CYSTOLITHIASIS AMONG FILIPINOS IN ASSOCIATION 
WITH DIETETIC DEFICIENCY 
By Recino G. Papua 
(From the Departments of Surgery and Physiology, College of Medicine 
and Surgery, University of the Philippines) 
ONE TEXT FIGURE 
INTRODUCTION 
Osborne and Mendel(19) in their series of dietetic experiments 
on lower animals found an incidence. of phosphatic calculi in 
the urinary passages of rats that had been subjected to a ration 
of inadequate nutritional value. In their conclusion theSe au- 
thors say: 
We can not offer any rigid proof of the etiologic relationship between 
the ration deficient in fat soluble vitamine and the formation of phosphatic 
calculi. The impressive statistical fact that in every case where the 
calculi were observed the animals had existed for some time on a diet 
of the sort indicated, *together with our failure to discover any other 
pathogenic factor common to all the affected animals, makes the hypothesis 
suggested above worthy of serious consideration. 
Following this valuable suggestion, I attempted to carry on 
an investigation that has practically become twofold: (1) an 
attempt to show as far as lay in my power the possible appli- 
cation of the hypothesis to a people collectively noted for an 
unbalanced, essentially avitamine diet such as exists in the 
Philippines; (2) an investigation into the chemical composition 
of Filipino vesical calculi, which is interesting in itself and may 
prove valuable, considering the relative scarcity of similar in- 
vestigations in foreign countries. 
The consensus among various writers who have studied the 
nutritional condition of the Filipino people is that a large ma- 
jority of them are not receiving sufficient nourishment for the 
maintenance of a stable physiological activity. The recent ex- 
periments of Concepcion(8) on the nutrition of normal Filipino 
subjects seem to confirm this opinion. 
The ordinary daily ration of the Filipino masses, consisting 
principally of rice which is at times so improperly prepared that 
most of the pericarp where the vitamines are said to exist has 
been removed, vegetables of moderate amount, scarcely any meat 
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