Pearl Summerfeldt

The comparative value of spinach and tomatoes in the child's diet*

Summary 1. Cooked spinach and canned tomatoes are approximately of equal value as a source of iron for the prevention and cure of nutritional anemia in spite of the fact that the total iron content of cooked spinach is more than three times greater than that of canned tomatoes. 2. Spinach, although it contains 0.19 per cent calcium, an amount 20 times greater than that found in tomatoes, actually tends to produce a negative calcium balance. On the other hand, the retention of the calcium in cooked tomatoes is excellent. 3. The vitamin A content of cooked spinach is approximately 4 times as great as that of canned tomatoes. 4. The vitamin B1 content of cooked spinach is approximately onehalf that of cooked tomatoes. 5. The vitamin C content of cooked spinach is less than one-quarter that of canned tomatoes. 6. The vitamin D content of cooked spinach and canned tomatoes is negligible, it requiring several hundred servings of either to furnish the amount of vitamin D in one teaspoonful of cod liver oil. 7. A very appreciable loss of many of the food elements of spinach may occur in the discarded cooking water, even when the cooking is carried out under ideal home conditions. If these conditions are not observed the loss may be greatly accentuated. On the other hand, there is no water discarded in the preparation of tomatoes for consumption.

Chronic pyuria (congenital defect)—Presacral sympathectomy

Summary A case of persistent pyuria in a female child, thirteen months, old, is presented. This had lasted for several months and was due to a neuromuscular dysfunction of the left ureter and bladder. The case was treated by doing a presacral sympathectomy. One month following the operation, there was a diminished capacity of the bladder and a decrease in the size of the upper third of the left ureter. On discharge the urine still contained organisms, a faint trace of albumin and 1 or 2 W.B.C. per high power field.

Bacteriologic study of pyelitis

Summary 1. In 109 cases of pyelitis the microorganisms isolated from the urine were chiefly species of gram negative bacilli. 2. Similar bacterial species were isolated from the stool and urinein 40 cases of pyelitis. 3. Similar cultures, biologically and serologically, were obtained from 7 cases of pyelitis. 4. Agglutinins for the homologous urine species were demonstratedin the sera of 23 cases of pyelitis, and none in the sera of 25 cases.

Ketogenic diet in persistent pyuria

The ketogenic diet as a treatment of persistent pyuria was first introduced by Clark and Helmholz in 19311. They found that when the acidity of the urine was increased below pH 5 4 the urine became bacteriafree in a short time and in conjunction with this the pus disappeared from the urine. Later Clark2 (1932) demonstrated that this sterilization was not due to the acidity of the urine. In 1933 Fuller3 showed experimentally that the principal factor inhibiting the growth of bacteria in the urine was due to the alpha-beta-hydroxy-butyric acid. This ketone body is inactive at a reaction more alkaline than pH 5-6. Gray4 has reported that he found the ketogenic diet helpful in pyelitis caused by staphylococci. Bell5 discussed the value of the diet as a therapeutic measure. Clark6 reported beneficial results in every one of fifty-three cases which he treated. Rennie7 on the other hand in six cases of pyelitis in children found that ketogenic diet cured two, caused temporary cessation of symptoms with later relapse in three, and was valueless in one. He cites a cure in one adult case. He considers ketogenic diet of little value as a curative agent in pyuria associated with an abnormality of the urinary tract.