376 THE VITAMINES 



disease. Schiff (I.e. 1444) sought the cause of the disease not in 

 the lack of calories, per se, but of potatoes, fresh vegetables and 

 milk; addition of yeast, beer and fat had no therapeutic effect. 

 Knack and Neumann (I.e. 1450) obtained good results with potatoes. 

 Reach (1464) made use of organotherapy, in the form of testicles, 

 with good results, v. Hosslin (1465) and Schittenhelm (1466) 

 believed mainly in the effect of protein therapy. Isenschmid (1467) 

 attributed certain edemas, like those occurring after dysentery and 

 other protracted diseases, to the same causes that bring about 

 hunger edema, and in his opinion, they should be treated in a similar 

 manner. Most investigators manifest a particular belief in protein 

 of animal origin as a therapeutic measure. The above therapy con- 

 stitutes the sum and substance of the leading ideas as regards the 

 etiology of hunger edema. 



ETIOLOGY 



Because of the great lack of fat during the war, some investigators 

 associated the etiology with this factor. We have just seen that 

 this is not likely and that it has to do chiefly with a lack of vitamine 

 A, and most animal products used contain more or less of this sub- 

 stance. Aron (1467a) considers that hunger edema is due to an 

 insufficient amount of calories in the diet. Park (1468) was of the 

 opinion that the edema was associated with a lack of protein and fat, 

 and an excessive water intake. Rubner (1469) and Determann (1470) 

 attributed it to the lack of protein. The latter conception is also in 

 accord with the experience gained in the studies on parenchymatous 

 nephritis by Epstein (1471) and on renal edema by Allbutt (1472). 

 Further confirmation is given by the study of the development of 

 experimental edema in animals, especially of rats and mice. Tachau 

 (I.e. 1244) stated that when the correct relationship between proteins 

 and carbohydrates is disturbed by the addition of the latter, edema 

 develops. Denton and Kohman (1473) observed that when rats 

 are fed on carrots, casein, starch, butter or lard and salts, this diet 

 is adequate only when the carrots provide half of the total calories. 

 However, if this relationship is changed by the addition of starch or 

 fat, then edema develops in a great percentage of the animals. 

 Kohman (1474) carried this idea further, in that by means of the 

 above diet, especially with the addition of water, the animals 

 developed edema, which was cured by the administration of casein. 

 No exact figures are given as to the food intake, but in any event. 



