Infantile marasmus is commonly attributed either to chronic inanition or to a derangement of tissue metabolism. According to the former and generally accepted view, the undernutrition is merely the end-result of prolonged starvation (insufficient caloric intake) or of repeated gastrointestinal upsets (defective absorption of foodstuffs) induced by or independent of parenteral infections. A few authors,1 however, maintain that the basic fault is a derangement of the energy metabolism resulting from defective utilization or from excessive combustion of foodstuffs in the tissues. They believe that some marantic infants fail to thrive in spite of an adequate diet and in the absence of parenteral or alimentary infection. The experimental evidence at hand is inadequate to enable one to decide finally on the merits of this view. The only systematic study of the subject was made by Fleming and Hutchinson,2 who concluded that evidence of defective absorption or of abnormal utilization
LEVINE SZ, WILSON JR, GOTTSCHALL G. THE RESPIRATORY METABOLISM IN INFANCY AND IN CHILDHOOD: VIII. THE RESPIRATORY EXCHANGE IN MARASMUS: BASAL METABOLISM. Am J Dis Child. 1928;35(4):615–630. doi:10.1001/archpedi.1928.01920220060006
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