This disease is characterized by the appearance of albumin and casts in the urine. The loss of this albumin from the blood leads to a disturbance of nutrition.

Whenever organs become diseased, the rational treatment always provides a rest more or less complete for the diseased organ. Naturally, this rest cannot be absolute in the case of some organs, and cannot be long extended in the case of any organ, because the function of no organ can be long dispensed with, if at all. However, the rational treatment is to lighten the work of the organ as much as possible and for as long a period as possible, after considering the general body conditions.

The work of the kidneys, as set forth in an earlier chapter, is to excrete the various soluble salts and end products of nitrogenous excretion - all these dissolved in water. The work of the kidneys seems to be facilitated when there is an ample supply of water in the body fluids. In many cases the excretion of water is not interfered with by the inflammatory processes in the kidneys. When such is the case water should be used very freely, as it facilitates the excretion of the nitrogenous products. If the water is not properly excreted by the kidneys, there will be no increase in the volume of urine and there will be a beginning edema of the loose, cellular tissues. When these symptoms are present the water must be reduced to two or three pints per day.

As uric acid and the other related bodies are formed from nu-cleins, it is best to exclude these from the diet as much as possible.

To that end, abstain from all dishes made from the glands of animals, such, for example, as liver, sweetbreads, kidneys, also brains. Any benzoic acid in the food is changed to hippuric acid and excreted by the uriniferous tubules. To relieve these tubules of the necessity of this work, abstain from green vegetables, stone fruit, and cranberries, all of which contain benzoic acid. Potassium salts should also be taken as sparingly as possible to that end; potatoes should be reduced to a very low limit.

A matter of the first importance is to follow throughout the course of the disease a low protein diet. As set forth above, this low protein diet is ample for the necessities of the body, while it relieves the kidneys of a very considerable portion of their work. To this end, never permit more than sixty grams per day (two ounces) of the protein, as shown in the table of chemical composition. In the early stages of acute nephritis the diet should be a liquid one of milk and cream mixed, two parts of milk to one of cream, and should not exceed three pints a day for the first few days. If the urine is very scanty, this may be reduced to one and one half pints, taken in four or five installments. After this initial period covering three to six or seven days, a gradual recourse may be had to carbohydrates and fats, as bread, rice, bacon, butter, all in very small amounts, continuing the milk and cream as the basis of the diet. As the patient convalesces, a general mixed diet in gradually increasing amounts can be presented.

2. Chronic nephritis, either parenchymatous or interstitial, should be treated dietetically in a way similar to the convalescing patient recovering from acute nephritis. In the occasional acute exacerbations, follow the diet outlined for acute nephritis above. To be strictly prohibited in all cases of nephritis are alcoholic beverages, pastries, puddings, spices, and condiments, including salt.

3. Renal Calculi

The presence of renal calculi is manifested by a renal colic, in which the calculi are passing from the kidney to the bladder. During this time the patient experiences excruciating pain and no food will be taken. Once a calculus is formed, nothing in a dietetic way can be done to dissolve it or to facilitate its removal. A modification of the diet may, however, have a prophylactic action and thus be important to observe. The best prophylaxis is the use of large quantities of pure water, as this holds salts in solution and hinders their deposit in the form of calculi. One should also avoid the use of tomatoes, because of the oxalic acid which they contain. Furthermore, there should be abstinence from all alcoholic beverages.