Abstract
To the Editor:— Dr. Wishnofsky is correct in that wear-and-tear is not scientific terminology but rather a figure of speech, and the amount of protein does not refer to an irreducible minimum with a diet which contains any protein. Gamble showed in studies of a week's duration that the protein-sparing action of more than 100 gm. of carbohydrate was negligible. However, Kolff found that after 12 to 20 days on a Borst diet, patients did have a slow reduction in nitrogen excretion, indicating a diminution in protein breakdown and an increase in protein-sparing action (probably mostly by carbohydrate) beyond the amount found by Gamble in his short-term experiments. A proteinfree diet, as Doctor Wishnofsky points out, would be of value in cases ofacuterenal failure but not in chronic cases, except in brief acute exacerbations.
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