184 PATHOLOGY OF PURIN METABOLISM 



Alkalinity of the Tissues in Relation to Uric Acid De- 

 posit. It is difficult to decide at present to what extent 

 physical factors, in contrast to chemical factors, are involved 

 in increasing the absorbing power of individual types of tis- 

 sue for uric acid. We are unquestionably here again dealing 

 with a very complex problem of physical chemistry. It has 

 been stated, for example, that aminoacids tend to inhibit the 

 absorption of uric acid by cartilage. 29 But, on the other 

 hand, monourates are separated from uric acid solutions, 

 and in the same way urates deposit in the tissues the more 

 readily, apparently, the higher the proportion of sodium 

 present. Van Loghem 30 has from this suggested that the 

 predilection of cartilage and connective tissue for uric acid 

 bears some relation to the large amounts of sodium contained 

 by these tissues; and he suggested that the formation of 

 tophi might be restricted by the use of hydrochloric acid or 

 increased by alkalies. It is the same old story! At any 

 rate one can derive this one point from it: The constant 

 effort to favorably influence gout by flooding the body with 

 "curative" alkaline waters is without the least theoretical 

 foundation. * ' That by the use of certain spring waters gout 

 can be therapeutically influenced, " says Umber, 31 "is at- 

 tested by a century of practice. But it is practically proven 

 that the essential reason for this fact does not exist in any 

 immediate influence of the inorganic constituents of these 

 waters upon the disturbances of purin-metabolism in gout. 

 The importance of the thorough flushing of the body, in which 

 even Garrod believed the pith of mineral water treatment 

 lies, the regulated life of the patients, their isolation, and, 

 not the least, the intelligent interest of specially trained 



'"Th. Brugsch and J. Citron (F. Kraus's Clinic, Berlin), Zeitschr. f. exper. 

 Pathol., 5, 401, 1908. 



80 Van Loghem (Amsterdam), Deutsche Arch. f. klin. Med., 85, 416, 1906; 

 Centralbl. f. Stoffw., 1907, 244; consult also Roberts, His and Paul, Gudzent, 

 E. d'Agostino: Rendic. della Societa Chim. Ital., 2, fasc. 6, 1910. 



81 F. Umber, Lehrbu. d. Ernahrung und Stoffwechselkrankheiten, p. 329, 

 1908. 



