A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
PATHOLOGY.--It would be impossible in the limits of this article to
review the many theories that have prevailed in regard to the pathology
of gout, or even to discuss fully those that may be said to divide
professional opinion at the present day. Since the discovery, by
Garrod, of the salts of uric acid in the blood-serum of gouty patients,
the humoral pathology of gout has certainly had the largest number of
adherents.
The lithæmic pathology may be said to be based primarily upon the
chemical theory of digestion or food-transformation. This theory
proceeds upon the idea that every atom of albuminous or carbonaceous
food that enters the body, whether it goes to the construction of
tissue or is destined for the direct conversion of potential into
active energy, is finally eliminated, for the most part, as urea,
carbonic acid, and water. This transformation, of course, is supposed
to be effected by a process of oxidation, but neither the exact mode of
transformation nor the share which the different organs and tissues
take in its accomplishment can be said to be certainly known. Recent
investigations seem to indicate that the liver is chiefly concerned,
not only in the metamorphosis of the carbohydrates, but also in the
formation of urea, so that the arrest in the conversion of starches and
sugars which results in glycosuria, and the check in the metabolism of
the proteids which give rise to lithæmia, may both have their origin in
hepatic derangement. The not infrequent association of glycosuria and
lithæmia in the same patient, and the frequent alternation of gout and
saccharine diabetes in gouty families, are significant facts in support
of the common origin of these diseases.
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