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The Significance of Body Size

The Significance of Body Size Abstract For some time I have felt that doctors have created unnecessary confusion in the rules intended to take account of the different body sizes of infants, children, and adults. The difficulty arises largely from failure to utilize available knowledge of physiological relationships. Doctors know that total metabolism is considerably greater per kilogram of body weight in infants than in adults. Consequently, total metabolism rather than weight is the appropriate measure of those functions dependent on rate of metabolic turnover. Body weight is the measure of the mass of water, electrolyte, and protoplasm in which metabolic changes are taking place. In other words, body size has two dimensions. Attempts to bypass either of these dimensions fails to bring into view the relevant physiological relationships and establishes no adequate frame of reference which permits logical analysis. However, using the correct dimensions, present knowledge permits the same physiological principles to be applied to References 1. Du Bois, E. F.: Heat Loss from the Human Body: Harvey Lecture , Bull. New York Acad. Med. 15:143, 1939. 2. Crawford, J. D.; Terry, M. E., and Rourke, G. M.: Simplification of Drug Dosage by Application of Surface Area Principle , Pediatrics 5:783, 1950. 3. Oliver, W. J.; Graham, B. D., and Wilson, J. L.: Lack of Scientific Validity of Body Sur face as Basis for Parenteral Fluid Therapy . J.A.M.A. 167:1211, 1958.Crossref 4. Moulton, C. R.: Age and Chemical Development of Mammals , J. Biol. Chem. 57:79, 1923. 5. Keys, A.; Anderson, J. T., and Brozek, J.: Weight Gain from Simple Overeating , Metabolism 4:427, 1955. 6. Frenk, S. J.; Metcoff, J.; Gómez, F.; Ramos-Galván, R.; Cravioto, J., and Antonowicz, I.: Intracellular Composition and Homeostatic Mechanisms in Severe Infantile Malnutrition , Pediatrics 20:105, 1957. 7. Cheek, D. B.: Observations on Total Body Chloride in Children , Pediatrics 14:5, 1954. 8. Forbes, G. B.; Reed, A. F.; Bonderant, J., and Etheridge, J.: Changes in Body Chloride During Growth , Pediatrics 17:334, 1956. 9. Friis-Hansen, B.: Changes in Body Water Compartments During Growth , Acta Paediat. , Vol. 46, (Supp. 110) , 1957. 10. Darrow, D. C., and Yannet, H.: The Changes in Distribution of Body Water Accompanying Increase in Decrease of Extracellular Electrolyte , J. Clin. Invest. 14:266, 1935.Crossref 11. Yannet, H., and Darrow, D. C.: The Effect of Depletion of Extracellular Electrolytes on the Composition of Skeletal Muscle, Liver, and Cardiac Muscle , J. Biol. Chem. 134:721, 1940. 12. McDowell, R.; Wolf, A. V., and Steere, A.: Osmotic Volumes of Distribution: Idiogenic Changes in Osmotic Pressure Associated with Administration of Hypertonic Solutions , Am. J. Physiol. 180:545, 1955. 13. Laragh, J. H., and Capeci, N. E.: Effect of Administration of Potassium Chloride on Serum Sodium and Potassium Concentration , Am. J. Physiol. 180:539, 1955. 14. Laragh, J. H.: Effect of Potassium Chloride on Hyponatremia , J. Clin. Invest. 33:807, 1954.Crossref 15. Darrow, D. C.; Pratt, E. L.; Flett, J., Jr.; Gamble, H. H., and Wiese, H. F.: Disturbances in Water Electrolytes in Infantile Diarrhea , Pediatrics 3:179, 1949. 16. Finberg, L.: Pathogensis of Lesions in the Nervous System in Hypernatremic States , Pediatrics 23:40, 1959. 17. Swan, R. C., and Pitts, R. F.: Neutralization of Infused Acid by Nephrectomized Dogs , J. Clin. Invest. 34:205, 1955.Crossref 18. Bergstrom, W. H.: Total Body Water and Normal Electrolyte Composition , Pediat. Clin. North America 6:5, 1959. 19. Cooke, R. E.; Segar, W. E.; Reed, C.; Etzwiler, D. D.; Vita, M.; Brusilow, S., and Darrow, D. C.: The Role of Potassium in the Prevention of Alkalosis , Am. J. Med. 17:180, 1954.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

The Significance of Body Size

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References (23)

Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1959.02070020418002
Publisher site
See Article on Publisher Site

Abstract

Abstract For some time I have felt that doctors have created unnecessary confusion in the rules intended to take account of the different body sizes of infants, children, and adults. The difficulty arises largely from failure to utilize available knowledge of physiological relationships. Doctors know that total metabolism is considerably greater per kilogram of body weight in infants than in adults. Consequently, total metabolism rather than weight is the appropriate measure of those functions dependent on rate of metabolic turnover. Body weight is the measure of the mass of water, electrolyte, and protoplasm in which metabolic changes are taking place. In other words, body size has two dimensions. Attempts to bypass either of these dimensions fails to bring into view the relevant physiological relationships and establishes no adequate frame of reference which permits logical analysis. However, using the correct dimensions, present knowledge permits the same physiological principles to be applied to References 1. Du Bois, E. F.: Heat Loss from the Human Body: Harvey Lecture , Bull. New York Acad. Med. 15:143, 1939. 2. Crawford, J. D.; Terry, M. E., and Rourke, G. M.: Simplification of Drug Dosage by Application of Surface Area Principle , Pediatrics 5:783, 1950. 3. Oliver, W. J.; Graham, B. D., and Wilson, J. L.: Lack of Scientific Validity of Body Sur face as Basis for Parenteral Fluid Therapy . J.A.M.A. 167:1211, 1958.Crossref 4. Moulton, C. R.: Age and Chemical Development of Mammals , J. Biol. Chem. 57:79, 1923. 5. Keys, A.; Anderson, J. T., and Brozek, J.: Weight Gain from Simple Overeating , Metabolism 4:427, 1955. 6. Frenk, S. J.; Metcoff, J.; Gómez, F.; Ramos-Galván, R.; Cravioto, J., and Antonowicz, I.: Intracellular Composition and Homeostatic Mechanisms in Severe Infantile Malnutrition , Pediatrics 20:105, 1957. 7. Cheek, D. B.: Observations on Total Body Chloride in Children , Pediatrics 14:5, 1954. 8. Forbes, G. B.; Reed, A. F.; Bonderant, J., and Etheridge, J.: Changes in Body Chloride During Growth , Pediatrics 17:334, 1956. 9. Friis-Hansen, B.: Changes in Body Water Compartments During Growth , Acta Paediat. , Vol. 46, (Supp. 110) , 1957. 10. Darrow, D. C., and Yannet, H.: The Changes in Distribution of Body Water Accompanying Increase in Decrease of Extracellular Electrolyte , J. Clin. Invest. 14:266, 1935.Crossref 11. Yannet, H., and Darrow, D. C.: The Effect of Depletion of Extracellular Electrolytes on the Composition of Skeletal Muscle, Liver, and Cardiac Muscle , J. Biol. Chem. 134:721, 1940. 12. McDowell, R.; Wolf, A. V., and Steere, A.: Osmotic Volumes of Distribution: Idiogenic Changes in Osmotic Pressure Associated with Administration of Hypertonic Solutions , Am. J. Physiol. 180:545, 1955. 13. Laragh, J. H., and Capeci, N. E.: Effect of Administration of Potassium Chloride on Serum Sodium and Potassium Concentration , Am. J. Physiol. 180:539, 1955. 14. Laragh, J. H.: Effect of Potassium Chloride on Hyponatremia , J. Clin. Invest. 33:807, 1954.Crossref 15. Darrow, D. C.; Pratt, E. L.; Flett, J., Jr.; Gamble, H. H., and Wiese, H. F.: Disturbances in Water Electrolytes in Infantile Diarrhea , Pediatrics 3:179, 1949. 16. Finberg, L.: Pathogensis of Lesions in the Nervous System in Hypernatremic States , Pediatrics 23:40, 1959. 17. Swan, R. C., and Pitts, R. F.: Neutralization of Infused Acid by Nephrectomized Dogs , J. Clin. Invest. 34:205, 1955.Crossref 18. Bergstrom, W. H.: Total Body Water and Normal Electrolyte Composition , Pediat. Clin. North America 6:5, 1959. 19. Cooke, R. E.; Segar, W. E.; Reed, C.; Etzwiler, D. D.; Vita, M.; Brusilow, S., and Darrow, D. C.: The Role of Potassium in the Prevention of Alkalosis , Am. J. Med. 17:180, 1954.Crossref

Journal

A.M.A. Journal of Diseases of ChildrenAmerican Medical Association

Published: Oct 1, 1959

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