There are many members of the profession who attach no importance to the occasional appearance of a hyaline cast. But, considering the finding of Professor Senator[225] that such casts are formed by degeneration of the tubular epithelium, we cannot take such a lenient view; for even if we find only one cast in two or three microscopic specimens, we must realize how many thousands of these there may be in a liter of urine. Thus every day thousands of these casts, and in a year enormous quantities, may be lost. But as each cast means the loss of important secreting elements, there can be no doubt that, after a certain time, we shall have lost an important part of these most important organs, whose place is taken by connective tissue. Thus the development of interstitial nephritis can be hastened by faults in our alimentary régime. In cases where meat is taken abundantly it is most probable that the continual excretion from the blood of nitrogenous end-products of metabolism means a serious overwork for the kidneys and grave damage to their epithelium. And still more so if, owing to a diminished activity of the liver due to senile degeneration, toxic products of a higher toxicity than urea, and even uric acid, are passed. Footnote 225: Senator: Loc. cit. We have observed the great frequency of albuminuria and casts in the urine of persons who were addicted for many years to a plentiful meat diet. According to Dr. James Tyson,[226] who has been for many years making accurate observations on diseases of the kidneys, and who has published a standard work on them, interstitial nephritis can be produced after the prolonged ingestion of much meat. If we wish to keep our kidneys in the best condition, a lacto-vegetarian diet with only little meat, once a day, is the most suitable. Still more than meat, bouillon and meat gravies should be avoided, since they contain irritating meat extracts. Footnote 226: Tyson: A treatise on “Bright’s Disease and Diabetes,” second edition, London, 1904. Milk diet in abundance is not only indicated in liver disease, but also in chronic kidney troubles. But when there are coexisting changes in the circulatory system, milk should not be given in large quantities, but in smaller amounts. Milk has also the great advantage of being a strongly diuretic substance, especially in its acidulated forms (yogurth or kefyr, or simple sour milk); and at the same time it irritates the kidneys very little, since it contains only a minute amount of common salt.