“…In some of the reported cases the presence of antecedent renal damage has been noted. Carpenter and Pautler (1954) suggest that the chronic milk-alkali syndrome is probably primary hyperparathyroidism with atypical changes due to excess alkali therapy, but, as Kyle points out, it is doubtful if their own case conformed to the syndrome, as no history of excess milk and alkali intake was present.…”