|13·0 | 90 | 11·1 | 265 | 8·7 | 144 | 11·0 | 225 ---------------------------+-----+-----------+-----------+--------- (Myers and Fine: “Arch. Int. Med.,” 1916.) The salient feature of the table is, however, the fact that in _early interstitial nephritis_ the retention of _uric acid_ precedes that of _urea_ or _creatinine_. Its importance resides in the reflection that it lends support to those who contend that _renal change_, leading to failure of excretion of uric acid, _is the primary cause of gout_; in other words, it gives colour to Magnus Levy’s contention that the phenomena of gout are referable to “a deficient and restricted secretory power of the kidney.” The existence of such a selective excretory incapacity, _i.e._, for _uric acid_, does not, he considers, predicate a genuine nephritis. He maintains that such disability on the part of the kidney for uric acid excretion may exist without _morphological_ change; in other words, he thinks it conceivable that a _single_ function of the kidney can become almost exclusively insufficient, though later real damage to the organ and a nephritis frequently follow. Reflecting on the above theory, it is obvious that, if carried to its logical conclusion, it would appear to postulate that gout is nothing more than a form of _renal disorder_, marked simply by _functional inability to excrete uric acid_. The postulate is no mean one, for, as Sir Archibald Garrod says, “If the fault is in the kidneys alone, gout must be removed once and for all from the category of metabolic disorders, and placed among the sequelæ of renal inadequacy, at least in so far as the uric acid phenomena of the disease are concerned.” Furthermore, Levy’s hypothesis involves the assumption that the excreting functions of the kidney for _uric acid and urea_ are separate and independent of each other, and to discussion of this we now pass on. THE RELATIONSHIP, IF ANY, BETWEEN THE AMOUNTS OF URIC ACID AND OF UREA, AND TOTAL NON-PROTEIN NITROGEN IN HUMAN BLOOD Taking samples of human blood from (1) _unselected insane_ subjects and (2) _chronic nephritics_, Folin and Denis determined the amounts therein of urea, total non-protein nitrogen, and uric acid. The figures obtained showed that “there is apparently no relationship between the amount of uric acid and the amount of urea or total non-protein in nitrogen, in human blood.”