1914] P- B. Hawk 433 



blood, and practically leaves the uric acid to itself. This is an im- 

 portant point, since it proves that the large amount of water gener- 

 ally taken with lithium salts has more to do with relieving gout than 

 hos the lithia." 



Before closing I would like to emphasize the fact that, in all of 

 the water studies made by my associates and myself, normal sub- 

 jects have been employed. We have made no clinical studies and 

 have made no clinical suggestions. It is probably true that a persort 

 with a deranged circulatory or gastric function, or any pronounced 

 lesion of heart or kidney, should not drink large volumes of water at 

 any tinie, either with meals or between meals. The ingestion of 

 large volumes of water with meals is probably contraindicated in 

 atonic or dilated stomach, since an excessive water ingestion might 

 promote further atony and dilation. It is also probably contraindi- 

 cated in gastroptosis, where the gastric support is relaxed and 

 insufficient and in certain cases of pyloric colic or spasm. If con- 

 traindicated in these conditions, however, it is because a large vol- 

 ume or weight at any one time is contraindicated and not because 

 of the water per se. I would say, therefore, that normal persons 

 may drink freely, of water, at mealtime, whereas those unfortunate 

 individuals who possess lesions of heart or kidney or who are 

 troubled with any circulatory or gastric disturbance, should have 

 their fluid intake regulated strictly according to medical advice. 



On the basis of a large number of experiments we feel war- 

 ranted in concluding that the average normal individual will find that 

 the drinking of a reasonahle volume of water with meals will pro- 

 mote the secretion and activity of the digestive Juices, the digestion 

 and absorption of the ingested food, and will retard the growth 

 of intestinal bacteria and lessen the extent of the putrefaction proc- 

 esses in the intestine. 



Our Claims for the efficiency of water have been verified by Brad- 

 ley, who found that pancreatic lipase acted more satisfactorily when 

 its Solution was diluted with water ; by Smirnov, who demonstrated 

 that fasting rabbits which were permitted free access to water were 

 less prone to show signs of fatty infiltration of the liver than were 

 similar fasting rabbits which were not permitted to drink water; by 

 Niles, who made an experiment upon sixteen medical students and 



