Now, as to feeding the gouty individual and choosing a proper diet. It is only necessary to read over the diet tables of many popular writers and teachers to see how far apart they are and really how unscientific many of their recommendations appear to be. Compare them, and see how antagonistic many of them are. Some of them appear to have been made like weather forecasts of the almanacs are made. The assistant asked the chief what weather he should put down for New Year. "Oh, hang it all, don't bother me. I am busy. Put down rain, snow, hail, and sunshine. Anything will do. Don't bother me."

As a great item in diet for the gouty, and as a remedy too, water holds a very high, if not the very first, place. Tyson, one of our best authorities, holds this view. Strange to say, gouty people, as a rule, drink very little water. All the water possible should be taken between meals and at bedtime, and even through the night when awake if the condition be chronic or in the acute attack. Von Noorden recommends very highly the free use of the alkaline waters of Europe, We have among the best of these at Saratoga, especially the Saratoga Vichy. Taking water carries off the nitrogenous waste, the toxic waste from the system, and thus we get a cleaner, healthier condition all around. Water is not properly appreciated either by medical men or by laymen as a remedy. It should receive more consideration from all.

From what we have before said of the purin bodies, it follows they are the first to be considered in a diet for gout. Purin-free foods must be sought for. Now, what are the purin-free foods and those containing a small amount of purins? The nearest we can get to a purin-free diet is to live on milk, butter, cheese as a relish rather than as a staple article, eggs, rice, white potatoes, lettuce, cabbage, and bread made from the best wheat, the so-called patent flour.

Now, as to beverages. The malt liquors are not purin free and are bad in gout, as we know empirically. Claret, volnay, sherry, and port hold no trace of purins, and if wine must be taken, they are best. Champagne is not so good. The effect of alcohol on metabolic processes is not fully decided. For the gouty probably spirit in small quantities is the best.

Coffee, tea, and cocoa are not purin free, and should be taken, if at all, in moderation. Coffee contains more purin than tea, particularly China tea. Ceylon and Indian teas are stronger in purin than China tea. Haig says tea does more harm in gout than coffee or cocoa. I do not know why. Chocolate and cocoa are more objectionable than coffee.

With an excess of hydrochloric acid in the gastric juice, beef extracts and soups are contraindi-cated, and in gout these are to be taken very sparingly, as a rule. According to Hall, if we feed a man with such food as fish, fowl, beef, beans, and beer the urinary purin is increased. This increase corresponds with 50 to 60 per cent. of the purin bodies ingested as food, and the purin is chiefly in the form of uric acid. This points clearly to the fact that we must be careful in allowing such foods for the gouty. Remember, again, we can control the exogenous purins and exogenous uric acid by diet; but by diet, only indirectly, can we control the endogenous purins and endogenous uric acid. Immoderate eating will doubtless increase the latter, moderation will decrease them. Peas, beans, oatmeal, asparagus, and onions contain purins, and high uric acid excretion has been found to follow the eating of these. Of course, then, in gout we must in a great measure avoid them, especially asparagus.

We are beginning to find out scientifically what we have long known empirically, that malt liquors are bad in gout from the purin bodies therein contained. Probably these same purins cause other pathological changes found in hard drinkers whose tissues are yielding.

Look at white meats and red meats. According to Hall, one contains about as much of purins as the other, and one will do as much harm as the other in diet, yet the old lady will say at her doctor's order she has quit red meats and only eats chicken and turkey and soups and fish and beans and peas and potatoes and jelly and icecream and pie, with a big big P. I cannot criticise this unfortunate old lady; her doctor is directing her. Like the Indian, I can only grunt. When travelling, you and I frequently see these deluded creatures, victims of the red and the white fad.

According to Hall, quinine checks somewhat the excretion of uric acid, and the sodium salts favor uratic deposits. Nucleotin phosphoric acid has a tendency to keep in solution the purins and thus prevent uratic infiltration. It is difficult to obtain this nucleotin phosphoric acid. Hall even goes so far as to say that possibly salicylate of soda, when given in gout, as it almost universally is by our best clinicians at the present time, increases the amount of circulating purin bodies, and hence is contraindi-cated in gout - one thing is sure, salicylate of soda does not wash out retained uric acid, and it cannot be employed for such a purpose. See how we are floundering yet in our treatment of gout. Colchicum, the great remedy of our grandfathers, is probably yet the best we have.

After all has been said, we must in gout get as near as possible to the purin-free diet. Then we must live as nearly as possible on milk, butter, cheese, rice, eggs, white bread, and water. As before mentioned in treating of eggs in diet, their yolk in digesting consumes much of the hydrochloric acid of the gastric juice, and as this is usually in excess in the gouty, eggs for this additional reason are proper food. Of other vegetables we can eat white potatoes, cabbage, lettuce, cauliflower. Be careful of sweet potatoes. White potatoes should be baked. Onions are in the doubtful list, and asparagus is in the prohibited list, absolutely, and so are all the legumes, as peas, beans, etc. As a rule, do not use the breakfast cereals, especially oatmeal. If we do transgress in any of these foods, let it be in moderate amounts only. Again, in gout, remember, moderation in all things.