URIC ACID. 219 



osteoporosis ; if it exhibit a tendency to decomposition and become 

 ichorous, caries as well as pyaemia may ensue. Unfortunately, 

 however, these alterations in the osseous system are not peculiar 

 to gout, but occur both from purely local causes, and from other 

 general diseases, especially from syphilis. The diseased condition 

 of the osseous system, however constantly it may be observed in 

 gout, when we adhere to the strictest definition of the term, affords 

 us no firm starting-point ; we must, consequently, have recourse 

 to the nodules and concretions, but these earthy deposits may 

 exist independently of gout, and there remains no characteristic of 

 the nature of gout excepting the concretions of urate of soda ; yet 

 how seldom do even these occur ; and how far advanced must be 

 the malady before we can base our diagnosis on their presence ! 

 The accumulation of great quantities of uric acid in the blood, in- 

 dependently of other symptoms, is also devoid of importance, since, 

 according to Garrod, this may likewise occur in Bright's disease. 

 In a word, we know not the nature of arthritis ; and if this ever 

 be elucidated by physiologico-chemical investigations, I believe 

 that the sole method which will conduce to this end will be 

 that of ascertaining the relation in which the chemical constitution 

 of the blood and urine stands to the above-named diseases of the 

 osseous system, and to osteomalacia in particular. 



It seems to us still more inappropriate and still less in accord- 

 ance with a rational natural inquiry, if, basing our views on a pre- 

 conceived and misunderstood proposition, we philosophise on the 

 analogy of " gout, gravel, and stone" ; a priori explanations of 

 morbid processes such as have been attempted in the organico- 

 chemical department of medicine, have usually failed in yielding 

 any results, from the misconception that, without physiology and 

 pathological anatomy, medicine might be established in accordance 

 with subjective chemical views. The pretended oxidation of the 

 constituents of the blood, which was supposed to explain phthisis 

 as well as gout and stone, is not the simple method by which alone 

 specific diseases or individual well -characterised processes can be 

 explained with scientific accuracy. For there are no acute and but 

 few chronic diseases in which the oxidation of the constituents of the 

 blood is not diminished or impeded. The proof of the assertion will, 

 in a future part of this work, be made as evident as the fact that 

 there is no disease characterised by a too sudden or rapid oxidato n 

 of the blood. 



Origin. Since we have already (see p. 168) mentioned that urea 

 is in part derived from uric acid, there can be no doubt that the latter, 



