MEDICINAL TREATMENT OF GOUT 191 



Medicinal Treatment of Gout. So far as the medicinal 

 treatment of gout 46 is concerned, one must confess frankly 

 that there is little satisfactory to be said. Colchicin, the 

 immemorially lauded poison of meadow-saffron, still has its 

 adherents, but no one has ever been able to explain its mode 

 of action. It is said that the much used salicylic acid and 

 its many related substances increase uric acid elimination ; 

 but whether its beneficial (frequently questioned) influence 

 on gout is due to this or simply to some "antirheumatic" 

 effect, is unknown. Quinic acid (hexahydrotetraoxybenzoic 

 acid) with its numerous derivatives may, perhaps, be named 

 in the same class ; but the hypotheses upon which its thera- 

 peutic use was based were unfounded. (It was supposed 

 that quinic acid, which is transformed in the body into 

 benzoic acid and undergoes a hippuric acid synthesis, pre- 

 vents glycocoll from entering into synthetic production of 

 uric acid ; but it is now known that synthetic formation of 

 uric acid from glycocoll does not occur in mammalia.) 



It is hard to say what there may be in the idea that the 

 quinolincarboxylic acids increase uric acid elimination 47 ; 

 the very favorable effects attributed to phenylquinolincar- 

 boxylic acid (atophan) have recently been given consider- 

 able prominence. 48 Efforts to increase the solubility of uric 

 acid in the blood by administration of piperazin, substances 

 producing formaldehyde by cleavage like hexamethylentet- 

 ramine (urotropin), nucleinic acids, urea, alkalies and alka- 

 line waters, have as little justification in theory as in practice. 

 A recent conclusion goes so far (vide supra) as to declare 

 that alkalies are not only useless in gout, but are actually 



46 Literature upon the Therapy of Gout: O. Minkowski, Die Gicht, pp. 299- 

 322, Vienna, 1903. 



4T A. Nicolaier and M. Dohrn, Deutsch. Arch. f. klin. Med., 93, 331, 1908. 



48 W. Weintraud, Therapie d. Gegenwart, 1911, 97; R. Feulgen, Inaug. 

 Dissert., Kiel, 1912, Centralbl. f. d. ges. Biol., 1912, No. 2840; B. Bauch 

 (Weintraud's Clinic, Wiesbaden), Arch. f. Verdauungskr., 17, Erganz. Heft, 186, 

 1911; E. Frank, in collaboration with Przedborski (Minkowski's Clinic, 

 Breslau), Arch. f. exper. Pathol., 68, 349. 



