Before I enter upon the subject of diet in gout let me give the average daily ration of a healthy man weighing one hundred and fifty-four pounds and five feet eight inches in height. The calculations are based on Church in his work on "Food." In a healthy adult the amount of food required may vary with circumstances. There may be peculiarities of the individual, and the amount of work he performs varies. Heat or cold causes variations, also the condition and quality of the food. What we want to arrive at is the average. Church gives this table as what the daily average should be:

Here the total daily ration weighs six pounds, thirteen ounces, one hundred and twenty-eight grains. Five and one-half pounds of this is water. All of the solid matter here does not have high food value, as the gelatin, animal membrane, etc., in meats, and the fibrous materials in vegetables, but the average is nearly correct. Food must taste well and be palatable to excite the digestive secretions, etc. To accomplish this the diet must be varied. As Church says, to get a complete ration from bread this man of one hundred and fifty-four pounds weight would have to eat four pounds to get a proper supply of albuminoids or flesh-formers and a proper amount of carbohydrates, the heat-givers or force-producers. Thus we see we must vary the diet to get proper results from food. Church gives what he considers a proper mixed diet containing the following for one day for this healthy man of one hundred and fifty-four pounds.

In this ration, from the bread we get starch, which gives heat and force, and some albuminoids in the gluten, etc., which gives flesh-formers. The milk gives fat, albuminoids, and sugar, in itself a complete food so far as it goes. The cheese gives fat and nitrogen. The bacon and butter chiefly fat. From the remainder we get enough to make the complete ration, including the necessary salts and the water to the amount of five pounds eight and three-quarters ounces made up from what is in the food and what we drink as water and in our tea, coffee, etc. We may increase or diminish the water and thus get along. We may decrease the albuminoids and take more fats, or take less fats and increase the albuminoids. In Church's calculations he gives the nutrient ratio as 1: 4 3/4. That is, for one ounce of albuminoids present in the daily ration, there should be present four and three-quarters ounces of starch, sugar, dextrin, gum, mucilage, etc., the starch equivalent of the fat one eats being added to make up the proper quantity.