428 JOSEPH H. PRATT 



seemed to prove conclusively that uric acid could be recovered quantita- 

 tively after injection into man. The work of McClure and Pratt, Gries- 

 bach and Burger, shows that much uric acid may be retained. Advocates 

 of uricolysis could advance these recent observations in support of their 

 theory with as much justice as their opponents did the old experiments 

 of Soetbeer and Ibrahim, v. Benezur and Umber. 



The injection of uric acid may be followed by the excretion of more 

 uric acid than has been injected. In one of Griesbach's cases this amounted 

 to 218 per cent. The uric acid injected, as has been shown, leaves the 

 blood and enters the tissue fluids, joining the reserves already stored there. 

 This newly discovered fact makes improbable the sharp distinction that 

 has been held between exogenous and endogenous uric acid. The injected 

 uric acid accumulates in the tissues and by increasing the concentration 

 in the tissue fluids favors the passage of uric acid back into the blood and 

 its excretion by the kidneys, possibly it also stimulates nuclear metabo- 

 lism. It is a remarkable fact that the complex nucleoproteins taken as food 

 produce a more speedy rise in the uric acid output than does uric acid 

 introduced directly into the blood stream. 



Uric Acid in the Blood in Gout 



Alfred B. Garrod(fr) discovered that the blood of gouty persons con- 

 tained as a rule more uric acid than that of healthy men. Garrod's first 

 observations were made in the summer of 1847 and the following year after 

 investigating several cases of gout with uniform results he published his 

 findings in the Transactions of the Medico-Chirurgical Society. At that 

 time he drew the conclusion that the "blood in gout always contains uric 

 acid in the form of urate of soda, which salt can be obtained from it in 

 crystalline state." Eleven years later he wrote that the only alteration he 

 would be disposed to make in this statement would be to append the words 

 "in abnormal quantities." Garrod even attempted a quantitative analysis 

 and obtained from the first patient the equivalent of 5 mg. of uric acid per 

 100 grams of blood serum. Garrod's(c) work did not receive the recogni- 

 tion it deserved until after the discovery by Folin and Denis in 1913 of a 

 simple colorimetric method for determining the amount of uric acid in the 

 blood. "The general harmony of his conclusions with current views is 

 surprising when one considers the methods which were then available. It 

 has been suggested that he drew on his imagination for some of his results, 

 but the correctness of his deductions and the quantitative data which he 

 gives do not support this" (V. C. Myers). 



G. Klemperer(a), Magnus-Levy, v. Jaksch and other German investi- 

 gators attempted to estimate the amount of uric acid in the blood either by 

 the ammoniacal silver method or the cupric bisulphite method for precipi- 



