mands large amounts of the mineral, so that diet of the mothers should be high in salts of calcium."

Soft Water.

The effect of soft water may be seen in regions where rain water is the chief drink of the people, and many readers of this article who have wandered much over the earth's surface may recall many instances of bow-legs, heart-shaped pelvis, spinal curvature, etc., resulting from a soft condition of the bone material and in all probability caused by too little mineral matter in the food and water. It has been my observation that such cases are most common in soft water regions and a very striking illustration came to my notice in the little town of Dilsberg in the Neckar Valley in Germany. Here a little town crowns the top of a round hill some hundred feet above the river and the location is such that the people are entirely dependent upon rain water for their drinking supply; and never have I seen in one place so many cases of bow-legs and other deformities in proportion to the number of inhabitants.

Some of the most important food materials, such as meat, potatoes, etc., are comparatively low in calcium salts and it is quite possible that unless these are supplied in part by the drinking water the body cannot get enough for proper replacement of the mineral matter of the bones. Furthermore, of the mineral matter taken into the body with the food and drink, only a small part is absorbed and made available as bone-building material, hence there must be a large excess in the food material. It is a fact that fish cannot live in distilled water. It has also been stated, again by the Germans, that in many cases of anemia and other diseases where ill nourishment or under feeding is a great factor, calcium salts have been lacking in the diet and drinking water. For this reason calcium salts, especially the chloride, are being used in these diseases and apparently with good results. It has, on the other hand, been shown that in those regions where the water is hard and in those occupations where the workers absorb large quantities of lime, as in the case of lime burning, lime handling, plastering, etc., cases of tuberculosis and anemia are more rare than among the general population. Furthermore, it has been shown that calcium has a favorable influence upon animal life, as is evidenced by experiments recently carried out. Calcium salts administered to guinea pigs and rabbits greatly increase their growth and productiveness.

In view of the data here given and because of many other facts, some investigators have given as their opinion that the human adult should receive an amount of calcium salts each day equal to one gram of the pure metal to supply the normal needs of the body.

Research Work on Calcium.

It was to determine the amount of calcium in the various food materials and to determine the average amount in the daily diet exclusive of water that we undertook in the Colgate Laboratory the following investigation, the results of which are stated in the table. The various substances to be analyzed were taken in the form in which they appear on the dining table and comprised almost a complete menu from breakfast foods through meats, eggs, etc., to pie, cake and other desserts. The menu from whien the items were chosen was that of our college Commons and of one of the fraternity houses and was the average hearty food demanded by the college boy.

The method of analysis was very simple and is given here in some detail on the chance that some reader may wish to follow our methods in analyzing some article which does not appear on the list. The samples were weighed, a large enough quantity being taken to insure a fair analysis, usually 5-10 grams, then ignited in a large crucible until complete destruction of organic matter was effected. The resulting ash was covered with water, treated with hydrochloric acid to solution, the insoluble matter filtered out and the iron and aluminum precipitated by means of ammonium hydroxide. The calcium was next precipitated with ammonium oxalate, after the iron and aluminum hydroxids had been separated from the solution by filtration. The precipitate of calcium oxalate was washed to free from all excess of ammonium oxalate, dissolved in warm dilute sulfuric acid and the calcium determined by titration with tenth normal potassium permanganate solution, 1 cc of which equals .002 grams of calcium. As the amount of iron could be easily found from the precipitate of iron and aluminum hydroxides we made this determination also and the results are given, as it may be a matter of interest to know the amount of iron in the common diet.

Calcium in Food and Drink.

In considering this table it must be remembered that the analytical work is that of young chemists. In spite of this fact, however, the work is fairly good. Certainly it will suffice to show a comparison of the various common foods as to calcium content. If all the calcium in such a diet could be utilized by the organism it would not be necessary to supplement it by means of a hard-drinking water to meet the 1 gram per day requirement suggested by the German writer. The fact is that only a small percentage of the mineral can be directly utilized, hence the necessity of a large excess. Note the loss of calcium through the urine, 100 cc. representing a loss of .07 grams daily on the diet used in the table. The conclusion seems to be perfectly safe that we need a moderately hard water to keep up the calcium supply.

First, attention should be given to the diet, by withholding nitrogenous foods and giving an abundance of starchy foods and fat.

The nitrogenous foods, such as meats, peas, beans, lentils, etc., yield an abundance of urea, uric acid and other end-products of metabolism; these are excreted by the kidneys, and an excess of them places a heavy drain upon the organs.

But the starchy or carbohydrate foods are broken down into sugars, carbon, etc., and are eliminated by the lungs as carbon dioxide.

Fats contain a very high proportion of carbon which is eliminated as carbon dioxide by the lungs. So it is very plain that a minimum of proteids gives rest to the kidneys, and of course the patient's body strength will be less than when put on a full diet. This should be explained in advance, so that he may not become discouraged with the treatment of adhering to a rigid diet.

Bowel Action Relief.

The next principle of resting the kidney is to have a watery evacuation from the bowel each day. Little urine is passed during a diarrhea, and sometimes when uremia is threatened nature sends a severe diarrhea to relieve the condition.

In a watery evacuation from the bowel a certain amount of urea is eliminated. While it may not have been determined by laboratory tests, yet from empirical and clinical experience we believe that urea is eliminated by the bowel.

Skin Action.

The skin also plays a big rôle as an excretory apparatus for urea, uric acid and water. It also has a compensatory action as the kidney becomes unable to do its work, and crystals of urea are found on the skin. So, then, a good diaphoretic should be given as a routine in every case of nephritis, not only when uremia is threatened, but during any stage, so that the kidney may rest.

Dry Heat.

The dry-heat apparatus of course is the remedy par excellence when it can be procured. High bloodpressure, in my mind, instead of being nature's effort to relieve the system of urea by forcing more work on the kidney and thus increasing the power of the kidney to excrete, is a very dangerous part of the vicious circle and should be combated by the use of vaso-dilators and thus rest the kidney. Some writers, however, actually commend digitalis as a diuretic in these cases.

Bad Medication.

One case of nephritis, in my earlier practice, was doing fairly well on something like the treatment outlined above, when an old physician was called in as a consultant. He recommended a tablet which contained a mixture of digitalis, squills, elder root and a few other remedies of the cardio-diuretic type. The patient next day developed nose bleed, almost complete suppression of urine, uremia and died within a few days.

In my earlier practice I did not carry out such a rigid principle of rest to the kidneys, and the patients did not do so well as now under this treatment.

Details of Treatment.

The theories outlined above are put in practice by the following treatment: Only a small amount of meat is allowed at but one meal per day, and two eggs are permitted. Many practitioners recommend a milk diet, but as milk is very high in casein (4%), it perhaps is too hard on the kidney, as of course casein is converted into urea.

The patient is encouraged to eat a full amount of starchy foods, fats, etc., but not the nitrogenous foods. He is given Epsom salts at least every other day in doses large enough to produce a watery evacuation. From 30 to 60 drops of fluidextract pilocarpus are given at bedtime to produce diaphoresis. This is kept up as a routine, but the patient soon develops more or less tolerance for the pilo

carpus.

High blood-pressure is combated by using 1/50 grain nitroglycerin about every two hours, and by using tincture veratrum in 6-drop doses about every four hours. By adhering strictly to the above rules, I have secured results that were really ahead of anticipations.

By WILLIAM BRADY, M.D.

1008 Lake St.

ELMIRA, N. Y.

Here is a testimonial published in a booklet issued by a quack concern:

P

R. F. D. 2, Box 50, HDEAR SIRS:

P

Ohio, Aug. 15, 1915. I enclose an order for another box of Dr. B 's Catarrh Remedy. Find it to be exactly as recommended. My family physician told me I had a bad case of catarrh, told me he could do no good and advised me to try your remedy, as an atomizer could not reach affected parts. I have used two boxes of the Remedy and think I am cured, although my husband insists that I use another box.

Yours truly, MRS. T. J. AAssuming that there is such a place as H

Ohio, such a woman as Mrs. T. J. Asuch an ailment as catarrh, and such a husband as T. J., what is wrong with this testimonial anyway? The only deplorable thing I can see in it is the rôle of the family physician. Evidently he imagines that "catarrh" is an entity and an atomizer the only available minus sign a family physician can put upon it.

In my experience as a writer of syndicated newspaper articles, I find that the eminent Dr. B

is right. He states in his booklet that there are about a hundred million people in the United States and that probably fifty million of them have what he calls "catarrh.” Yes, that must be so! I've had letters from most of them myself.

Covering Ignorance.

When a physician says, "You have contracted a cold," he is merely evading the issue, hedging, avoiding a diagnosis, is he not? What is a "cold" but a lightning-change title to apply to an unknown infection for the time being?

When a physician says, "You have catarrh," he is just covering his ignorance, is he not? He means: "God knows what ails you, my friend, but I don't, and I have neither the ability nor the desire to find out." The mere use of the word "catarrh" or the phrase "catarrhal trouble” by a doctor is grist for the quacks, because the fifty million Mrs. A- -'s in America don't like to take chances; they like to

-'s for

get the family doctor's opinion that it is just "catarrhal trouble" first, and then send the money to the B's who thrive on credulity and ignorance. Yet, who can blame the Mrs. Agetting "cured" or the Mr. A- 's for insisting upon a sort of clincher, when the A- 's family physician allow the B-'s of trade to "do humanity good," as Dr. Bputs it in his booklet.

A Word to the Young Doctor. Young physicians particularly-the old ones are hopelessly wedded to their negligent ways-but the young men in practice may find the treatment of patients who complain of “catarrh” a stepping stone to family patronage and good will, but not if they fall into the slovenly ways of the older practitioners and harbor the notion that an atomizer or an impressive vaporizer covers the requirement of treatment in such cases.

"Catarrh" Easy to Treat-if One Cares.

The young physician who commands enough judgment, skill and patience to treat any of the fifty million Mrs. A's who may happen to come his way will find them quite as eager to sing his praises to the countryside and proclaim themselves "cured" while still under treatment as they are to give the "catarrh specialist" of newspaperdom testimonials. With the simple equipment of head-mirror, speculum, applicators, two or three sterilizable atomizers and a few stock solutions, a man is prepared to accept for a course of effective and always satisfactory treatment patients who say they have "catarrh," instead of dismissing them carelessly with a prescription for something to spray or drop in the nose. A treatment takes perhaps five or ten minutes; the material used costs the doctor perhaps a cent; a minimum fee is a dollar. Treatments are given at first on alternate days for a week, then twice a week for a month, then once a week or every ten days for another month or so. Of course some doctors don't like to bother with office work. They prefer to ride the swivel chair for a living.

A Workable Technic.

In order to outline the method which I have found successful and, when I had time to devote to my practice, a money-getter, let me describe the management of a typical case.

Miss A comes to get "something for a cold and a