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
The vista opened up by these advances in physiology suggested
investigations into the _amino-acids_, their association with the output
of _uric acid_ in _gouty_ patients. No less than eighteen different
amino-acids enter into the constitution of protein, but of these the most
interesting from our point of view is _glycocoll_ or amino-acetic-acid.
Now, glycocoll plays a great _rôle_ in the organism as a _detoxicating_
agent, rendering innocuous, _e.g._, benzoic and cholic acids by
transmuting them into _hippuric_ and _glycocholic_ acids. In short, the
body always has glycocoll at its disposal for coupling or combination
purposes.
Now it appears likely that glycocoll can be split off from all the
amino-acids, a probability reinforced by the results of the researches
of Embden and Reese and Lipstein, these observers having shown that
amino-acids are present in all urines to about 1 per cent. of the total
nitrogen output.
Ignatowski, working with the urine of _gouty_ patients, found
_amino-acids_ present in large amounts; not that it was peculiar to
such subjects, for he found it in other diseases, but only traces were
detectable in the urine of _healthy_ individuals. Again, Walker Hall,
investigating urines drawn from the subjects of gout, the victims of
other diseases, as well as healthy and diseased children, determined
the presence of _glycocoll_ in about 70 per cent. of the cases. His
researches, to his mind, confirmed the conclusion that “normally a
certain amount of glycocoll escapes through or is eliminated by the renal
filter.”
Burger and Schweriner, from their researches on gouty subjects, have
confirmed Walker Hall’s findings as to the excretion in excess of
amino-acids, especially _glycocoll_. Lastly, Almagia has in gouty urines
detected the presence of _glyoxylic_ acid. What its significance may be
is uncertain, but it is at least interesting to note that, as MacLeod
suggests, the synthetic formation within the body of glycocoll may very
probably result from the interaction of ammonia and glyoxylic acid.
THE GLYCOCOLL THEORY OF GOUT
Excessive meat feeding in dogs, according to Kochmann, induces
degenerative changes in the liver and kidneys. Similar tissue
alterations were noted by Walker Hall in rabbits, after injection with
_hypoxanthine_, while the same was observed by Kionka in mice. These
findings suggest that, although _anatomical lesions_ are not apparent in
the _livers_ of “gouty” men, it is at least probable that _functional_
damage results from the overeating of meat.
Now, if glycocoll be added to a solution of (neutral) dialkali-urate,
it expedites the appearance of the (acid) mono-alkali-urate, a reaction
more noticeable with the sodium salt. _Urea_, in contrast to glycocoll,
markedly inhibits the formation of the acid salt. But if _glycocoll_
be added to a solution of the (neutral) dialkali-urate and urea, the
latter parts to some extent with its powers in this respect, and the
mono-alkali-urate is deposited.
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