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These drawings quote Longhi’s most famous genre paintings arthritis in my back and hips diclofenac 100mg on line, such as the Rhinoceros immune arthritis in dogs buy diclofenac in india, and a painting showing an elephant (Ca’ Rezzonico) arthritis knee diet treatment order diclofenac 50mg with amex, and commemorated a tradition of displaying 21 exotic animals in Venice during Carnival arthritis gloves imak buy cheap diclofenac on-line. A further sheet from the Divertimento showing a caged lion is quoted directly from Scenes of Contemporary Life arthritis diet foods not to eat buy 50 mg diclofenac mastercard, although 22 Pietro Longhi depicted a lion during the carnival of 1762 arthritis in back and exercise buy diclofenac 75 mg lowest price. Longhi was most famous for chronicling aspects of the daily lives and entertainments of eighteenth-century Venetians: a genre to which Domenico happily committed himself when he was not obliged to assist his father on grandiose paintings in the family tradition. Quotations from the Work of Venetian Painters from the Fifteenth and Sixteenth Centuries Other Venetian artists evoked by Domenico, albeit fleetingly, are Titian, Paolo Veronese, the Bellini and Carpaccio. Veronese is paraphrased, albeit through Giambattista’s work most notably in the scenes depicting Pulcinella’s wedding scene and wedding banquet. They are primarily re-workings of Giambattista’s compositions 20 Vetrocq (1979), p. Sichterman brought her to Europe where she was publicly exhibited, to great acclaim, for the duration of her twenty-year life. She was an attraction in the Venetian carnival of 1751 where she was immortalised by Longhi. Glynis Ridley, ‘Laying down with the Lion – Carnival in Venice’, Clara’s Grand Tour: Travels with a Rhinoceros in Eighteenth-century Europe (New York: Grove Atlantic Ltd, New York, 2004), (hereafter referred to as Ridley (2004)), pp. According to Ridley, the animal was so tame that ‘for many contemporary commentators and subsequent historians of Venice, the poor beast only seemed to emphasize the fact that this was a once mighty power in real decline. Titian is suggested in two sheets in the Divertimento: the drawing showing Pulcinelli Stealing Apples and Fighting is reminiscent of Titian’s Worship of Venus which depicts a significant tangle of Putti picking up golden apples (Fig. It is a painting which Tiepolo would undoubtedly have known, having worked in Madrid. Titian is more overtly lampooned in the drawing depicting Pulcinella Cattle-Dealers where a bearded figure, in white, wearing a skull cap, whose facial features significantly recall those of Titian in his late Self-Portrait (Madrid) which again Domenico may well have seen during his sojourn in the city. The turbaned Oriental figure which appears no less than sixteen times in the Divertimento is a recontexualisation of a recurring feature in Venetian paintings depicting the near and middle East from the Bellini and Carpaccio. Quotations from Other Artists There are two particularly striking examples of Domenico quoting other Italian artists. The first is Michelangelo Buonarroti’s (1475-1564) famously elegant drawing of Ganymede (Fig. Morassi quotes an excerpt of a letter from Algarotti to Heinrich Count von Brühl, statesman at the Court of Saxony, which describes Tiepolo’s enthusiasm for Veronese’s painting: ‘J’ai consulté particulièrement Tiepolo, qui a étudié toujours et imité si bien la manière de Paul Veronese. Morassi cites Hans Posse, Die Briefe des Grafen Francesco Algarotti an den Sächsischen Hof und seine Bilderkäufe für die Dresdner Gemäldegalerie, 1743-1747 (Berlin: 1931), pp. One of Domenico’s animal studies, the monkey riding a donkey, paraphrases Goya’s studies with monkeys in Los Caprichos, etching 38 Bravissimo! The image of the swing became popular in the eighteenth century, it was most famously depicted by Jean-Honoré Fragonard in 1766. Domenico sends up Fragonard’s gently erotic composition with Pulcinella taking the place of Fragonard’s flirtatious female figure on the swing. Domenico uses the swing elsewhere in his work, in compositions showing a satyr on a swing in one of the Zianigo frescoes, and 24 in an engraving printed by Teodoro Viero in 1791 (Fig. The source for Domenico’s sheet is the twelfth plate of Callot’s the Miseries and Misfortunes of War (Fig. Domenico is documented to have known Callot’s 25 work, although it is nowhere recorded that he possessed the Miseries of War. Certainly the execution and death scenes form a striking, and most extensive, part of the Divertimento and anticipate Goya’s famous painting, the Third of May 1808 (1814) (Fig. For example, the turkey birth may be an indirect reference to the Birth of Christ (Fig. However, according to Paul Barolsky, a hallmark of wit prevalent in Italian art in the fifteenth and sixteenth centuries is its 26 ambiguity. The hatching scene could be understood as a parody of the Virgin Birth for, according to iconographic tradition, an egg is a symbol of creation in ancient and near eastern religions as well as a Christian symbol of the resurrection, and the ostrich’s egg would have been understood by Domenico as symbolising the Virgin Birth. Other childhood and birth scenes have Christological resonance, for example, the drawing showing Pulcinella in swaddling bands is reminiscent of the biblical 27 text. The next drawing, showing Pulcinella’s wedding ceremony is conceivably reminiscent of the fact that Christ’s first miracle was the transformation of water into wine at the Marriage at Cana. Various compositions with Pulcinelli and camels 26 Paul Barolksy, Infinite Jest: Wit and Humour in Italian Renaissance Art (Columbia and London: University of Missouri Press, 1978), (hereafter referred to as Barolsky (1978)), p. This is especially paraphrased in the sheet showing a Pulcinella caravan, which shows Pulcinella with a female figure and child, as though they are exiting the sheet to the extreme right in front of the pyramid. Other scenes which recall the Life of Christ are a Pulcinella Supper which evokes the Last Supper, Pulcinella collapsing by a villa wall (Fig. Most prevalent of the classical resonances in the Divertimento are the 28 allusions to Ovid’s Metamorphoses. For whilst the sheet has Christological inferences, the scene also evokes the story of Leda and the Swan, given that Leda was loved by Jupiter, who came to her in the form of a swan and that, as a result of their union, she laid 29 eggs from which their infants were born. The presence of the racquet in the scene showing Pulcinella in Love could be a reference to a, characteristically witty, subversion of Ovid’s Metamorphoses by Giambattista in his depiction of the Death of Hyacinth which shows Hyacinth having been killed by a tennis ball, as opposed to the 30 discus of the original story (Fig 116). Likewise, Pulcinella Ganymede is a comical re-interpretation of a narrative form taken from Ovid’s Metamorphoses. Ovid describes how Ganymede, a beautiful shepherd-boy, was snatched by Zeus in the form of an eagle and carried off to Mount Olympus. Fehl refers to Giambattista Tiepolo’s interpretation of the Death of Hyacinth, (Fehl, 1979), p. Sheets 97-104 of which 97, 98, 99, 103 and 104 are numbered by 31 Domenico, all deal with the death and burial of Pulcinella. Vetrocq suggests that Domenico may have intended to parody the simultaneously visual and textual convention of rendering 32 deathbed scenes, especially in the ars moriendi. Significantly, among the lots in the Vente Tiépolo catalogue is an emblem book (lot 256), La manière de se bien preparer 33 à la mort (Antwerp, 1700). The Function of Divertimento per li Regazzi Having demonstrated that the drawings in the Divertimento operate on a number of levels, I now wish to consider their function. First, it is worth meditating more generally on the function of drawing within an artist’s studio, and specifically that of the Tiepolo family. Although drawing was eventually to become a significant aspect of the work undertaken in Giambattista’s bottega, according to Knox, prior to the 1740s, Giambattista’s oeuvre appears to have included only a few sheets of drawings, 34 because very few were made. Indeed, the only graphic works from this date are 31 To avoid confusion, I wish to clarify that here I am referring to the chronology of the illness and death sheets as they were numbered by Domenico, thus distinguishing them from the chronology they are given in the illustrations referenced in this thesis which are listed as (Figs. For conventions in eighteenth-century genre painting see, David Solkin, Painting for Money: the Visual Arts and the Public Sphere in Eighteenth-Century England (Yale University Press, New Haven and London, 1993). However, Knox’s view is contradicted by Da Canal in his biography of Giambattista’s master, Gregorio Lazzarini, who states that in the early stages of his career, Giambattista worked on highly finished drawings made for sale to collectors, amongst 36 whom they were in great demand. In the second half of Giambattista’s career, drawings were made, but preserved in his studio with some care, conceivably to act as visual inspiration and so that the painter could bequeath a visual repertory to his sons to enable them to continue with the family business beyond his death. Another purpose for the production of drawings in the artist’s studio would have been as a stage in the production of books and prints. The production of printed material in eighteenth-century Venice was considerable, and the percentage of leading 37 artists making prints was unprecedented. Certainly Giambattista became involved with printmaking early in his career, making copies after sixteenth-century artists for 38 Lovisa’s project. This is significant, for it reveals that copying other artists’ work was a process familiar to the Tiepolos and an accepted part of their artistic production. Similarly the adaptation of an artist’s work from one subject to another was common practise. Boorsch describes for example how the printmaker, Pietro Monaco, worked on making prints after sacred subjects. In the process, he adjusted Giambattista’s painting of the Banquet of Anthony and Cleopatra (1743) by removing Cleopatra’s 39 pearl and renaming it the Banquet of Nabal, thus qualifying it as a biblical subject. Consequently, reusing a work of art and transforming it from a secular to a biblical scene, or vice versa, would have been another familiar process to Domenico and one that he used extensively in his work. Domenico had worked with the engraver Teodoro Viero (1740 1819) in the early 1790s to produce a short series of etchings deriving from Scenes of Contemporary Life. It is therefore conceivable that he may also have been thinking about disseminating the Divertimento in this way. Indeed, the Roman artist, Giovanni Domenico Ferretti (1792-1768) painted a series of canvases, the Disguises of 40 Harlequin (1740-1760), showing Harlequin in various professions and situations. The series was certainly known in Venice because Ferretti’s paintings were engraved by his pupil, Francesco Bartolozzi for the Venetian print-publisher Giuseppe Wagner in 1760, and this may have provided Domenico with the inspiration to produce a 41 similar series using Pulcinella. Although Byam Shaw once suggested that Domenico had intended the Divertimento as a series of etchings, he later dismissed his own hypothesis. This was based on his own assumption that Domenico had neither the need nor the inclination 42 to please a general public or patron. However, in view of the fact that the drawings are highly finished and numbered, one viable hypothesis might be that Domenico was planning to disseminate the Divertimento as a print series. After all, as already discussed the Tiepolos had direct dealings with collectors who, as can be seen in Domenico’s correspondence with Mariette, were often anxious to receive the artists’ 43 etchings. Moreover, they were in touch with the leading connoisseurs of their day and this could account for the high level of quotation in their drawings – if the intended viewers had been amateurs. Additionally, approximately one-fifth of the drawings show the vestiges of charcoal under drawing which give an insight into the way in which Domenico planned and altered his sheets if the drawings were to be examined in their original 44 form. Consequently, it seems that Domenico may have been inventing a ‘game’ for those connoisseurs who would have relished the opportunity to identify in the Divertimento motifs from other works of art a hypothesis which is further explored below. Moreover, the aleatoric nature of the drawings is apparent by the fact that they are difficult to conclusively categorise in terms of theme, narrative and iconography, and demonstrated by the way in which themes merge and conflate. Gealt has suggested that in his biblical drawings, Domenico devised ways of dealing with non linear narrative and that this re-emerges in the Divertimento. It might also form a visual counterpart to musikalisches würfelspiel (musical dice game) a system for 45 using dice to randomly compose music. A further reason as to why Domenico should have quoted from other sources might be that the artist was working on this series as a summation of his artistic life 44 the following drawings show varying degrees of alteration: Pulcinella is born to a Turkey-mother, Pulcinella in Swaddling Bands, Pulcinella with a Leashed Bird, Young Pulcinelli Beg for Treats, Pulcinella’s Wedding Banquet, Pulcinella brings Home his Bride, Pulcinella Learns to Walk, Pulcinella: the Shuttlecock/(Volano) Champion, Pulcinella Goes to School, Pulcinelli at Dinner, Pulcinella Dancing, Pulcinella Chops Logs, Pulcinella Barber, Pulcinella Tailor, Pulcinella-couturier Fits a Lady, Pulcinella Rides a Dromedary, Pulcinella Ganymede, Pulcinelli Hunt Boar, Pulcinelli and Humans Walk in the Rain with Umbrellas, Pulcinelli Firing Squad. Another famous example is Joseph Haydn’s (1732-1809) Philharmonic Joke (1790), and the Paduan composer Antonio Calegari (1797 1828) wrote Gioco Pitagorico (1801) in which he suggests the possibility of composing music using a combination of mathematical formulae and of throwing dice. In view of the artist’s advanced years, and the extended meditation on Pulcinella’s death, the question lingers as to whether Domenico might have been preoccupied with his own mortality, and whether he may have created a witty conclusion to a life devoted to artistic production. This would certainly make sense in view of Domenico’s partial commemoration of other artists’ work and more general themes in Western art. Certainly the Divertimento could be described, albeit anachronistically, in a ‘Proustian’ sense, as Domenico using the work of art to recapture and commemorate the past. A false prestige has come to be attached to the postulation of profound meanings or ulterior 1 motives. In his book, Homo Ludens Johan Huizinga (1872-1945) remains unconvinced that visual art can possess the same quality of playfulness inherent in poetry and music, partially because it is based in matter, and its formal limitations do not allow for ‘the flight into ethereal spaces 2 open to music and poetry. The analysis of sources and themes in the series, undertaken in the previous chapter, read in conjunction with the descriptive paragraphs in the catalogue raisonné entries reveal that the drawings possess playful qualities. Such qualities are apparent in terms of their content, the way in which Domenico made them, and within the broader context of the Tiepolos’ oeuvre. To recapitulate, there is the mass use of the figure of Pulcinella, the archetypal commedia dell’arte buffoon, who infiltrates his way into designs reconfiguring well known stories and themes depicted in Western art, for example, the Life of Christ, Ganymede, and the Triumph of Flora to mention but a few. There are Pulcinella’s playful exploits, most notably his airborne activities: swinging on a trapeze, tightrope walking and his favourite game of volano/shuttlecock (Figs. Domenico is also teasing in the way in which he assembled his drawings by quoting other artists’ works, and in the way in which he tantalisingly leaves vestigial evidence of under-drawing on his sheets – indications of different scenarios as well as minor compositional adjustments, for instance was Pulcinella originally visualized as being born in a stable before he became the progeny of a turkey? There is demonstrably a pervasive sense of playfulness underlying the art of the Tiepolos, and it was this absence of earnestness together with a re-emergence of seriousness in late eighteenth-century art that, according to Philip Fehl, has made it 4 difficult for a contemporary viewer to fully appreciate the artists’ work. Fehl also cites Giambattista’s Rape of Europa which pays homage to Paolo Veronese’s interpretation of the same subject. In my opinion, in its comic quality, it also paraphrases Rembrandt’s Rape of Ganymede. Rembrandt depicts Ganymede as a frightened child, hanging from the eagle’s beak, simultaneously crying and urinating, whereas Giambattista includes Cupid standing on a cloud and urinating into the air at his approaching companions, as Jupiter’s eagle stands gazing upwards, as if in admiration, at the young boy at his side (Figs. There is also Giambattista’s two series of wittily-enigmatic etchings, the 3 Gealt (1986) pp. It evolved in the 1870s when British military officers played a derivative of shuttlecock at Badminton Hall, the Cotswold estate of the Duke of Beaufort; the game subsequently became known by the name of the Duke’s country seat. Shuttlecock is an ancient game which originated in the Far East and which reached Europe by the seventeenth century. See Merilyn Simonds Mohr, the Games Treasury: More than 300 Indoor and Outdoor Favourites with Strategies Rules and Traditions (London: Robert Hale, 1994) (hereafter referred to as Simonds Mohr (1994)). It is evident that the Pulcinella drawings do not fall easily into any particular category. The drawings are ambiguous, containing elements of eighteenth-century genre scenes, Christological resonance, great historical and mythological themes from Western art, citing and occasionally blatantly parodying the work of other artists, and all of which is then thrown into confusion by the appearance of many Pulcinella figures, and the farcical nature of some of their activities. Consequently I propose that Domenico was being deliberately playful when he made the Divertimento. It is my own hypothesis, on account of internal evidence in the drawings, that Domenico was creating a sophisticated visual game for connoisseurial spectatorss. Related to this is the fact that the Divertimento sits most comfortably in the capriccio genre – that of visual jokes. This can be substantiated by unpacking seventeenth and eighteenth-century terms such as capriccio and scherzo, and also by considering examples of these forms, and suggesting their significance to amateurs. In view of musical interpretations of the terms, and other ‘playful’ musical titles that Domenico used in the posthumous publication of etchings of his father’s work, this chapter reflects on the formal qualities of the Divertimento within the context of eighteenth century musical practice and theory, and its similarity, albeit in a visual form, to 5 musical improvisation.

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Over the course of the next thirty years arthritis latest treatments buy diclofenac 50 mg with visa, he watched children’s dentition—and indeed their overall health—deteriorate arthritis treatment vellore purchase diclofenac cheap. Tere were suddenly children whose teeth didn’t ft inside their mouths arthritis in the feet and knees order diclofenac 100mg without prescription, children with foreshortened jaws rheumatoid arthritis physical therapy 100mg diclofenac sale, children with lots of cavities arthritis pain extended relief generic diclofenac 75mg fast delivery. Not only were their dental arches too small arthritis in the knee pictures buy diclofenac 50mg online, but he noticed their nasal passages were also too narrow, and they had poor health overall: asthma, allergies, behavioral problems. His hy pothesis was that these deformities and deteriorations were caused by nutritional defcits. To test his hypothesis, he and his wife, Florence, a nurse, traveled the globe looking for cultures that achieved perfect health in their members. He also found people whose kin had abandoned their traditional foods for “the displacing foods of our modern civilization” with the same results everywhere. In his report on his travels, Nutrition and Physical Degeneration, he wrote: In presenting the evidence I am utilizing photographs very liberally. The pictures are much more convincing than words can be, and since the text challenges many of the current theories, the most conclusive evidence available is es sential. The perfect string-of-pearls teeth in the parents leaned and twisted in their chil dren. He was looking for perfect health: freedom from dental decay and from chronic, degenerative, and infectious diseases across generations. He examined the teeth and overall health of Swiss people in the Alps and Gaels on the Outer Hebrides, Inuit and Cree peoples in North America, and Melanesians and Polynesians in the South Pacifc. Price found a range of human cultures from hunter-gatherers to pastoralists to agriculturalists, and a wide variety of foodstufs. Ron Schmid, author of Native Nutrition: Eating According to Ancestral Wisdom, writes: Tribes eating grains-based natural-foods diets had well-formed dental arches and resistance to infectious diseases, but their physical development, resistance to dental decay, and strength were inferior to tribes eating more animal-source foods. The people strongest physically and often 100 percent resistant to dental diseases were herdsmen-hunter-fsherman. In towns and ports where some groups ate a combination of refned and primitive foods, problems developed, but not to the ex tent occurring when native foods were abandoned entirely. When their diet was displaced by refned agricultural food, “tuberculosis and crippling arthritis became common. The government physician for the islanders stated that in his thirteen years among the native population of four thousand, he had never seen cancer. He had operated on several dozen malig nancies among the white population of about three hundred. In fact, among the indigenous, any conditions requiring surgery were extremely rare. They understood that government Nutritional Vegetarians 189 stores were a danger, and on a number of occasions almost took up violence against such stores. In New Zealand, the Prices met with Maori people at all stages of assimilation to Westernization and documented the same decay of health and increasing vulnerability to chronic and degen erative diseases. He wasn’t distracted by the variations in macronutri ents or by diferences in basic foodstufs. He was able to identify the dietary principles that granted perfect immunity to chronic and degenerative diseases. Writes Schmid, “Price gave us over whelming evidence of natural laws concerning dietary needs, laws that operate in human beings everywhere to regulate immunity, reproduction and virtually every other aspect of health. Schmid writes that “foods from one or more of six diferent groups were absolutely essential. Fats of certain birds and monogastric (one-stomach) ani mals such as sea mammals, Guinea pigs, bears and hogs. Teir food also provided over four times more minerals and 190 The Vegetarian Myth water soluble vitamins. Writes author and activist Sally Fallon, “Price referred to the fat-soluble vitamins as ‘catalysts’ or ‘activators’ upon which the assimilation of all the other nutrients depended—protein, minerals and vitamins. In other words, without the dietary factors found in animal fats, all the other nutrients largely go to waste. Vitamins A, D, K, and E are only available in animal fats, and those fats are neces sary for minerals to be absorbed and for protein to be digested. Other doctors have also observed the near-universal perfect health of hunter-gatherers. Edward Howell, a pioneer in enzyme research, reported on another doctor who lived with the indigenous people near Aklavik (northern Canada), stating, “He has never seen a single case of malignancy. Josef Romig, a surgeon who served both the traditional and assimilated native people in Alaska for thirty-six years. Tat diet consisted of “whale, cari bou, musk ox, Arctic hare, rock ptarmigan, walrus, seal, polar bear, seagulls, geese, duck, auks, and fsh, all often (but not always) eaten raw and fermented. Plant foods eaten were mostly sorrel grasses and fower blossoms preserved in seal oil and the fermented stomach contents of caribou. An elevated number of ketone bodies in the blood and urine is a state called ke Nutritional Vegetarians 191 tosis. The levels of ketone bodies in people eating low-carb diets like the Atkins diet are an endless source of controversy. If the low-carb detractors in both the medical profession and the media knew their biology a little bit better, they’d drop it. Journalist Gary Taubes inter viewed ketosis experts for his groundbreaking New York Times article, “What If It’s All Been a Big Fat Lie? One expert “has shown that both the heart and brain run 25 percent more efciently on ketones than on blood sugar. But what is more interesting is that studies of indigenous people eating essentially nothing but protein and fat “showed no ketosis. Tese native people completely metabolized the fats in their high protein and high-fat diet because many of the fats were raw. This is not surprising since lipase [an enzyme for fat digestion] is found in concentrated amounts in raw, natural fats. Tose members of our species who remembered the value of raw fats—with their enzymes, their intact vitamins—are the ones who have kept the human template undiminished. When Price asked immune groups why they ate the foods they did, the reply was always the same: “So we can make perfect babies. Immune groups ate some fermented foods, which are full of enzymes and pro-biotics; especially nutritious foods were eaten by prospective parents; and any seeds (nuts, grains, tubers) that were eaten were soaked, sprouted, and/or fermented to disable the antinutrients. Phytates, for instance, are present in all seeds including nuts, legumes, and grains. Remember that, generally speaking, plants don’t want to be eaten either, but they 192 The Vegetarian Myth use chemicals instead of locomotion. Phytates bind with minerals in the eater’s digestive tract, making the minerals inaccessible. The body loans itself calcium from accessible storage spots like teeth and bones, on the theory that the food ingested will pay it back. Eating is a promise we make our bodies, and it’s a promise we break each time we eat pro cessed foods, like white four and sugar, that have had their minerals removed mechanically, or untreated seeds like the whole grains being pushed on us as “healthy” from every direction. Seeds soaked in warm water are fooled into thinking that condi tions are ripe for growth. They disable their phytates and their tiny radicles begin their tentative search for soil. People all around the world have fgured out ways to make seeds more digestible through sprouting, rinsing and fermenting them. The long preparation process that some Na tive American tribes use on acorns is another. The widespread use of fat breads made from whole, untreated wheat in the Middle East results in stunted growth and short adult stature: there are too many phytates removing too many minerals in their diets. Of course the food with the most minerals are marine foods, which is why the healthiest people Price found were coastal-dwelling fshing peoples. First runner-up would be land-based mammals, which explains why the hunter-gatherers and pastoralists placed next. Price looked specifcally for indigenous groups that achieved perfect health on plant foods only. Understand the pain level I was living in by then: I couldn’t sit for more than thirty minutes or stand for more Nutritional Vegetarians 193 than ten. Every daily task had to be broken down into the smallest activities, separated by endless stretches of lying down. One extra load of laundry or a long line at the bank and pain would eat my life to the bone. Fourteen cultures where teeth and bones held through their lives, all the way to the end. Tere was an exact moment when knowledge took hold, and it was cold clean through: I had done this to myself. Now, combine that with the poor-quality plant protein of vegetarian and especially vegan diets. Your brain would like you to know that all of your neurotransmitters are made from amino acids. Whatever happiness you’ve been allotted in life will only be felt through protein. And, as nutritionist Julia Ross points out, “Most vegetable foods contain much less tryptophan than animal-derived foods. I had a full-blown anxiety disorder by the time I was done, and I lost most of my youth to the dull, gray noth ing of depression. When the tiniest task is inexplicably overwhelming, and the world is all surface, repulsive and fat, the self is a cage. One of my colleagues wrote, A bunch of my vegan friends would eat candy and make disgustingly sugary concoctions of various kinds. And then later I fgured they probably craved sugar because of their various nutrient defciencies. The frst is that on a diet of carbohydrate, they’re bound to be hypoglycemic, and when blood sugar is falling, there is a terrible imperative to get it back up. And because their food doesn’t contain any quality protein, their brains are desperate for serotonin and endorphins. Endorphins are a collec tion of brain chemicals that “transmit enjoyment, contentment, and euphoria. But a sugar hit will trigger an adrenaline rush which sends your endorphin levels up temporarily. And anyone who isn’t eating enough good quality protein is also at risk for serotonin depletion—i. Even the good sources of tryptophan have been virtually destroyed by industrial agriculture. Tere should be more tryptophan than there is in our meat, eggs, and dairy: probably three times as much. Hence, the animal products that should keep our brains happy are defcient once again because of grain and factory farming. Julia Ross points out that “tryptophan Nutritional Vegetarians 195 has been diminishing from our food supply for the past one hun dred years, about as long as our rate of depression has been climb ing. Insulin moves through your bloodstream, sweeping up sugars, fats, and amino acids, and transporting them into your cells for storage. With all the other amino acids out of the way, trypto phan suddenly has no competition in crossing the blood-brain bar rier. Hence, for a brief time, a serotonin-deprived brain gets some desperately needed tryptophan. We don’t have a word in English that encapsulates the concept of vital force or life energy. Tere’s a tipping point for all of us: once that vital energy is gone, you don’t get it back. Of course the author takes it as self-evident that this can’t be true: such people simply “weren’t eating balanced meals. The posters, of course, can’t let themselves believe that a vegetarian diet might cause harm to anyone’s body: we all can and should be vegetarian, if not vegan, and anyone who suggests otherwise is a heretic. And I will live in life-altering pain for the rest of my days because I be lieved and believed and believed in veganism. How did the traditional foods recognized as essential, if not sacred, since forever get demonized by our cul ture? Tat history has been documented by writers like Gary Taubes and Ron Schmid, and a full recounting is beyond the scope of this book. As the industry grew, farming as a lifestyle declined; forty percent of Americans lived on farms in 1900, compared to less than two percent today. Today, a few corpora tions produce nearly all our chickens through a system known as vertical integration: a single corporation owns all stages of Nutritional Vegetarians 197 production and marketing. When Schmid says “locally grown food” that means an actual farmer raised it, instead of a corporate-owned factory producing it. Tat farmer would have been your neighbor, a member of your faith community, an ofcial on your local school board. Tere was a moral economy of social capital that un derlay the economic exchanges. Tose local communities and the bonds of care they both created and depended on have been de stroyed by the corporate takeover of our food supply. Look at the numbers Schmid supplies: local farmers are down from 40 percent to 2 percent. And those 2 percent, growing price-fxed commodities and committing suicide, might as well be serfs.

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Alpha lipoic acid reduces expression of vascular cell adhesion molecule-1 and endothelial adhesion of human monocytes after stimulation with advanced glycation end products. Endothelial dysfunction and intima-media thickness in relation to cardiovascular risk factors in patients without clinical manifestations of atherosclerosis. Effect of tobacco smoking on endothelial function in patients with coronary arteriosclerosis. Endothelial dysfunction in patients with exaggerated blood pressure response during treadmill test. Endothelial function and carotid artery wall thickening in patients with early essential hypertension. Hypercholesterolemia and hypertension have synergistic deleterious effects on coronary endothelial function. Insulin impairs endothelium-dependent vasodilation independent of insulin sensitivity or lipid profile. Molecular mechanisms of impaired endothelial function associated with insulin resistance. Endothelial dysfunction and increased arterial intima-media thickness in children with type 1 diabetes. Effect of exercise training on endothelial function in men with coronary artery disease. Cytosolic triglycerides and oxidative stress in central obesity: the missing link between excessive atherosclerosis, endothelial dysfunction, and beta-cell failure? The relationship between insulin resistance and endothelium-dependent vasodilatation in obese subjects. Chronic infections and the risk of carotid atherosclerosis: Prospective results from a large population study. Educational attainment, anger, and the risk of triggering myocardial infarction onset. Measuring plasma fibrinogen to predict stroke and myocardial infarction: An update. Measuring plasma fibrinogen to predict stroke and myocardial infarction: an update. Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease. Markers of myocardial damage and inflammation in relation to long-term mortality in unstable coronary artery disease. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. Impaired glucose tolerance and cardiovascular disease: the possible role of post-prandial hyperglycemia. Serum ferritin levels and other indicators of organic iron as risk factors or markers in coronary artery disease. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. Chronic selective hypertriglyceridemia impairs endothelium-dependent vasodilatation in rats. Influence of postprandial hypertriglyceridemia on the endothelial function in elderly patients with coronary heart disease. Marked elevation of myocardial trace elements in idiopathic dilated cardiomyopathy compared with secondary cardiac dysfunction. Cardiac and electrocardiographical manifestations of acute organophosphate poisoning. Medical care costs and quality of life after randomization to coronary angioplasty or coronary bypass surgery. Diet, lifestyle, and the etiology of coronary artery disease: the Cornell China study. Serum lipid levels and the severity of coronary and cerebral atherosclerosis in adequately nourished men, 60 to 69 years of age. Relationship between serum lipids and aortic atherosclerotic lesions in sudden accidental deaths in Guatemala City. Relation of serum total cholesterol and triglyceride levels to the amount and extent of coronary arterial narrowing by atherosclerotic plaque in coronary heart disease. The relation of antemortem characteristics to cardiovascular findings at necropsy. The function of aldosterone in patients with diabetes, American Family Physician, Sept 1, 2003. Economic implications of evidence-based prescribing for hypertension: can better care cost less? Reduction in mortality of persons with high blood pressure, including mild hypertension. Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Morbidity and mortality in the placebo-controlled European Trial on Isolated Systolic Hypertension in the Elderly. Randomised trial of treatment of hypertension in elderly patients in primary care. Medical Research Council trial of treatment of hypertension in older adults: Principal results. Nutrient intake and serum cholesterol level in normal children six to 16 years of age. Dietary studies and the relationship of diet to cardiovascular disease risk factor variables in ten-year-old children—the Bogalusa heart study. Serum cholesterol: Its distribution and association with dietary and other variables in a survey of 10,000 men. Effect of different antilipidemic agents and diet on mortality: A systematic review. Slide presentation at: National Institute of Health Bioavailability Conference; January 5, 2000. Prescribing aerobic exercise for the regulation of postprandial lipid metabolism: Current research and recommendations. Effects of flavonoids on the susceptibility of low-density lipoprotein to oxidative modification. Some aspects of the in vivo neuroprotective capacity of flavonoids: Bioavailability and structure-activity relationship. Rivlin of Memorial Sloan-Kettering Cancer Center and Weill Medical College of Cornell University in New York quoting Nutrition in Clinical Care August 2000;3:145-152. Endothelial dysfunction induced by postprandial lipemia is neutralized by addition of proteins to the fatty meal. Blocking carbohydrate absorption and weight loss: a clinical trial using Phase 2 brand proprietary fractionated white bean extract. Low levels of endogenous androgens increase the risk of atherosclerosis in elderly men: the Rotterdam study. Effect of genistein on endothelial function in postmenopausal women: A randomized, double-blind, controlled study. A Randomized Controlled Trial of Stress Reduction for Hypertension in Older African Americans. Usefulness of the transcendental meditation program in the treatment of patients with coronary artery disease. Maina and Juliette Crepin Department of Botany National Museum of Natural History Smithsonian Institution Washington, D. The three Guianas comprise, from west to east, the countries of Guyana (area: 83,000 square miles; capital: Georgetown), Surinam (area: 63,251 square miles; capital: Paramaribo), and French Guiana (area: 35,135 square miles; capital: Cayenne). Evidently the earliest physical contact between Europeans and the present-day Guianas occurred in 1500 when the Spanish navigator Vincente Yanez Pinzon, after discovering the Amazon River, sailed northwest and entered the Oyapock River, which is now the eastern boundary of French Guiana. As early as 1503 French colonists attempted to settle the island upon which Cayenne is built. Within the boundaries of today’s Guianas, the land was originally occupied by Amerindians of Carib and Arawak language-families, and from the late 1500’s onwards was almost interchangeably settled by Spanish, British, Dutch, and French traders, adventurers, agriculturists and colonists. Gradually the land was sorted into areas controlled exclusively by either British, Dutch or French interests. The former British domains became independent on May 26, 1966 as the Cooperative Republic of Guyana, and the former Dutch domains became independent on November 25, 1975 as the Republic of Surinam. French Guiana became an Overseas Department of France in 1946 and is an integral part of France. Many of the species of tropical medicinal plants utilized at present in the Guianas were introduced in historical eras, and under circumstances, which seem the distance of a universe away from the conditions that often prevail today. The earliest European acquaintance with tropical vegetation had actually been the result of Alexander the Great’s invasion of northern India in 326 B. Information about the wondrous banyan fig tree with its dangling aerial roots flowed back to Greece and was recorded by the classical Greek scholar Theophrastus. The impressive Indian vegetation was soon largely forgotten by Europe; indeed, the literature was later sometimes suppressed for being of pagan (non-Christian) origin. The first travelers came to South America primarily in search of gold, spices, and th new souls for the Church, for in the 16 century, the divine scheme of the universe was the redemption of sinners in a disobedient world prior to the second coming of Christ. Thus the discoverers, after praying to the Madonna of the Navigators for protection, sailed to bring news of “The Redeemer” to the “misguided” peoples of America. It required many years to acknowledge the existence of South America and fit it into the already established “triple-world” cosmography of Asia, Africa and Europe, an i Medicinal Plants of the Guianas (Guyana, Surinam, French Guiana) essentially Mediterranean-oriented concept of the globe. A four-part world was gradually th accepted in the 16 century, comprising the four great land masses of Asia (formerly one half the world), Europe (formerly one-quarter of the world), Africa (formerly perceived to be one-quarter of the world), and America as a fourth continent often signified by the River Plate (now Argentina). The Amerindians indigenous to the Guianas in the 1700’s lived in relative ecological harmony with their forested surroundings and had a rather thorough knowledge of the use of plants. In contrast, the first Europeans in the area often felt themselves imprisoned in an impenetrable and meaningless green blanket, as they eked out a living from the forest. The perceived role of man in the forest was early studied and influenced by the famous French naturalist, Count George-Louis Leclerc de Buffon (1707-1788), who produced in 44 volumes the encyclopedic Histoire Naturelle (published in Paris, 1749 1804). Buffon was the intendant (supervisor) of the Jardin du Roi in Paris from 1739 1788; during his tenure the South American expedition of C. Buffon was deeply interested “in the changes which men had made in their natural environment, particularly the transformation which had accompanied the growth and expansion of civilization and the migration and dispersion of human beings and their domesticated plants and animals throughout the habitable parts of the earth” (Glacken, 1960). In the days of Buffon (long before the ‘greenhouse effect” was understood), many people believed that Nature is of divine origin and must be improved and arranged by Man, who is also of divine origin. This led to several erroneous theories, including the idea that humanity must aid Nature by changing it through deforestation so that more of the sun’s heat could warm the earth’s surface, and compensate for the heat lost due to the cooling of the earth. Thus, Buffon’s studies of the physical effects of man’s intervention in the world environment led him to consider the climatic changes that occurred as a result of land-clearing, agriculture and drainage, as being in a beneficial context. Buffon’s viewpoint, as expressed by Glacken (1960), was that, for 3,000 years, “Flowers, fruits, grains, useful species of animals have been transported, propagated, and increased without number; useless species of animals have been eliminated. Unfortunately, for partial proof of this theory he chose to indicate “the deforestation, scarcely a century earlier, of a district around Cayenne (there are many references to French Guiana throughout the Histoire Naturelle), which caused considerable differences in air ii Medicinal Plants of the Guianas (Guyana, Surinam, French Guiana) temperature, even at night, between the cold, wet, dense forest into which the sun seldom penetrated and the clearings; rains even began later and stopped earlier in them (clearings) than in the forest” (Glacken, 1960). Lawrence valley in North America (also with French settlements): “The theory was the forests held the cold; once the land was cleared and brought into cultivation, the climate would then become like that of France” (Dickason, 1984). An article on forest conservation was published by Count Buffon in 1739, as he also believed that deforestation could be reconciled with conservation under certain locally mitigating circumstances. Essentially, he felt that “large areas inimical to man had to be cleared to make the earth habitable, but once societies were established on them, the forests were resources which had to be treated with care and foresight. The judicious exploitation of indigenous medicinal plant resources following careful inventorying of species and habitats in the Guianas will hopefully assist the economic development of the region. Much conservation work in the Guianas is currently sponsored by the Biological Diversity of the Guianas Program of the Smithsonian Institution, and by the Amazon Conservation Team headed by ethnobotanist Mark Plotkin. As the Europe of earlier times became intrigued by the human inhabitants of the New World, the Amerindians were gradually incorporated to an extent into European culture. The famous natural historian Alexander von Humboldt, for example, noted in the early 1900’s that “when we speak in Europe of a native of Guiana, we figure to ourselves a man whose head and waist are decorated with the fine feathers of the macaw, the toucan and the hummingbird. Our painters and sculptors have long since regarded these ornaments as the characteristic marks of an American” (Honour, 1975). Inevitably, New World plants were destined to play a much more important role in European like than would American tribal peoples and wildlife. Useful plants of New World origin sent to Europe from 1493 onwards included maize (Indian corn), tobacco, sweet potatoes, tomatoes, vanilla, cotton, chocolate, red peppers and pineapples. The annatto plant, Bixa orellana, which is sometimes used for medicinal purposes in the Guianas, produces a seed from which a food-coloring paste is derived.

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For sedentary persons arthritis medication and high blood pressure diclofenac 100 mg low price, increased physical activity will improve both physical fitness and food utilisation arthritis uk back pain exercises order diclofenac 75 mg with amex. Some clinicians prefer that the patients adhere to the dietary and life style changes arthritis diet not to eat buy discount diclofenac 100 mg, which have been found to reduce the serum cholesterol in a number of studies arthritis in fingers numbness buy diclofenac 50mg visa. A low fat good shoes for arthritic feet generic diclofenac 75 mg on-line, 1600 calorie diet to maintain one’s ideal body weight has been presented in table 29 arthritis in lab dogs purchase diclofenac toronto. The possibility exists that the medications used to alter the blood lipids may cause long-term negative effects. It is important to discuss these aspects with your doctor and take remedial steps suggested by him/her. Heart and Blood Vessels Diseases Therapy in ailments of heart and blood vessels involves nutritional care. Hypertension is the most common problem in humans in India, though almost seventy-five per cent of the cases are mild. Normal blood pressure is less than 140mm Hg Systolic and less than 85mm Hg diastolic. Hypertension has many causative factors though in 90 per cent of cases, the cause is unknown. Atherosclerosis (narrowing of the arterial walls due to deposits of fatty material) causes resistance to blood flow, making the heart to pump harder, thus increasing the blood pressure. The increase in blood pressure injures the arteries further, thus worsening the atherosclerosis. Nutrition in Cardiovascular Diseases 309 Therefore, it is essential to bring the blood pressure back to normal, to prevent the damage to the circulation system. Diet Therapy: Hypertension may be often due to obesity, because the increased weight means increasing work of the heart to supply blood to the extra tissue formed. For many overweight hypertensive people, dietary changes which result in weight loss will lead to reduction in blood pressure. The second possibility is excessive sodium intake, which draws more water into circulation, thus increasing blood volume, leading to increased blood pressure. There are about 20 per cent people who are sensitive to sodium and may be affected by excess sodium intake; other 80 per cent appear to be relatively free from the adverse effects of excessive sodium intake. Research studies have shown that increase in potassium intake can lower blood pressure. It is important to remember that blood pressure control is one of the most effective ways to decrease mortality in adults. In patients, whose only problem is mild hypertension (diastolc pressure of 90-94 mm Hg), therapy without use of drugs is used to achieve control. This includes: (a) Moderate sodium restriction (1000-1500 mg/day): No salt in cooking or at the table. Potassium is present in higher concentration than sodium in fruits and vegetables by a factor of 5 to 50 fold. Hence intake of three to four servings of fruits, which need no preparation (hence no addition of salt), can ensure adequate potassium intake. It involves regular planning of one’s activities allowing realistic scheduling of work, relaxation, physical activity, mealtimes, prayer/meditation and rest. This removes the stress from one’s days, as there is time available for each aspect of the day. Thus one does not rush from one activity to the other, gulp down food on the run or skip meals. They are worried and tense all through the day, because so many tasks are unfinished due to no planning or poor planning. A planned, enjoyable routine of each day is the most important part of therapy to stress management. If one cannot follow it, alcohol intake must be restricted to occasional 2 oz limit. Sodium Restricted Diets Most people’s daily intake of salt is 3-7 g (3,000-7,000 mg). Levels of sodium restriction commonly prescribed are: (a) 500-700 mg is severe restriction. A small plastic spoon (given with ice cream cups at stores) could be used to add salt in cooking, instead of a teaspoon to avoid excess sodium. Sources of Sodium in the Diet All living things, plants and animals require some sodium. Hence all foods contain some sodium, even before they are processed or cooked in the home. Eggs are especially high in sodium (most of sodium is in the egg white) Most vegetables which are low in sodium, are permitted in the diets restricted to less than 1000mg; but not beets, spinach, chad and kale, which contain large amounts of sodium. Fruits, unsalted butter, unsalted cereals and breads, oils, sugars can be used without restriction, as these contain very little or no sodium. This list may be useful in selection of foods to be included in sodium-restricted diets. Salt contains 40 per cent sodium, so a teaspoon of salt, which weighs 6 g, contains 2. So if a teaspoon of salt is added to a recipe which serves six persons, each person would get 400 mg in the serving. Nutrition in Cardiovascular Diseases 311 Sodium compounds used in food preparations: Soda or sodium bicarbonate used in baking and food preparations. The exchange list for meal planning (Appendix B) may be modifiedfor sodium restricted diet. Food Preparation for Sodium Restricted Diet It takes about 3 months to get used to a sodium restricted diet. Angina Pectoris Narrowing of arterial lumen and hence insufficient blood supply to the heart causes angina pectoris. It manifests by tight chest pain, often shooting pain in the shoulder, arm and hand. Physical exertion, excitement, the pressure of digesting a heavy meal or sudden exposure to cold wind may precipitate it. Myocardial Infarction An infarct is necrosis (dead) local area, due to lack or poor blood supply resulting in the death of cells. When such an infarct forms in the heart, it is known as myocardial infarction (or heart attack). If the infarct (cluster of dead cells) is small, the rest of the tissue may heal, but the infarct leaves a scar. But if more infarcts are formed, the ability of the organ is continuously reduced, which may imperil life. Acute Stage: Care is highly individualized, suited to the condition of the patient. Diet: For 24 to 48 hours the patient is only given parenteral dextrose and no food is given by mouth, but sips of cool water are given. After that low fat liquid diet (500 to 800 calories and 1000 1500 ml fluid diet) is given in very small feeds for 2 to 3 days. The patient progresses to a soft diet (about 1000-1200 calories), which may help establish circulation needed for digestion and absorption of food. The fat content of the diet is less than 30 per cent of total calories, with less than. The sodium is restricted to less than 1000 mg for a congestive heart failure patient, while it may be mild for less serious condition. The patient is gradually helped to progress to maintenance diet, before leaving the hospital. The patient is helped to get used to a low salt diet, low cholesterol diet so that the recurrence of heart attack is prevented. Congestive Heart Failure In this condition, the heart is unable to maintain sufficient circulation to tissues. Kidneys are unable to excrete sodium normally, resulting in accumulation of sodium in extracellular fluid and water retention. This results in at first of the extremities and later the abdomen and the chest retaining water and swelling. The gastrointestinal tract and hence, digestion slows down due to reduced blood supply. Nutrition in Cardiovascular Diseases 313 Diet: the workload of heart must be reduced. In addition severe sodium restriction (500 – 1000 mg) and fluid restriction may be advisable. Write notes on: major risk factors leading to cardiovascular diseases, desirable serum lipid levels, steps to monitor serum lipid levels, saturated and unsaturated fatty acids. Write short notes on: Hypertension, atherosclerosis, stress management, sodium-restricted diets, sources of sodium in the diet, myocardial infarction. D to Calciferol Causes of Kidney Diseases: Inflammation and Degeneration, Other Diseases Damage Kidney Function, Chemical Damage & Infection and Obstruction Kidney Ailments Glomerulonephritis: Diet Therapy Chronic Glomerulonephritis: Diet Modifications Nephrotic Syndrome: Diet Modifications Acute Kidney Failure: Diet Modifications Chronic Renal Failure: Dietary Modifications, Energy, Protein, Minerals & Fluid Dialysis, Kidney Transplant Kidney Stones: Diet therapy Calcium Stones, Oxalate Stones, Uric Acid Stones Prevention of Kidney Stone Formation Introduction Like the liver, kidneys play a vital role in maintaining the body’s normal state (homeostasis). Bowman’s capsule (a cup shaped top of the nephron) with a network of capillaries called the glomeruli (plural of the word glomerulus) in it, and the renal tubule. The tubule is a long winding tube, the first part of which surrounds the glomerulus. The fluid is driven by a pressure gradient from glomerulus into the tubule and the filtration begins. As the filtrate moves along, the materials needed are returned to the blood and waste material is carried to the bladder for storage and discharge at normal intervals. Diet and Nutrition in Kidney Diseases 315 Each nephron functions independently to produce urine. But the volume of plasma filtered by two million glomeruli amounts to a formidable 150-180 liters in 24 hours. This means that over 99 per cent of the filtered water, all the glucose and vitamin C, almost all amino acids, sodium and other substances are returned to the blood. But if the intake of salt exceeds the body’s needs the excess is excreted and extra water is needed to excrete it. Functions of Kidneys the kidneys help to regulate the internal harmony by performing the following functions: 1. Filtration: the kidneys are the filters through which all dissolved substances pass and selectively absorb those to be retained. The end products of protein metabolism (urea, creatinine, uric acid and urates) are removed from blood by filtration to be discarded in urine. Excess of chloride, potassium, sodium and hydrogen ions are also filtered out from the blood. By being selective filters, kidneys try to maintain a constant blood composition and volume. Ions from the blood are secreted into the urine to maintain acid-base balance In this process they monitor the composition and volume of blood and other body fluids. Kidneys maintain fluid electrolyte and acid-base balance as they carry out selective filtration. Excretion: the kidneys excrete dissolved unwanted substances filtered out of the blood as urine. Kidneys produce erythropoietin (a hormone), which stimulates maturation of red blood cells in the bone marrow. The conversion of vitamin D to its most active form calcitriol occurs in the kidneys. Activated vitamin D regulates the absorption of calcium and phosphorus and thus helps regulate calcium and phosphorus levels in the blood. When kidney function is disturbed due to disease or trauma, all the above functions are affected adversely. Habitual intake of high protein diet may increase the work of kidneys and cause damage. Reducing weight, decreasing protein intake to normal level can decrease the risk of kidney disease. Bacterial infection in urinary tract may cause mild discomfort, which can be alleviated by medication, if treated promptly. Kidney stones may block drainage and may cause further infection and tissue damage. Diet therapy in renal disease is based on the nature of the disease and individual response. Kidney Ailments Any disease that affects the function of the glomerulus or tubule disturbs the body’s ability to utilise food and can cause havoc. Glomerulonephritis Nephritis is a general term used to indicate inflammation of the kidneys. An acute form of glomerulonephritis often follows a streptococcal infection of the respiratory tract, tonsillitis, pneumonia or scarlet fever. If the infection is very mild, it may not be detected and treated, resulting in permanent damage to the system, which may be detected after many years. The symptoms include nausea, vomiting, fever, rise in blood pressure, albumin (proteinuria) and small amounts of blood in the urine (hemanuria) and edema. Diet Therapy: When there is nausea and vomiting in the acute stage, sweetened fruit juices, sweetened tea, ginger-lemon sherbet, high carbohydrate, low electrolyte supplements are given. As soon as the patient is able to eat, a diet to maintain weight containing sufficient calories is given. Chronic Glomerulonephritis It can either be an untreated acute glomerulonephritis or an immunological cause of unknown origin. In the early stages, abnormal urine analysis results such as protein, red and white blood cells are observed in the urine. As the ailment advances, the patient may suffer from tiredness, edema, increase in blood pressure and blurred vision. As the kidneys cannot concentrate urine, there is frequent urination and need to urinate often in the night, thus disturbing sleep. Diet Modification: the diet must be planned to suit the patient’s kidney capacity.

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