(Continued from page 22) of fatty tissue. Patients may have a four-pound a day loss for about the first four days. This probably represents mostly fluid since each gram of protein destroyed is accompanied by 3 gm of water. However, over a 60 to 90 day period, this loss averages out to 1 lb/day, and protein catabolism diminishes. This would mean that after the first two weeks of starvation, most of the tissue lost is actually fat."
Dr. Karns said that the disadvantages to prolonged starvation include transient nausea which occurred in 6 patients; mild weakness which occurred in 8; and re-feeding edema which occurred in 4.
He added that periodic chemical imbalances including hypokalemia, hyponatremia, hyperuricemia and hyperchloremia emphasize the importance of close monitoring.
Psychological counseling also must be given during the starvation period.
"The good response from our patients including those with other disorders leads us to believe