adily seen
in the table just given that meat and eggs show a marked excess of
acid-forming elements, whereas vegetables and fruits yield an excess
of base-forming elements. With these data, it becomes more simple to
balance the diet and to avoid the acidosis which may arise from
impairment of the fat metabolism of the body.

PELLAGRA

The enormous increase in the number of cases of pellagra in America
during the last twenty years makes it necessary for something to be
done to arrest its progress. The cause of this disease is still under
discussion, but much has been done to find out definitely the reason
for the tremendous increase in the number of cases, especially in the
Southern States, where the increase has been most noticeable.

~Cause.~--This disease has been the subject of much study and
discussion in this country in recent years. Voegtlin, in an article
published in a Report of the United States Public Health Service
(Reprint 597 of Public Health Report), summarizes the current findings
on pellagra as follows:

"1. The hypothesis that there is a causal relation between pellagra
and a restricted vegetable diet has been substantiated by direct
proof to this effect and has led to results of considerable practical
and scientific value.

"2. The metabolism in pellagra shows certain definite changes from the
normal, which point to decreased gastric secretion and increased
intestinal putrefaction.

"3. In the treatment and prevention of pellagra, diet is the essential
factor. The disease can be prevented by an appropriate change in the
diet without changing other sanitary conditions.

"4. A diet of the composition used by the pellagrins prior to their
attack by the disease leads to malnutrition and certain pathological
changes in animals, resembling those found in pellagra. A typical
pellagrous dermatitis has not been observed in animals. Pellagrous
symptoms have been produced in man by the continued consumption of a
restricted vegetable diet.

"5. The nature of the dietary effect has not been discovered, although
certain observations point to a combined deficiency in some of the
recognized dietary factors as the cause of the pellagrous syndrome."

~Dietetic Treatment.~--The diet in pellagra is one which is well
balanced in all its particulars, and one in which the proteins are
carefully adjusted as to type. The best results have been observed on
diets in which the complete proteins (milk, meat and eggs)