88 THE PHYSIOLOGY OF URIC ACID 



one of the most powerful and satisfactory stimulants 

 known, producing a really increased capacity for 

 mental and physical work. Every one knows how 

 a cup of strong tea, coffee, or beef-tea will refresh the 

 weary and give new energy to the student. We know 

 that squads of soldiers doing forced marches are 

 greatly helped by caffeine. It has been repeatedly 

 proved in every army that the cold-tea brigade comes 

 in first, the water men second, and the alcohol squad 

 a bad third. But we must set against this the 

 certainty that purin bodies produce earlier degenera- 

 tion of the arteries, and occasionally they are respon- 

 sible for very severe types of migraine. 



A few words should be said here on the subject of 

 gout. The immense controversies which have raged 

 about this interesting disease are gradually giving 

 place to some settled conclusions. The essential 

 point is that the kidneys are not sufficiently permeable 

 to uric acid, or rather, to the urates. In many 

 cases, but not all, they are obviously diseased, some 

 form of chronic interstitial nephritis being the 

 commonest abnormality. The daily output of uric 

 acid is therefore found to be subnormal, whereas the 

 blood contains too much. Whenever any unusual 

 amount of purin bodies has to be disposed of, 

 whether after a meal too rich in meat, broths, or the 

 vegetables previously named, after some unusual 

 exercise, or an attack of fever, or when katabolic 

 changes in the body have been stimulated by alcohol, 

 an acute attack of gout results. The output of uric 

 acid in the urine rises, the high blood content forcing 

 its way as it were through the resistance of the 



