Other Articles
October 1924


Author Affiliations

From the Harriet Lane Home, Johns Hopkins Hospital, and the Department of Pediatrics, Johns Hopkins University.

Am J Dis Child. 1924;28(4):447-457. doi:10.1001/archpedi.1924.04120220043008

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, Hilliger2 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

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