The philosophy of this monograph is best illustrated by direct quotation: "The dangerously sick patient today is not a problem in diagnosis, sepsis, technique, pain. He is a problem in balance, in nutritional decompensation, in endocrine function, in extrarenal loss." This volume deals, then, with the patient's contribution to successful surgery—his biologic response to surgery.
A large mass of carefully collected metabolic balance data on nitrogen, potassium, sodium, and calories is clearly presented in the explanatory texts and numerous charts. The theories of the catabolic response to injury are analyzed briefly, followed by a detailed consideration of the role of starvation, immobilization, and endocrine (adrenal cortex) factors in this response. Interesting control experiments on college students, including general anesthesia and mock operations, are described, and the analogies and differences between the metabolic processes of surgical trauma and the artificial combination of short-term starvation, immobilization, and administration of corticotropin (ACTH) are