336 DIET FOR GRAVEL AND STONE. 



form of uric acid which is convertible into urate of soda, the char- 

 acteristic deposit of gout. At any rate, experience shows that in 

 some subjects the disorder attends a highly nitrogenized diet, 

 sedentary habits, immoral self-indulgence and a free indulgence in 

 the heavier kinds of wine and beer. Even intellectual pursuits, by 

 working the brain without exercise of the limbs, contribute to the 

 development of gout. There is, therefore, perhaps no disease in 

 which properly chosen and well regulated diet ana hygiene are of 

 greater importance. 



Those, then, who inherit a predisposition to this disorder, who 

 exhibit premonitory symptoms or who have actually suffered from 

 it, should abstain from rich living. The children of gouty parents 

 should be accustomed to eat a large proportion of vegetables, so as 

 to acquire a taste for them and be habituated to the digestion of 

 them. Oatmeal-porridge for breakfast, buttermilk for drink and a 

 very moderate proportion of meat at any time should form their 

 diet while growing. When years of maturity are reached the diet 

 should be simple, that temptation to excess may be avoided, 

 limited in nitrogenous material and consisting largely of vegetables, 

 especially if the habits of life be inactive. Meat should be eaten 

 only once a day; soles, whiting and cod, mutton, tender beef, fowl 

 and game, are suitable. Salmon, veal, pork, cheese, and highly 

 seasoned or made dishes, pastry, greasy or twice-cooked meat, raw 

 vegetables, articles which cause eructation or belching, or other 

 symptoms of dyspepsia, and anything likely to lead the patient to 

 eat more than is strictly moderate, must be avoided. The gouty 

 person should be even more abstemious with regard to drink than 

 to food, altogether avoiding sweet beer, strong and sweet wines. 

 Port is to be particularly eschewed. The lighter wines, such as dry 

 sherry, claret, Burgundy, hock or dry champagne, may be taken by 

 some persons in moderation; but if the gouty predisposition is 

 established even these will bring on a paroxysm. Malt liquors 

 should not be used. 



DIET FOB GRAVEL (LITHGEMIA) AND STONE. 



Patients having a predisposition to the formation of stone, 

 especially if they have passed gravel with their urine, require 

 medical treatment and careful supervision to correct the tendency 

 to such formations. But in addition to the employment of medi- 

 cines, attention to diet will be of considerable service. A reference 

 to the varieties of stone, and what produces it, will indicate those 

 ingredients of food that should be avoided. 



Uric acid forms the nucleus of most urinary concretions, and 

 many entirely consist of it. The small red cayenne-pepper-grains, 

 (red gravel), and the brown lumps of stone are due to the excess of 

 this acid. This excess is closely related to the constitutional dispo- 

 se 



