A certain amount of meat or fish is permitted as an addition to the above diet, a great deal depending upon the individual peculiarities of each case. The unit, quantitatively, is 100 g. of roast beef (weighed roasted). The following quantities of other meats and fish are equivalent to this as far as their uric acid forming capacity is concerned:

100 g. roast meat (beef, veal, lean pork, mutton, warm or cold ham, ox tongue, calves tongue, venison, rabbit).

100 g. of salmon, salmon trout.

70 g. beef steak, veal cutlet.

140 g. boiled meat (beef, veal, mutton, pork).

200 g. of fish (with the exception of salmon or salmon trout).

200 g. of lobster, crab.

2 dozen oysters.

2 pigeons, or one spring chicken, or 1/2 a capon of average size, or 1 guinea hen, or 1/2 a duck, or of a goose.

The physician may, according to varying circumstances, order 1 or 1 1/2 or 2 portions of this accessory diet, rarely more; in other cases, he will have to forbid it altogether or exclude one or the other variety of meat on account of certain morbid conditions present. As a rule the patient should be allowed free choice among the articles of diet enumerated above.

A very good plan, originally suggested by Umber, is to forbid on one day of each week all the articles of diet that are included under the category of additional diet, even though they are permitted on the other days of the week in certain quantities.

The amount of alcoholic beverages that is per mitted should, of course, be carefully prescribed by the physician.

It may appear rather complicated to adopt the method described above of separating the purin-free articles of food designated as the Main Diet from the purin containing articles designated as "Additional Diet" in such a rigid manner, and to demand that the patient should use weights and measures in using the latter.

But the method is very valuable and has proven of such great use in actual practice that these objections become invalid. In the beginning, of course, the patients must measure their tolerance, but they soon learn without careful measuring how much of the "Additional Diet" they can take.

This is the only method by which the physician can exercise real control over the quantity of uric acid forming material that a patient ingests.