to limit the
purin-bearing foods. Meats are used sparingly and these should be
boiled rather than roasted or broiled. Eggs and cheese and milk should
be substituted for at least part of the regular allowance of meat.

~Exercise and Massage.~--The patient should be recommended to take a
certain amount of mild exercise in the open air, or massage if he is
accustomed to living an indoor life or is confined to office work. He
must be warned against overindulgences of all kinds, especially of
overeating and drinking. A glass or two of hot water before breakfast
is recommended.

~Treatment of Obesity.~--The treatment of obesity when occurring in
gouty patients is much like that used in other conditions. Ebstein
regards obesity under such circumstances as an unfavorable symptom. He
advises a reduction in the carbohydrates to the smallest possible
amount and allows meat and fats in the diet.

~Allowable Foods.~--The following foods are practically purin-free and
may be used in the diet of gout:[157] Milk, cheese, butter, eggs,
nuts, gelatin, fruits, sugar, breads made with white flour, cereals,
cream of wheat, farina, rice, hominy, tapioca, cornstarch, potatoes
and other root vegetables, green vegetables, except asparagus,
spinach, and all fats.

~Avoidable Foods.~--The following foods are rich in purins and should
be avoided in the diet for gout: Sweetbreads, liver, kidneys, beef,
mutton, veal, pork, turkey, chicken, goose, rabbit, duck and other
game, fish, with the exception of cod, sardines, and anchovies, tea,
coffee, and cocoa.

The following list shows the purin content of some of the
above-mentioned foods. The purins are computed by Hall as follows: 1
kilogram contains,

_Grams Purin_
Milk
Butter
Eggs
Cheese
Farina
Rice
Hominy
Potato 0.02

Flour
Bread
Cauliflower
Eggplant
Cabbage
Lettuce
Sugar
Peas 0.39

Asparagus 0.21
Lentils 0.38
Halibut 1.00
Cod .05
Salmon 1.00
Mutton 0.96
Beef 1.10-2.00
Veal 1.10
Ham 1.10
Pork 1.20
Oatmeal 0.53
Beans 0.63
Chicken 1.20
Sherry
Claret
Whisky
Brandy
Beer 0.12
Porter 0.14
Ale 0.14
Chocolate per pint 0.70

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