684 



METABOLISM 



renal insufficiency. This uricemia can not in itself, however, be the cause 

 of the deposition of urates in the joints, because it also occurs in other 

 diseases with renal retention, such as nephritis. Moreover, the blood 

 serum is capable of dissolving much larger quantities of uric acid than 

 are ever found present in it in gout. The real cause for the gouty deposits 

 must depend on some change affecting the blood so as to alter the form 

 in which uric acid exists therein, with the result that it passes into the 

 joints and is deposited there. 



Other diseases showing uricemia are lead poisoning and nephritis. In 

 the latter disease the damaged excretory function of the kidney is 

 manifested first of all by an increase in the uric-acid content of the 

 blood, accompanied later by a retention of urea and later still by one 

 of creatinine. The severity of the renal involvement may therefore be 

 gauged by determining the percentage of these three metabolites. On 

 account of the importance of these facts from a clinical standpoint, we 

 append a table containing results secured by Myers and Fine, in which 

 the behavior of the metabolites in the blood is shown in relationship 

 to the severity of the case as gauged by the blood pressure. 



Lastly, regarding the influence of drugs on. the blood uric acid in dis- 

 ease, it has been found by Fine that both atophan and salicylates cause 

 a pronounced decrease in the amount, but that it gradually rises to the 

 old level even while administration of the drugs is being continued. 



Important contributions to the behavior of uric acid in blood are 

 constantly appearing at present, mainly from the laboratories of Foli] 

 in Boston, of S. R. Benedict, and of Myers and Fine in New York. 



