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JAMA. 1952;150(2):141. doi:10.1001/jama.1952.03680020075013.
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The surgeon has long been interested in protein nutrition as evaluated by the state of nitrogen balance. Marked negative balances following surgical trauma were described by Cuthbertson1 and later by Howard.2 Recently, work in this field has been reviewed3 and a report made of a series of 55 patients who were fed either orally or by a tube placed in either the stomach or the jejunum and who were studied for five days after operation. When the caloric intake was 30 calories per kilogram per day and the nitrogen intake below 300 mg. per kilogram per day, only 2 of the 37 subjects showed a positive balance; however, at or above these levels of feeding, 11 of the 18 subjects were in positive nitrogen balance. It is believed that these data indicate that the catabolic effect of an extensive operation such as a subtotal gastric resection could


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