Spices proper must be included among directly harmful and injurious articles, particularly irritating condiments like pepper, ginger, mustard, etc. Salt, vinegar and lemon juice on the other hand are not included in this class. Nothing definite is known in regard to the exact dose of certain condiments that is injurious, nor in regard to the manner in which they exercise their deleterious effects on the kidney; in fact we do not know accurately which of the group of condiments are really harmful. It is quite possible that in interdicting a diet containing spices to nephritic patients we deprive them of more than is really necessary. In view of the fact that we know so little on this subject I may be permitted to record an observation that I made a number of years ago. The patient was an engineer of 29 years, who had been suffering for two years from a disease of the kidneys that had been diagnosed as atrophic kidney. Notwithstanding the lesion of the kidneys, that had produced a distinct hypertrophy of the left ventricle, the pa tient's general condition was good and his strength up to par. In June the patient, whom I had seen before, consulted me because his urine had become markedly darker. The urine contained a very small quantity of blood pigment and under the microscope red corpuscles and blood casts could be discovered. This finding, notwithstanding the fact that the patient's urine had been examined at frequent intervals, had never been made before. On investigating the recent history of this case it was found that he had been eating large quantities of summer radishes during the preceding week, although the use of this vegetable had been strictly interdicted. A few days later it was found that all the blood had disappeared from the urine. The patient who was passionately fond of radishes would not believe that they had caused the aggravation of his condition but thought he had caught cold. In August of the same year despite the warnings I had given him, he again ate radishes, two or three as large as an apple a day, and again developed hematuria by the end of the week, this time of a more severe type than before and lasting over three weeks. This was an experi-mentum crucis. I made a similar observation some time ago in a patient who ate much celery. I had performed some experiments some time before on the diuretic effect of celery in certain heart lesions with the result, by the way, that I found the effect to be too slight to warrant the use of celery as a diuretic. In a patient with contracted kidney I had also tried celery as a diuretic and had found that it increased diuresis tempor arily by about 600-800 c.cm. without at the same time harming the patient. In another patient afflicted with the same disease however the administration of celery was immediately followed by increased albuminuria persisting for two days. On the other hand, I have not been able to verify the generally accepted statement that asparagus does harm in nephritic cases and should be forbidden. I gave two women a pound of asparagus a day for ten days and failed to note the slightest bad effects, above all no increase in the albuminuria. In one of the patients in fact diuresis and the percentic and absolute albumen excretion were at no time so favorable as during the ten days during which she ate asparagus.

Other observations in this field were made in cases of diabetes, who in addition to glycosuria suffered from albuminuria, some of them without distinct signs of contracted kidney. Many of these patients were treated in my private clinic for diabetics in Frankfurt and received large quantities of asparagus every day during the asparagus season and in none of them did I notice any increase in the albuminuria nor in the nephrogenous microscopic elements of the urine. In some of them albumen actually disappeared from the urine during the time they were getting asparagus.

Since then, following the usual custom observed in the dietetic treatment of contracted kidney, I have, it is true, warned against the excessive use of asparagus, but have always permitted small quantities (i.e., about half a pound two or three times a week during the asparagus season), and have never seen any bad effects from this practice. It would be well if clinicians would publish similar observations; if many reports of this kind could be collected we might learn more in regard to the injurious or non-injurious character of different condiments and of the vegetables that contain them.

I will briefly enumerate those spices and similar substances that are supposed to exercise a harmful effect on the kidneys. It will be well to eliminate these articles from the diet of nephritic cases until their non-injurious character is established:

White and black pepper, cayenne pepper, paprica, curry, cloves, vanilla (?), nutmeg, English and German mustard, anis, leek, garlic, caroway, knob celery and table celery, asparagus (?), mushrooms (?), morel and truffles.