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April 1926, Vol 37, No. 4 >
ARTICLE | April 1926

THE THERAPEUTIC USE OF DIETS LOW IN WATER AND IN MINERAL CONTENT

NORMAN M. KEITH, M.D.; FLORENCE H. SMITH, B.S.; MARY WHELAN, M.A.
Arch Intern Med (Chic). 1926;37(4):550-558. doi:10.1001/archinte.1926.00120220100006.
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The importance of a diet low in chlorides for certain cases of nephritic edema was demonstrated by Widal1 in 1903. In his cases chlorides were readily retained, but equal retention of water was not shown. The ingestion of a diet low in chlorides was followed by diuresis and loss of edema. In our experience, in cases of obstinate edema due to renal disease inability to excrete both chlorides and water usually was manifested and thus the so-called salt-free diet failed to produce diuresis and loss of edema. While considering possible dietetic reasons for this failure, we found by analysis that our routine salt-free diet contained a small quantity of chloride, from 2 to 3 Gm., but from 1,200 to 1,400 cc. of water. This amount of water when added to that ingested as fluid, from 600 to 1,000 cc., made the daily intake from 1,800 to 2,400 cc. In revising

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