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 frequent painful attacks of gout.
OBESITY
Causes.—Heredity, overeating, unbalanced diet, chronic alcoholism, and disturbed metabolism, as manifested in gout and other pathological conditions.
Cures are more or less of a risk, except when undertaken upon the advice and under the care of a competent physician. As a rule they are too strenuous to be carried out alone and are of no good unless persisted in. Among the best known obesity cures may be mentioned those formulated by Banting, Oertel and Ebstein.
Most physicians have their own methods of treating obesity, but all are based primarily on diet and exercise.