With such a record of cases I have not been able to escape the conclusion that whilst the purin-free diet is occasionally an admirable method of treatment in chronic cases of disease, it is not suited as a dietary for ordinary purposes of nutrition in everyday life. The cases admirably illustrate the old adage that "every man is a law unto himself," and demonstrate the fact that most of them were extremely susceptible to the action of excess of purins in the diet; that when these were cut off completely, freedom was obtained from their particular malady; but that when malnutrition arose, their troubles returned with the old force. When they cautiously adopted a diet containing their old protein forms of food, with a minimum of purins, then they regained their health and strength, and because they were capable of dealing with all the purins they ingested, kept free or comparatively free from their malady. It is not necessary to suggest that this was due to an excess of uric acid in the blood or tissues, but simply that for some reason or other, probably toxic, they were unable to deal with these particular foods.

With this experience to guide me, I am now in the habit, in all chronic cases of disease in which the ordinary methods of treatment have yielded no good result, of cutting off all xanthin-containing and purin-containing articles of diet, which are at the same time non-nutritious or practically so - and this includes tea, coffee, meat soups, beef-teas and gravies.

The first three contain methyl-purins, which, although they add no uric acid to the excretions, increase very largely the total urinary purin-content. Nothing is lost by this means, because it has been proved that purins yield no potential energy and exert no influence on the circulation or nervous system, although they may temporarily remove feelings of fatigue, and because of their peptogenic effect slightly aid digestion. But they undoubtedly throw a great deal of extra work upon the organs of excretion, and thus cause a loss of energy, and by increasing the complexity of the digestive processes are liable to form toxins. I am strongly of opinion that when all these food accessories have been expunged, or nearly so, from the diet list, very little harm can result from the other purin-containing elements; and as these are chiefly proteins to which our digestion and tissues are accustomed, their deprivation is not lightly to be recommended - a fact which has been abundantly demonstrated in the series of cases I have just detailed. The conclusion of the whole matter would appear to be that the man who lives on simple diet in a moderate way is perfectly well able to deal with all the purins with which he is likely to meet. Octogenarians of all classes always declare that they owe their long life to the use of a simple, moderate diet, not depriving themselves of any ingredients, but using all cautiously, and indulging in hard work, many of them in the open air.