Gout, with a section on ocular disease in the goutyLlewellyn, Llewellyn J. (Llewellyn Jones)
Science
Gout, with a section on ocular disease in the gouty
Llewellyn, Llewellyn J. (Llewellyn Jones)
Eye -- Diseases; Gout
It may be recalled that Wiechowski and others observed that in man, of
_parenterally_ introduced uric acid, 80-90 per cent. reappears in the
urine. Accordingly, Schittenhelm and Wiener argued that, if uric acid is
indestructible in the human body, then, given _retarded elimination_, the
_tissues_ should contain considerable quantities thereof. Subsequently,
in 1914, they sought to investigate human tissues as to their content
of uric acid. Their studies were conducted on three examples, a case of
anuria, one of pernicious anæmia, and one of gout.
The case of _anuria_ occurred in a male, aged sixty-two, in sequence to
thrombosis of both renal veins following operation. Two-hundred gram
samples of the following tissues, lung, heart, spleen and liver, were
examined for uric acid with wholly negative results. The residue of
the organ was worked up together, but only 0·01 gram of uric acid was
isolated.
In the case of _pernicious anæmia_ no uric acid was demonstrable. The
_gouty_ subject had for twenty-five years suffered from typical attacks
and exhibited many auricular tophi. The following organs, in their
entirety, were analysed, the _liver_ (1,550 gram), no uric acid; _spleen_
(290 gm.), 10 mg. uric acid (3·5 mg. per 100 gm.); _kidney_ (270 gm.),
no uric acid; _lung_ (930 gm.), 15 mg. uric acid (1·6 mg. per 100 gm.);
_muscle_ (440 gram), no uric acid; and _intestine_ (420 gram), no uric
acid.
It will be seen that _uric acid was either absent or present in minimal
amounts_, and these results Schittenhelm and Wiener interpreted as
confirming their long advocated contention as to the _destructibility of
uric acid_ in the human organism.
Morris S. Fine, from the results of similar investigations, considered
the failure of these observers to isolate _uric acid_ in these cases of
_anuria_ and _gout_ as most remarkable. He considers “their results may
in part be ascribed to the use of hot sodium hydroxide previous to the
precipitation of the proteins in the extraction of the tissues, as the
instability of uric acid in alkaline solutions is a well-known property.”
In this criticism Fine would appear to be fully justified, in view of the
marked contrast between the findings of Schittenhelm and Wiener, and his
own data is recorded in the tables on p. 159.
While it is unfortunate that Fine’s theory contained no instances
of _gout_, his findings are a definite proof that, to quote his own
words, _uric acid can be demonstrated in considerable concentrations
in human tissues_. Incidentally, also, his tissue analyses are flatly
contradictory to Schittenhelm and Weiner’s persistent contention, viz.,
that the human organism _can decompose uric acid_.
Public-domain text, read in full here on John Shaqi.
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