ATTEMPTS TO PRODUCE GOUT EXPERIMENTALLY 185 



physicians in their little and their great complaints, all 

 this in the methods of a health resort for the gouty is a more 

 important therapeutic factor than the minerals that are 

 contained in the waters. " 



Attempts to Produce Gout Experimentally. Research 

 upon the nature of gout would surely be in position to 

 show more rapid progress, were it not that experimental 

 attempts to produce this fault of metabolism have thus 

 far always proved failures. The part taken by uric acid 

 in avian metabolism (in birds the bulk of nitrogen ex- 

 creted appears as uric acid, and in thein the latter is without 

 doubt formed synthetically) is so fundamentally different 

 from its role in the economy of man and the mammalia, that 

 it is decidedly difficult to recognize much of importance to the 

 study of gout in the uric acid deposits obtained in the viscera 

 of birds after ligation of the ureters (by Ebstein) or after 

 exclusive meat diet (by Kionka). His has been experi- 

 mentally able to produce tophi by local injections of rela- 

 tively insoluble sodium monourate in dogs with coincident 

 administration of alcohol. These coincide in detail with 

 spontaneous gouty nodules, and confirm the view (vide sup.) 

 that uric acid deposits may act as local irritants and cause 

 the surrounding tissue to become the seat of an inflammatory 

 infiltration, and produce a capsule from the granulation tis- 

 sue thus occasioned. Spontaneous formation of gouty 

 nodules (as by flooding the circulation with urates) has up 

 to the present time not been successfully induced ; and this 

 is the real object to be attained. 



Among the different factors which favor the development 

 of gout, as is well known, alcoholism, chronic plumbism, and 

 long continued and excessive ingestion of foods rich in purin 

 bodies are the most prominent. 



Alcoholism. The belief in a close causal relation between 

 chronic alcoholism and gout has been fully confirmed by thou- 

 sands of examples, from the days when the lusty Herr von 



