482 Philippine Journal of Science 1919 
or fish, and some other dietary articles of minor importance, is 
as a whole deficient from a nutritional standpoint. An almost 
exclusively vegetarian existence, low in phosphorus and protein 
(Aron and Hocson(2)), or a protracted consumption of a one- 
sided diet may result in diseases of metabolic or nutritional 
deficiency, exemplified in these Islands by the existence of beri- 
beri, the theory of dietetic deficiency as the causation of which 
is apparently well established by the work of Andrews,(1) Cham- 
berlain, Vedder, and Williams,(7) Fraser and Stanton,(11) de 
Haan,(9) Highet,(14) Gibson,(12) Williams and Saleeby,(26) and 
many others. 
MATERIALS AND METHODS 
In the museum of the surgical department of the Philippine 
General Hospital there were found, at the beginning of this work, 
forty-eight bladder stones from Filipino subjects, some of which 
were intact, while others were half-cut. These had been col- 
lected from the latter half of 1914 to almost the end of 1917. 
The incompleteness of the clinical histories of these forty-eight 
cases caused some difficulty in correlating the facts in the attempt 
to establish a relation between the nutritional state of the patient 
on admission and the character of the stone surgically removed. 
However, during the chemical analyses of these calculi, ten cysto- 
lithiasis cases were admitted to the surgical ward during the last 
two months of 1917, and these were thoroughly examined from a 
nutritional standpoint. Therefore, the present investigation is 
based on fifty-eight cases of vesical calculi with a view to cor- 
relating as far as practicable the clinical data with the chemical 
composition of the different layers of the individual stones. 
To present a picture of the nutritional condition of the patients, 
it was planned to collect and condense all the essential points in 
the clinical-history record of the cases. All of the patients were 
Filipinos, of different age, sex, social condition, occupation, 
etc.—all of which factors must be considered in determining the 
relative frequency, and in tracing the nutritional etiology, of the 
disorder in each group. It must be emphasized that, except for 
the last ten cases, the history of beriberi as a whole was un- 
reliable. Fortunately, however, most of the hospital records 
show, from objective examination of the patients, the degree of 
their body development and nutrition. The importance of con- 
sidering the associated diseases, including intestinal parasitic in- 
festation, lies in the fact that they tend to decrease the vital 
resistance of the body to the development of superimposing mal- 
