44 APPLIED PHYSIOLOGY 



actually lead in some way to an increased formation of 

 sugar. Certain facts seem to suggest that fat may be 

 the source of the increased sugar formation, but this is 

 not yet clearly established. 



If the kidneys be diseased, the excretion of sugar 

 under the influence of phloridzin is much less than 

 normally occurs, or may even be absent altogether. 

 Advantage has been taken of this as a test of the 

 glandular activity of the kidney in cases of suspected 

 renal inadequacy. 



Metabolism of Uric Acid. A knowledge of the 

 metabolism of uric acid is of special importance to 

 the physician because of its bearings upon gout. It 

 must be confessed, however, that, in spite of an 

 enormous amount of work which has been done upon 

 the subject, we are still very far from a complete under- 

 standing of it. Some facts, however, have been made 

 out beyond dispute, and these, with their clinical applica- 

 tions, must now be briefly set forth. 



The first point to grasp clearly is that uric acid 

 metabolism goes on quite independently of general 

 protein metabolism, and pursues special lines of its own. 

 The amount of protein in the food has therefore no 

 necessary connection with the metabolism of uric acid, 

 and in considering the pathology of gout this must be 

 constantly borne in mind. The disentanglement of uric 

 acid metabolism from general protein metabolism, indeed, 

 must be regarded as one of the most important advances 

 in chemical physiology, and when it has once been 

 thoroughly grasped by physicians will do much to 

 dissipate the rather confused thinking about gout and 



