192 PATHOLOGY OF PURIN METABOLISM 



harmful, and that it is possible to ohtain beneficial results 

 from long continued use of hydrochloric acid, which is sup- 

 posed to alter the absorption capacity of the blood and 

 tissues for the uric acid. 49 Altogether, F. Umber 50 comes to 

 the rather unedifying conclusion "that all the medicinal 

 methods introduced with view of increasing uric acid elimi- 

 nation, of determining solution of the uratic deposits or of 

 limiting the formation of uric acid, are entirely worthless. 

 To the present time we have not known of any means of 

 influencing the gouty metabolism, and the good results which 

 we are getting as our knowledge advances are clearly due to 

 the matter of diet." Whether radium or atophan will 

 make any difference in the force of such a statement can 

 only be awaited with patience. 



The Diet in Gout. The present view of the general sub- 

 ject is somewhat as follows : The true nature of gout is still 

 unknown ; but we at least know that the affection is in some 

 way due to an accumulation of uric acid in the blood and that 

 increase of this accumulation is an unfavorable feature. 

 Therefore, in the dietetic management one may proceed on 

 the idea that the ingestion of substances which form uric acid 

 are to be limited as far as possible. Here belong particu- 

 larly the extractives of meat, as well as those tissues which 

 are highly nucleated and therefore contain considerable 

 nucleinic acid, like thymus, spleen, liver, lungs and kidneys. 

 These latter may be forbidden with propriety, as sufficient 

 instances are known where a gouty patient has suffered an 

 acute paroxysm directly traceable to a meal of thymus 

 (bries). Meat should be eaten only when well boiled, not 

 roasted. Meat broths and "whole" soups, as well as all use 

 of meat extract, are to be prohibited. In the proscription 

 list coffee and tea should also be placed because of the 

 methylpurins they contain, together with alcohol in all 



49 Falkenstein, Berl. klin. Wochenschr., 1906, 228; J. J. Schmidt, Miin- 

 chener med. Wochenschr., 1911, No. 83, 1764; consult also van Loghem, 1. c. 

 60 F. Umber, Lehrbu. d. Ernahrung und der Stoffwechselkr., p. 333, 1909. 



