This is a disease of luxury and intemperance. It is likely to visit people, especially men of past middle age who have for many years indulged in heavy foods, such as rich pastries and puddings, meat three times a day at least, and in large quantities. They have usually indulged in a free use of alcoholic beverages.

The disease is characterized by excruciating pains of the joints of the feet, especially the metatarso-phalangeal, supposed to be caused by deposit there of uric acid and other waste materials. Whether or not this theory of the cause of the disease is correct, the dietetic treatment appropriate for the condition must be clearly evident. In the first place, the gouty patient who would have any respite from his condition must be willing to make a complete reversal of his eating and drinking habits. He should change to a low protein diet, abstemious as well in the quantity of fats and carbohydrates; absolutely all use of alcohol must be suspended, preferably stopped indefinitely. As these patients have usually been very inactive, a change must be introduced in this field of the hygiene as well, and he must begin regular daily exercise in the open air for several hours if possible. This may begin with very light exercise, such as driving, followed by horseback riding, and this in turn by cross-country walks and golf. The influence of baths and of a free use of various mineral waters should not be forgotten in the treatment of this condition.