The primary cause of gout is faulty metabolism; behind this, however, are other causes. The metabolic process is rendered faulty or incomplete by the overingestion of heavy starchy foods. This excess of starch, which the body is not able to appropriate or use, becomes acted upon by the excess of acid which is always present when too much starch is consumed. This harmful process is often augmented by the eating of fruit-acids such as grapefruit, lemons, oranges, pineapples, and other citrus-fruits. In addition to these causes the uric acid residual in meat and in the yolk of eggs is an important factor in the causation of gouty or rheumatic conditions. GOUT--THE SYMPTOMS The earlier symptoms of gout are nervousness, irritability, and sometimes insomnia. In the second stages, shooting pains through the fingers and toes are experienced, and later a swelling or a slight inflammation of these terminals. After this acute condition has existed for perhaps a year, the pain may cease and the joints may begin to swell. Knots are also often formed, especially upon the hands, and sometimes upon the feet. RHEUMATISM, GOUT--THE REMEDY The remedy for these disorders may be said to lie wholly within the realm of diet, exercise and oxidation, supplemented by a liberal superficial application of heat, such as Turkish and electric light baths. In all cases of rheumatism and gout, the following should be omitted: All acid fruits, such as, Grapefruit Lemons Limes Oranges Pineapples Eggs Red meats Starchy foods (Carbohydrate class) The diet should be confined to-- Fish and white meat of fowl Fresh vegetables Nuts Salads Sweet and non-acid fruits (See Lesson VIII, p. 313) [Sidenote: How to prevent the active principle of rheumatism] If the diet were confined wholly to green salads, fresh vegetables and white meats, it would remove the causes of these disorders, and inasmuch as Nature is always striving to create perfect health, the cause being removed, she would begin at once to apply the remedy, by removing the congested mass of undissolved calcareous matter, atom by atom. Thus the active principle of rheumatism would disappear. Where the joints have become enlarged, the best that can be done is to render them flexible. It is almost impossible to take out of them all the accumulated deposits, and to reduce them to their natural or normal size. [Sidenote: Natural perspiration vs. artificial in the treatment of rheumatism]