In January 1947, I came to Duke Medical School as professor of medicine, chairman of the Department of Medicine, and physician-in-chief of Duke Hospital. I was directly responsible for the care of staff patients and for any private patients who came to me for medical services. The medical students, interns, and residents supervised the care of the staff patients under guidance from the senior staff and me. They also helped with the care of private patients, both those of my own and of other members of the staff. From the beginning, the students and house staff pointed out to me that edematous patients and patients with malignant hypertension treated by Kempner with his rice diet did better than the patients treated by me with digitalis, diuretics, and moderate sodium restriction. My own observations supported theirs and, with the aid of the Durham-Orange County Heart Association, Bernard C. Holland, MD and