Especially noticeable here is the low intake of fat and carbohydrate, with the corresponding low fuel value, and also the relatively high consumption of proteid, averaging 2.0 grams daily per kilogram of body-weight. Dr. Fenger concludes that for a man of this age and weight, with the relative inactivity characteristic of old age, a heat value in the intake of 30 calories per kilogram of body-weight is quite sufficient for the needs of the body. This may be quite true, but to maintain nitrogen equilibrium under such conditions requires a larger intake of proteid food than is desirable. It will be observed that in the last period of four years a very decided change in the diet was instituted; proteid was diminished somewhat, but the noticeable change was the decided increase in fat, produced in large measure by the substitution of whole milk, with its contained cream, for skim milk. In the words of Dr. Fenger, this change was necessitated by the appearance of gout in the subject. From superficial examination of the dietary of the preceding eleven years there would seem no occasion for criticising the subject for high living, and yet I believe we are quite within the limits of reason in saying that the proteid exchange for a subject of this body-weight was altogether too high. The heat requirements of the body were being met in an unnecessarily large degree from the breaking down of proteid material, with consequent formation of excessive nitrogenous waste, among which uric acid was plainly conspicuous. One comment to be made here is that meat and other rich purin-containing foodstuffs are not the only source of gout and uric acid. Excessive proteid katabolism, both exogenous and endogenous, is a possible source of danger in this respect, and the above subject, though living on an exceptionally simple diet, was consuming far more proteid per kilogram of body-weight than was necessary or desirable. Increase of fatty food naturally served to diminish the rate of proteid katabolism, and this could have been advantageously accompanied by a still greater reduction in the amount of proteid ingested, and a larger addition of non-nitrogenous foodstuffs. In old age, there is naturally a slowing down of the metabolic processes, and both nitrogen equilibrium and body equilibrium can be satisfactorily maintained by a relatively small intake of food and with gain to the body; but there is every reason to believe that economy in proteid food can be more advantageously adopted than economy in non-nitrogenous foodstuffs.