Feast and Famine: The Chronicle of the Stones

Abstract

McCarrison's observations in India on the occurrence of endemic stone there was perhaps the initial stimulus to his ultimate experimental and epidemiological work relating dietary structure to wellbeing or disease. The pattern of occurrence of bladder stone and its associations in India and elsewhere are described. The association with faulty maternal nutrition is established. The eradication of this affliction now from all but the poorest communities indicates the result of greater prosperity and health education. The surge in incidence of renal stone which continued on from the eradication of bladder stone reflects the influence of the dietary structure of affluence on the causation of the primary lesion in renal stone formation — nephrocalcinosis — and on the quality of the urine whereby it becomes stone forming. This lesson of epidemiological and then laboratory research is now being applied in the management of renal stone disease.