MINERAL WATERS 849 



in secretion is likewise probably to be credited to the carbon dioxid evolved, 

 pei haps also to calcium (Polimanti). The effect of lithium salts and 

 water is to be explained in the same way (Mayeda). 



Purely alkaline waters also depress pancreatic secretion, while car- 

 bonated waters, like the saline waters stimulate it; these also increase 

 biliary secretion (Jappelli), all of which effects can probably be traced 

 back to a gastric origin. 



Information as to their influence on the utilization of food is scanty. 

 Early experiments indicate little if any change in the utilization of pro- 

 tein and fat as a result of drinking 1 liter of alkaline water, and ethereal 

 sulphates were also unchanged. The influence of alkalies themselves on 

 ethereal sulphates is variable and there is need of data on the effect of 

 mineral waters in cases of high ethereal sulphates and indican. By the 

 ingestion of alkaline water the ammonia content of the urine is decreased, 

 and the normally acid reaction of the urine may be changed to an alkaline 

 reaction with sufficient alkaline water, but with wide variations in indi- 

 vidual cases. Such results are also reported in the case of infants (Ylppo). 

 More recently in an experiment on four men lasting 18 days the effect of 

 an alkaline mineral water (Manitou) on digestion and utilization was de- 

 termined (Mattill). This water contains a large amount of lime (secon- 

 dary alkalinity), some chlorids and sulphates and a considerable amount of 

 free carbon dioxid. During the mineral water ingestion a true alkalinity 

 of the urine was observed together with marked reduction in urinary am- 

 monia. There was a slight retention of nitrogen in all four subjects. 

 Uric acid and indican excretion were very slightly reduced, the latter, 

 however, not because of a better utilization of the food. Fecal moisture 

 and fat in particular were somewhat increased, nitrogen only very slightly. 

 The larger proportion of the added lime was excreted by the intestine; 

 during the mineral water periods all subjects showed a marked retention 

 of lime and the positive balance continued with a gradual decrease in 

 the post-water control period. Earthy phosphates in the urine were 

 slightly increased but total urinary phosphate was reduced, presumably 

 through a deviation into the intestine by lime. 



Alkalinization of the urine has been of interest because of the greater 

 solvent power of such urine for uric acid. For such alkalinization the 

 carbonates and citrates of the alkaline earths (especially calcium) offer 

 some advantage over those of the alkalies because Ca is excreted for the 

 most part by way of the large intestine and because, since it tends to 

 divert phosphate from the urine to the feces (Rose) a relative as well as an 

 absolute decrease in primary phosphates occurs (Strauss(a)). In his 

 short experiment on alkaline earth waters Heim found no decrease in 

 monosodium phosphate but the diet was not kept constant. But although 

 alkalinized urines possess greater solubility for uric acid, the ingestion of 

 alkaline mineral waters to provide such a condition has little or no effect 



