METABOLISM IN NEPHRITIS 407 



attempted to duplicate Allen's results and have not succeeded in raising 

 the blood pressure by the administration of ten grams of salt. It is prob- 

 able that the influence of rest, relief from nervous strain, and confidence in 

 the treatment are the elements that relax the blood vessels and lower the 

 blood pressure, and that the sodium chlorid in the amounts in question is 

 of very little or no importance. 



A low protein diet is not effective in lowering blood pressure or a high 

 protein diet of raising it. At least this is the case in observations carried 

 out over a period of few weeks (Mosenthal(/) ). A sub-caloric regime pur- 

 sued in normal persons for a long time will result in a lowering of blood 

 pressure (Benedict and collaborators). This phenomenon is accompanied 

 by a depression of the vitality and efficiency of such individuals and the 

 diminished arterial tension is probably an expression of the general state 

 rather than a specific effect of low protein feeding. The work of Hecht 

 and Loeb(a) are often quoted in this connection, but neither the results ob- 

 tained nor the methods of observation in these papers are sufficiently 

 striking to draw any specific conclusions as to the effect of diet, upon blood 

 pressure. 



' As to the influence of purins upon arterial tension, it may be suffi- 

 cient to quote the experience of Sir Clifford Allbutt(a) in this connection: 

 ". . . 'again and again I have placed high-pressure patients on purin-free 

 diets, or on vegetarian diet with cheese, milk and eggs, with no appreciable 

 reduction of blood pressure within such limit of weeks as to satisfy the 

 conditions of an experiment." 



Recently the author has seen a few cases in which a reduction of an 

 excessive carbohydrate intake, as indicated by a high blood sugar in non- 

 diabetic patients, resulted in a material reduction of blood pressure. 

 Whether these were accidental relations or are of any real significance 

 remains to be determined. 



In conclusion, it may be said that at present there are no definite facts 

 that point to any of the food substances as having a causative relation to 

 blood pressure. Much remains to be accomplished in regard to this prob- 

 lem, as most of the observations thus far published, although very nu- 

 merous, lack accuracy and proper control periods. 



Lesions in the Glomeruli 



This subject deserves brief mention inasmuch as Volhard has lately 

 stressed glomerular lesions as the main cause for increased blood pressure. 

 He believes that the effect of the blood flow through the glomeruli has a 

 reflex influence upon the other vessels in the body ; when there is any inter- 

 ference with the current flowing through the glomerular capillaries, an 

 increased tone of the arteries and arterioles is brought about through re- 

 flex paths and hypertension is the result. When there are no glomeruli 



