with the metabolism on the first days of the first fasting period, for, aside from the expected increase in metabolism due to the influence of the ingestion of food, Albitsky reports that the intensity of metabolism, even with an insufficient amount of food, was greater in the later realimentation period as compared with the earlier. Albitsky's whole conception, however, is complicated by the fact that considerably larger quantities of food were taken during the third realimentation period. It is interesting to note in this connection that the statement is made that on account of this greater intensity of metabolism which was accompanied, at least in some experiments, by a high temperature,1 the animal in the realimentation period should eat from 1 to 1.5 times as much food as would be taken normally and drink twice as much water to regain the weight lost in fasting.