While they consider that such _urea_ and _total nitrogen retention may_ possibly bespeak _latent_ or _incipient nephritis_, they recognise that no appreciable effects on health have as yet been determined in connection therewith. But more pertinently to our point, they make the further pregnant observation, “In the case of uric acid it seems to be purely a matter of insolubility that corresponding or even smaller degrees of kidney insufficiency with slight uric acid accumulation should result in all the serious consequences involved in the development of gout”! Again, some have attempted to account for the assumed renal incapacity as being part of the _tissue peculiarity_ of the gouty subject. “Without doubt,” says Duckworth, “there are peculiarities of tissue in the gouty, and with this may very possibly be associated peculiarities of tissue function and metabolism.” Naturally this suggests the further question, Are there any distinctive _histological_ changes in the _gouty_ kidney? On this point Walker Hall has some apposite reflections. Taking Folin’s figures as a basis, it transpires that in _acute_ and _chronic nephritis_, also in _arterio-sclerosis_, there is an average content of 2·5 mg. uric acid per 100 grams of blood. Now, notwithstanding the fact that in these conditions an appreciable quantity of the renal tissues is, functionally speaking, temporarily or permanently out of action, nevertheless “the extraction of uric acid from the blood and its subsequent excretion are practically normal.” The inference is that a relatively small moiety of renal tissue suffices for the excretion of the daily quantum of uric acid in the urine. Now in contrast thereto, the blood content in _gout_ and _lead poisoning_ is about 4·5 mg. uric acid per 100 grams of blood, or “an increase of about 50 mg. in the total blood-stream at any one moment (an increase from the normal 70 up to 120 mg.).” Continuing, Walker Hall observes that “the gouty kidney _per se_, even when arterio-sclerotic conditions prevail, does not show anything like the amount of cellular damage which occurs in acute or chronic diffuse nephritis.” Thence he argues if _histological_ changes be taken as a criterion of functional efficiency, then the _gouty_ kidney should be more capable of excreting freely than the _diffuse nephritic_ organ.