~Methods of Increasing the Diet.~--The above diet furnishes three
times as much food as is needed to maintain the body living a
sedentary life, or about as much as would be needed to maintain a
lumberman at hard outdoor labor in the Maine woods. It would be
impossible for an ordinary individual to handle such an abundant diet
without making the increase in the diet gradually. This is best done
by adding the milk and cream at the end of each meal and a glass of
milk between meals and at bedtime, then gradually adding the fattening
foods already mentioned until the diet approximates the diet sheet
here computed.

SUMMARY

GOUT

Gout is a constitutional disease characterized by an inflammatory
condition of the joints.

~The Joints~ are the seat of chalky deposits of uric acid or sodium
salts.

~Metabolism~ in gout is disturbed, with a consequent retention instead
of elimination of uric acid by the body.

~The Blood~ contains an excess of uric acid which increases greatly
during an acute attack.

~The Urine~ in true gout does not contain an excess of uric acid
except during an acute attack, whereas in the so-called goutiness
there is a constant excess of this acid.

~Uric Acid~ is produced as the result of the metabolism in the human
body of the nucleoproteins and in food of the purin bodies.

~Alcohol~ undoubtedly assists in the retention and increases the
difficulty of uric acid elimination by the body.

~Chief Causes of Gout.~--Overeating, excessive alcoholism, and too
little exercise, especially in the open air.

~Treatment~ consists in regulating the diet both as to the quantity
and type of food eaten; reducing or eliminating the alcohol in the
dietary, and increasing the amount of outdoor exercise.

~Dietetic Treatment.~--The best results are obtained by reducing the
size of the meals and avoiding the purin-bearing foods as far as
possible. Eggs are purin-free and may be substituted for much of the
meat in the diet. In chronic gout it is impossible to eliminate meat
entirely from the diet, but the quantity can be materially reduced and
that which is eaten may be rendered less harmful if it is boiled
instead of roasted or broiled, as in this way much of the purin is
dissolved out. Highly spiced and seasoned foods, rich gravies, etc.,
are apt to cause an acute attack and should be omitted. Excesses of
all kinds must be avoided to enable the patient to live a fairly
comfortable life, free from frequ