406 HERMAN O. MOSENTHAL 



characterized by marked breaking down of kidney substance, the nephrosea 

 and acute and chronic diffuse nephritides, are not inevitably accompanied 

 by high blood pressure. Janeway believes that, "This fact, to my mind, 

 so argues against the hypotheses that have been cited that I think it is 

 reasonable to dismiss them from consideration." The burden of proof 

 in solving the problem of the relation of a possible internal secretion of the 

 kidney to hypertension certainly must be assumed by the advocates of this 

 rather fanciful contention. 



The Influence of Food Products on Blood Pressure 



There have been researches without number on this subject. Most of 

 them have lost sight of the fact that physical and especially mental relaxa- 

 tion are of the greatest importance in their influence upon lowering blood 

 pressure. The observations in most instances concern themselves with pa- 

 tients in bed or under supervision in sanatoria and all the results obtained 

 are attributed to the diet, which is not correct. Moreover, the dietetic 

 control in most instances is far from ideal and usually does not measure up 

 to the required standards of accuracy. 



Sodium chlorid, proteins and purins have all been accredited with the 

 attribute of pressor substances. 



Sodium Chlorid. There have been many attempts to attribute a causal 

 relation between the salt intake and blood pressure. Lowenstein, among 

 others, believed that this was not correct and the general experience has 

 been that patients on a bland, salt free diet did exhibit a reduced blood 

 pressure while at rest but that the hypertension again manifested itself 

 when normal activity was resumed. A very good illustration of this sort 

 was a middle aged man suffering with mild diabetes, albuminuria and a 

 systolic pressure of 240 mm. of mercury. He was placed on a salt free 

 diet, which was conscientiously carried out as determined by the progres- 

 sively -lower output of salt in the twenty-four hour specimens of urine. 

 The systolic blood pressure dropped to 130 and remained at that level 

 for some time. The patient was then allowed to get up and gradually 

 resume his former occupation. The blood pressure slowly rose approach- 

 ing its former height, although the diet was unchanged. The relief from 

 physical and mental strain were doubtlessly the factors that were effective 

 in reducing the hypertension; the restriction of the sodium chlorid ap- 

 parently had little influence. Recently- Allen (d) has revived the idea that 

 salt is responsible for an increased blood pressure and that very marked 

 effects may be produced by the ingestion of ten grams of sodium chlorid. 

 Some of this observer's cases have a low blood chlorid content ; furthermore, 

 in many patients a paroxysmal rise of blood pressure may be witnessed 

 without the administration of salt so that it is certain that salt is not the 

 only factor concerned. Furthermore, J. H. Short and the author have 



