The possibility of an effect of oestrogens on citric acid excretion was first considered by Shorr, Bernheim & Taussky [1942], who found a regular variation in the excretion of citric acid throughout the menstrual cycle. The daily excretion of citric acid in the urine rose to a maximum mid-menstrually, and fell abruptly just before menstruation. They also showed that oestradiol benzoate increased the urinary excretion of citric acid in two girls with primary amenorrhoea, and concluded that a relationship existed between oestrogenic activity and citric acid excretion. On the basis of these findings, Shorr [1945] recommended treatment of renal stone with the synthetic oestrogen, stilboestrol, in order to raise urinary citrate levels and to dissolve calcium salts by forming a soluble unionized complex. Kissin & Locks [1941] had suggested that the lowered excretion of urinary citrate observed in urinary lithiasis was responsible for the deposition of insoluble calcium salts in
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