498 VICTOR C, MYERS 



a glandular depressant, causes a reduction. With uric acid yielding- foods 

 as meat, meat extracts, pancreas, liver, thymus, peas, beans, etc., the out- 

 put will, of course, be the sum of endogenous and exogenous uric acid. 

 Mendel and Wardell have demonstrated that uric acid excretion may be 

 very definitely increased by the taking of methylated xanthins in coffee, 

 tea and cocoa, obviously indicating a demethylation of these purins. On 

 a mixed diet 0.5 to 0.6 gram of uric acid may be taken as the average 

 output of the human adult. 



The greatest increase in uric acid elimination is observed in leucemia, 

 as much as 12 grams having been found to be excreted in 24 hours. This 

 high elimination of uric acid is without doubt to be referred to the enor- 

 mous increase in the number of leucocytes and consequent leucolysis. 

 An increased uric acid excretion is observed in other diseases associated 

 with a high grade of leucocytosis. Although in gout deposits of sodium 

 urate may be found in certain of the articular cartilages, and the blood 

 uric acid increased owing to faulty elimination, still the quantitative ex- 

 cretion of uric acid in gouty individuals does not differ markedly from that 

 found normally. It may, however, be noted that for two or three days 

 preceding an attack of acute gout the uric acid elimination is diminished ; 

 while during and for a few days after the attack it may maintain a level 

 somewhat above normal. 



It has been recognized for some time that the excretion of uric acid 

 was stimulated by the administration of salicylic acid and phenylcincho- 

 ninic acid and their derivatives, and they have frequently been referred to 

 as "uric acid eliminants." Myers and Killian(c) have recently pointed out, 

 however, that this action is not specific for uric acid. It has been found 

 that in suitably selected cases, having slightly increased blood urea (and 

 possibly also creatinin) findings, administration of the above compounds 

 will lower the blood concentration of these constituents as well as the uric 

 acid. 



Ordinarily uric acid is present in the urine in combination with sodium, 

 potassium or ammonium. Only when the urine is especially acid does 

 uric acid itself separate out. When the urine is concentrated or after the 

 ingestion of considerable meat, pancreas, etc., urates may be deposited 

 shortly after the urine is voided. In other cases such deposits may form 

 on standing in a cool place. 



Purin Bases. A small portion of the purin bases, adenin, guanin, 

 hypoxanthin and xanthin escape conversion to uric acid, and appear un- 

 changed in the urine. About 0.02 to 0.05 gram of such compounds may 

 be eliminated. 



Hippuric Acid. Hippuric acid is a combination of glycocoll and ben- 

 zoic acid. By this conjugation which takes place in the kidney, although 

 it may be formed elsewhere (Kingsbury and Bell), the body is able to de- 

 fend itself against the more toxic benzoic acid. For this reason small 



