Milk, white bread, and potatoes contain practically no purins. Similarly, cream, butter, fats, eggs, apples, grapes, figs, dates, and raisins are purin-free. Macaroni, cheese, and nuts are in the same category. In comparison with foods containing purins, we therefore see that purin-free foods are on the whole much less appetising, and on that account are less likely to be taken to excess. A typical purin-free dietary is as follows: -

Breakfast

1 pint milk.

Bananas.

Apples.

Pears.

Plums, fresh, dried, or cooked.

Any other fresh fruit.

Eaten to any extent for which there is appetite.

Lunch

Vegetable soup made with milk.

Potatoes (with butter, oil, or milk).

2 ounces cheese, eaten with potatoes and any other vegetables in season. Stewed fruit, or tart. Fresh fruit. I pint of milk drunk during the meal.

Dinner

Much as Lunch.

I pint milk.

1 ounce cheese. Any variety of vegetables and fruits in season; if potatoes and fruit are taken in larger quantity, less milk and cheese will be required.

Points To Attend To In The Administration

In order to get the best results from treatment, the transition from an ordinary diet to a purin-free dietary should not be effected too quickly. At the outset there may be slight difficulty in digesting certain foods, and constipation may be a troublesome feature. These difficulties are not as a rule difficult to overcome. It is of the first importance to enjoin thorough mastication of the food.

Advantages And Defects Of A Purin-Free Dietary

The advantages may be summarised as follows: - It is a simple diet; its adoption prevents over-eating; it restricts intestinal putrefaction, and so prevents auto-intoxication from the products of imperfectly digested protein foods; it has the further advantage of being a "special system," and on that account is followed more rigidly and therefore more successfully than other dietaries framed along more conventional lines. These advantages give this system of feeding a distinct place in therapeutics. Its undoubted value is probably explained along the lines just referred to, rather than by regard to any specific action associated with the absence of purins in the dietary.

The disadvantages of the diet must be referred to. Some patients find the regime very unattractive, and as a result the amount of food taken, and especially the amount of protein food, falls below the necessary standard, and ill-health results from a continuation of the diet In others its too rigid adoption may induce diarrhoea and other gastro-intestinal disturbance, with resulting deterioration in health.