The causes of this disease are, as a rule, excessive eating of rich foods and lack of exercise. The blood contains an excess of uric acid or its salts.

It frequently follows digestive troubles of long standing. Uric acid should be converted into urea, if all the functions do their work properly; but if there is any lack of oxidation in the tissues, the process is frequently upset or entirely checked, and sediment appears in the urine. When this occurs, animal foods and sugar must be reduced in amount, or better still, entirely given up. Substitute nitrogenous vegetables, such as soy beans and lentils, and milk, for meats. The morning bath and rub, and exercise in the open air, are of importance; in fact, the patient would recover in much less time if he would live and sleep out of doors.

May Eat

Cream soups

White-fleshed fish, broiled or boiled An occasional bit of chicken Soup a la Reine Puree of lentils, peas, old peas and beans Vegetable gelatins, unsweetened Very little butter

Dishes made from yolks of eggs Coffee, cocoa, chocolate, broma, alkathrepta, racahout, without sugar Skimmed milk Modified milk Whole wheat bread Oatmeal bread Unleavened bread Crisp crackers Well-cooked cereals

Rice and arrowroot, but not with sugar Macaroni and spaghetti, without cheese Gluten mush Gluten bread

An occasional aleuronat gem Soups, maigre Fresh green vegetables Peas

Lima beans

Tender hearts of lettuce Young celery Baked potato Globe artichokes Stewed turnips Jerusalem artichokes Fruits without sugar Fruit juices Roborat

Avoid

All sweets

Red meats

Sauces

Meat soups

Yolks of eggs

Fat

Pork

Veal

All pink-fleshed fish, Crustacea, oysters, clams Rhubarb Gooseberries Strawberries

Grapes Pears Dates Figs Raisins Prunes Currants

Coarse vegetables Cheese

Milk, except in coffee and cocoa All milk dishes, as leban and koumys

In Children

This disease is frequently seen in children of rheumatic or gouty parents. As each case is a law in itself, the food must be regulated by the attending physician. A general outline, however, may be given for the benefit of the caretaker.

Fothergill, in speaking of uric acid diathesis in children, says "lean meats and beef tea are equivalent to so much poison."

A child under five years of age must be kept strictly on skimmed milk and milk preparations. Milk gruels made from farina, cornmeal and banana flour are to be recommended. The hard-boiled yolk of egg may be grated over milk toast and given once or twice a week. Baked apples without sugar, dry whole wheat bread without butter, an occasional bit of white meat of chicken, cooked spinach, cauliflower, summer squash and cucumbers, are admissible. Avoid for some time to come all fats, cream, butter, olive oil; such foods as rice, potato, sago, tapioca, sweet dishes, sugar, red meats and the internal organs of animals used as food. Nut dishes, milk, puree of lentils, with an occasional egg, must take the place of meat. As the case proceeds toward a cure, add to this diet weak cocoa, dry toast, zwieback, tender celery, hominy grits, plain stewed macaroni, watermelons, prunes, cooked without sugar; oranges, apples, raw and baked without sugar, and baked bananas. There must be no nibbling between meals. All foods must be lightly cooked. The method of cooking is quite as important as the food prescribed. Children even at the age of twelve to fourteen should not be given pink-fleshed fish, veal, pork, salt foods, dried meats, fried foods, hot breads, candies, pastry, cake, dense hard vegetables, condiments or pickles.