uice with crackers or zwieback.

6 P.M. Creamed toast, escalloped potatoes, fruit salad, toast, cocoa,
and cocoa junket.

CHRONIC NEPHRITIS (BRIGHT'S DISEASE)

Chronic nephritis may develop as a sequel to an acute attack, and an
individual suffering from chronic nephritis may at any time develop
acute symptoms. In any case the dietetic treatment would necessarily
have to be made to cover the existing symptoms.

~Dietetic Treatment.~--In cases where the patient has entirely
recovered from uremia but still manifests symptoms of water and salt
retention, the diet would be naturally directed to cover the latter,
at the same time taking care not to strain the weakened functions by
giving more food than could be readily handled. The water and salts
still have to be restricted, but a certain amount of fat and
carbohydrate with small additions of nitrogenous food materials may be
added from time to time as the kidneys show improvement. It must be
borne in mind, however, that at this time it is very easy to overtax
the renal organs and it is safer to err on the side of under rather
than over feeding.

The logical treatment, therefore, consists of utilizing the improved
functions while those still failing to react are getting further rest.

~Adjusting the Proteins in Diet.~--If the individual shows a definite
anemia, as is often the case after acute attacks, either as a result
of the disease itself or the necessarily low diet, which the acute
symptoms of uremia and edema made necessary, other measures are
necessary to bring the body back to a normal condition. It has been
found that in these cases where there has been no permanent damage to
the renal organs, but merely a temporary impairment of the functioning
power, the treatment must be, first, a rest to the affected parts;
second, the temporary restriction of all articles of food which impose
a tax on the kidneys to eliminate; the third, the gradual return to
normal diet as the acute symptoms decrease and the function of the
kidneys no longer shows impairment. Such a case is cited by Strouse
and Perry[127] as occurring in the Michael Reese Hospital. Mr. X.
recovered from the acute stage of nephritis and all signs of edema and
uremia disappeared; the man was kept on a low salt and low protein
diet for a long time. His urine was clearing up, but he did not feel
up to standard and remained anemic. Thinking in all probability that
his symptoms were due to a low protein di