The kidneys are great agents in the work of excreting nitrogenous waste, and if these organs become clogged with accumulation of nitrogenous waste products they are not able to perform their functions.

As soon as we have evidence sufficient to prove that the kidneys are laboring and are burdened by their work, we must endeavor to remove the strain by regulating the diet; and one clear indication is to limit the supplies of nitrogenous foods.

Large amounts of animal food and the use of alcohol must be stopped, and better stopped altogether.

In many cases the effect of feeding the patient for six weeks, or even two or three months, upon an exclusive milk diet, is remarkably gratifying. The quantity of milk to be prescribed for an exclusive milk diet in Bright's disease must depend on the age and size of the patient, as well as upon his ability to take exercise and use up force in muscular energy. If the patient is invalided so as to be confined to his room or the house, from five to seven pints of milk daily are quite sufficient. If the patient loses weight on a milk diet, although it otherwise agrees with him, it may be well to add farinaceous food in the shape of rice or bread. In the worst cases it is desirable to give the milk at brief intervals, in quantities of six ounces, once an hour during the daytime, with an extra tumblerful at night, and on awakening in the morning.

The quantity of milk necessary to support life for any length of time and maintain good nutrition, especially if the patient is exercising at all, is considerable, and he must take from fourteen to eighteen, or even twenty-two six-ounce tumblerfuls of milk in the twenty-four hours.

It is usually impossible to commence at this rate without producing gastric disturbances from souring of the milk in the stomach, and possibly diarrhoea. The latter symptom is an almost certain indication that the milk is being imperfectly digested, and a temporary reduction in its quantity is advised.

As the patient improves the milk diet may be given up, but it should never be too suddenly abandoned. In adopting any other diet it is a good rule never to let the nitrogenous food bear a greater proportion to the non-nitrogenous than one to four.

When, after a milk diet, the change is to be made to a more liberal menu, the hours of taking the milk may be reduced in frequency, and some of the milk may be replaced by the more hearty food.

Diet: Soup

Vegetable or fish soup, broths with rice or barley.

Fish

Raw oysters or clams, fresh fish broiled or boiled.

Meats

Eat sparingly, chicken, game, fat bacon, fat ham.

Farinaceous

Stale bread, whole wheat bread, toast, milk toast, biscuits, macaroni, rice, cereals of all kinds.

Vegetables

Onion, cauliflower, mashed potatoes, mushrooms, lettuce, watercress, spinach, celery, cabbage.

Desserts

Ripe raw fruits, stewed fruits, rice, tapioca, bread and milk puddings, junkets, cocoa.

Liquids

Toast water, weak tea, pure water, peptonised milk, malted milk, fresh buttermilk, milk with hot water equal parts, whey, unfermented grape juice.

Avoid

Fried fish, corned beef, hashes, stews, pork, veal, heavy bread, batter cakes, lamb, mutton, beef, gravies, beans, peas, malt or spirituous liquors, tobacco, coffee, ice cream, cake, pastry.