CONCERNING LOW PROTEIN DIETARIES 123 



special source of danger, and likely to result in permanent injury. 

 Chittenden brings forward evidence from the observations on his 

 three groups of subjects to corroborate these conclusions, and to 

 show how greatly the different individuals benefited during the 

 period when the protein intake was low. 



As a general criticism, it may be said at once that there is 

 no evidence whatsoever that the consumption of 100 grammes 

 of protein is in any way injurious ; there is no relation- 

 ship between it and high arterial tension, arterial degeneration, 

 and, least of all, between it and the incidence of granular kidney. 

 We shall enter into this in more detail when dealing with the 

 conditions that obtain in the Bengali ; suffice it to say at present 

 that there would appear to be a far greater danger viz., that of 

 malnutrition of the renal epithelium from the lowered or im- 

 poverished condition of the blood which accompanies, and is the 

 direct result of, a low protein dietary. 



This lower vitality permits of invasion of the kidneys by micro- 

 organisms which, under healthier conditions, would have been 

 destroyed. Further, it may be well to point out that, according 

 to Chittenden's views, all excess of nitrogen and amino-bodies 

 beyond that necessary for endogenous metabolism a few 

 grammes daily is rapidly converted into urea by the liver, and 

 thus never has a chance of acting deleteriously on the organs and 

 tissues ; so that, on his own showing, Ihe fear of injurious effects 

 from the protein of diet is groundless. " Per contra," as Hutchi- 

 son puts it, " Chittenden has not succeeded in convincing me 

 that a high protein standard is not possibly beneficial by its 

 specific dynamic effect ; that means that it is stimulant of 

 metabolism that makes for vitality, and that for resistance to 

 disease." 



The general consensus of opinion amongst physiologists and 

 clinicians is against Chittenden's conclusions : it cannot be said 

 to be proved that any benefit to health results from a low protein 

 dietary. In England the number of recruits refused admission 

 into the army is very high, many of them being in poor condition 

 from want of food. The poor, who suffer from defective supplies, 

 are generally stunted, poorly developed, and, for years after 

 reaching adult age, remain incapable of good bodily or mental 

 work.* As we shall have occasion to point out, the quality and 

 sufficiency of the food, and particularly a liberal allowance of 



* Rowntree, quoted by Haig, British Medical Journal, vol. ii., 1911. 



