NUCLEIN OR PURINE METABOLISM 



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there is an increased amount not only of uric acid itself but of various intermediate 

 products in its formation from the purine bases of the food and of the tissues. The 

 deposit of the uric acid in the joint cartilages, characteristic of acute gout, appears to be 

 simply a crystallisation of urate of soda from a supersaturated solution of this substance 

 in the blood. The whole question of the pathology of gout and of the disordered 

 metabolism, which may precede or intervene between actual acute attacks of the disease, 

 is in need of further investigation. Especially is it important to determine the influence 

 on this condition not only of the nucleins and proteins of the food, but of the other 

 constituents such as carbohydrates and fats. Speaking broadly, gout is a disease 

 of the well-to-do, of the person who, while pursuing a sedentary or no occupation, is 

 not limited in his food-supply. It is almost unknown in the labouring class, where 

 hard manual work is combined with a bare sufficiency of food. It seems therefore 

 that it is not so much the supply of purines in the diet which must be controlled as the 

 general conditions of nutrition, which determine the fermentative changes in the purines 

 either of the food or tissues under normal conditions of meta.bolism. 



