886 THOMAS ORUWAY AND ARTHUR KNUDSON 



The experiments on which these investigators based their theory of 

 gout and action of radium were at first apparently confirmed. Mesernitsky 

 and Kemen, Kikkoji; Von Xoorden and Falta, and Skorczewski and Sohn 

 report increased excretion of uric acid in cases of gout under the influence 

 of radium emanation. Plesch and Karczag observed a similar effect with 

 thorium-x. 



With reliable methods and carefully controlled observations Chace and 

 Fine could not confirm these observations. Inhalations of radium emana- 

 tion (containing as high as 100 Mache units per liter) and injection of 

 fifty micrograms of radium bromid in no case had any influence upon 

 uric acid concentration in the blood of patients with gout. McCrudden and 

 Sargent(fr) likewise could observe no effect on the concentration of uric 

 acid in the blood of a patient with gout receiving water impregnated with 

 radium emanation. The patient received daily 20,000 Mache units. No 

 effect could be found on the rate of uric acid and total nitrogen excretion 

 but they did observe a slight increase in the creatinin excretion which per- 

 sisted for a few days after discontinuing the radium treatment. 



Chace and Fine and McCrudden and Sargent (6) have also studied the 

 effect of radium emanation on cases of chronic arthritis. They could ob- 

 serve no effect on the concentration of uric acid in the blood or the rate of 

 its excretion in the urine. McCrudden did observe, however, a slight 

 increase of creatinin excretion. In a case of rheumatoid arthritis treated 

 by intravenous injection of fifty micrograms of radium salts Rosen- 

 bloom (&) noted an increased nitrogen excretion and a marked increase in 

 the amount of total sulphur and neutral sulphur in the urine. The increase 

 of nitrogen and sulphur lasted for about three days following the injection. 



The metabolism of cases of pernicious anemia, rheumatoid arthritis, 

 and unresolved pneumonia treated by x-ray have been reported by Edsall 

 and Pemberton. In the cases of pernicious anemia and rheumatoid ar- 

 thritis x-ray exposure produced a toxic reaction. The chief point of interest 

 in these two cases is the remarkable drop in excretion of nitrogen, phos- 

 phates and uric acid that followed the exposure. The drop was followed 

 subsequently by an equally striking rise in excretion to a point much be- 

 yond that at which it had previously been. In the first case the drop oc- 

 cuired directly after exposure and in the second it was postponed two days 

 but occurred as in the-first case when the man had become seriously ill. In 

 the cases of unresolved pneumonia the effects were striking. There was an 

 immediate marked increase in the nitrogen and chlorid excretion. The 

 phosphates were increased somewhat less and uric acid was little affected. 

 This effect upon- metabolism was coincident with a rapid improvement. 

 The only apparent explanation the authors give to these results is 

 that in those cases, such as unresolved pneumonia and leukemia, which 

 responded favorably to x-ray treatment an increased tissue destruction 

 occurs directly after exposure resulting in an increased excretion of 



