After three or four days I cut from this list the bread; in a day or two more the potato and in one or two days more the raw cabbage, cauliflower, beans, onion, raw tomatoes, radish, celery, fruit, oysters and clams, and limit the amount of meat eaten to a small portion. If possible, this closely restricted diet is adhered to for one or two weeks, during most of which time sugar will have been absent from the urine. Moreover, during this time a readjustment often takes place which permits a normal metabolism of a limited amount of starch. A variable period of two to six weeks may follow when a more liberal diet is permissible (similar to that outlined above or often with only one kind of any food rich in starch, such as potatoes or wheat-bread or squash or carrots). However, it is best at least once a week during it to prescribe a day when only a minimum amount of meat or eggs and green vegetables are permitted. This may be outlined as follows: tea, coffee, boullions, spinach, lettuce, asparagus, cooked cabbage, sea-kale, endive, water cress, cucumber, two eggs and a small portion of chicken or fish, butter and olive oil. In the severe cases, periods of closely restricted diet must be alternated with the more liberal diet. In the mildest cases a modicum of starch may be permitted over long periods but the urine should be examined frequently and if sugar reappears in it, a period of restricted diet should be instituted.

In mild cases at first for many months at a time it is easy to exclude sugar from the urine by very moderate dietetic management but as time goes by, when it appears, it gradually becomes more and more difficult to eliminate it from the urine and more and more difficult to keep it from reappearing. This condition is usually developed several years, often ten or more, after the disease began. Usually by this time traces of albumen appear in the urine either from time to time or continuously and hyalin and a few granular casts are also discoverable. Blood tension is higher and frequently the heart is somewhat hyper-trophied. Under these circumstances it is safest to permit the eating of a modicum of starchy food most of the time, but if the sugar at any time becomes considerable, it is well to prescribe a period of nonstarch and sugar-bearing foods to be followed by one of the oatmeal or potato diet or an exclusive milk diet. Thus at first affecting a reduction of glycosuria and later resting 27 the kidneys from excessive nitrogen elimination. The carefully prescribed mixed diet can usually be resumed with safety for a time. The total quantity of food eaten at this time must be limited carefully. The bowels must be kept open, much exercise must be avoided and everything possible done to lessen arterial tension and to prevent any sudden heart or vascular strain. During the periods when the diet is limited to meat, eggs, green vegetables, butter and olive-oil, alkalies and alkaline waters must be given regularly.

When a strict diet must be maintained, the cook should endeavor to furnish by skilful preparation a large variety of dishes from the limited number of articles that the patient is allowed to use.

It must be remembered also that several of the vegetables usually eaten raw which are permissible at this time can also be cooked and thereby provide a more varied menu. Moreover, some of them contain less starch when cooked. This is notably true of cabbage, sea-kale, vegetable marrow, tomatoes, lettuce, celery, and cucumbers. All of which may be permitted when cooked though some of them cannot be allowed when eaten raw.

When patients are maintaining a 'fast day,' it is best to prescribe only two meals a day - one at breakfast-time and one about six in the evening. At noon an egg-lemonade made with saccharin may be taken if it is desired. The amount of food eaten at the two meals should be limited.