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
His conclusions were: (1) That necrosing and necrotic processes are
developed in various organs as a result of some irritant. (2) That uratic
deposits occur in the necrosed area resembling those met with in gouty
subjects. (3) That an inflammatory reaction with small cell infiltration
ensues in the vicinity of such necrotic areas.
But, in regard to these experimental investigations, they are obviously
incomparable to the morbid processes that presumably occur in gout in
man. Moreover, as shrewdly pointed out by Levison, experimental ligation
of both ureters would certainly engender _uræmia_ rather than anything
approximating to gout.
Again, his experiments with urates and uric acid, by which he claims to
have demonstrated their action as chemical irritants capable of inducing
necroses in tissues, have proved fallacious. This, for the very cogent
reasons pointed out by Luff, which run as follows: “Not only is there
no proof that the neutral sodium urate upon which he depends for the
starting of the gouty changes, ever exists in the human body, but, on the
other hand, very strong evidence to show that it never can exist in the
human body.”... “The neutral sodium urate is an extremely caustic and
unstable compound, and is decomposed in the presence of carbonates, so
that it is impossible for it to exist in the blood. The first factor upon
which Ebstein relied for his theory for the causation of gout therefore
disappears.”
Again, Ebstein’s fundamental proposition that in gout uric acid was
produced in many tissues not normally concerned in its production, was
ruled out by Horbaczewski’s establishing the fact that in health uric
acid is a by-product of the metabolism of almost all tissues. Lastly,
the strong _toxic_ properties accredited by him to solutions of the
urates was disproved by Pfeiffer’s experiments. This observer showed that
urates, in such degrees of concentration as may exist in the human body,
are incapable, when injected into the tissues, of inducing _necrosis_.
Public-domain text, read in full here on John Shaqi.
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