The fruits likewise show a predominance of base-forming elements over acid-forming elements and for this reason may be used to balance the diet.
Diabetic Acidosis.—The acidosis during diabetes has been already discussed in the chapter devoted to that disease.
It has been found advisable in the majority of cases of acidosis to restrict the fat in the diet of all patients who, during the course of a disease, have given evidence of this condition; at the same time it is well to remember that fat is one of the essential food constituents and absolutely necessary to the welfare of the individual, consequently it is impossible to eliminate it from the diet entirely. The only feasible method, then, to pursue under the circumstances is to restrict the fats in the diet so long as there are symptoms of acidosis and to add them gradually and in very small amounts until the individual’s tolerance for fats is determined.
Balancing the Diet.—In many cases of acidosis due to starvation, no matter what the cause, the diet must be necessarily regulated and properly balanced. It would be decidedly unwise to attempt to build up the body by giving building foods alone, without due consideration to the foods containing the agents provided by Nature to neutralize the acid formed during the process of their metabolism. It is readily 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.