CHAPTER XXI 



URIC-ACID METABOLISM AND GOUT 



THESE subjects have been the object of such a prodigious 

 amount of research that it is far beyond the scope of this work 

 to review the history and the details of the investigations. 

 Such a review is also particularly unnecessary, since it can be 

 found in the works on physiological chemistry and various 

 treatises on metabolism, and also since it has been recently 

 thoroughly covered in English by Barker and by McCrudden. 1 

 The more recent advances have also been discussed by Chit- 

 tend en in his Shattuck Lecture, 2 and by Mendel in his Harvey 

 Lecture. 3 



Consequently the attempt will be made in this chapter 

 merely to give, as briefly as possible, the views now most gener- 

 ally accepted concerning the nature and metabolism of uric acid, 

 and its relation to pathological processes. For the historical 

 discussion, indicating by what devious steps we have reached 

 our present understanding concerning this long-disputed subject, 

 the reader is referred to the articles mentioned, upon which I 

 have freely drawn. In these articles will be found a complete 

 bibliography to the beginning of 1906. 



THE CHEMISTRY OF URIC ACID 



It is the very great service of Emil Fischer to have shown 

 us the structure of the uric-acid molecule, the empirical formula 

 of which, C 5 H 4 N 4 O 3 , had long been known. He demonstrated 

 that it is a member of a group of substances, which are all 

 characterized by being built up about a certain nucleus, C 5 N 4 . 

 As the simplest member of the group is a synthetically formed 



1 L. F. Barker, " Truth and Poetry Concerning Uric Acid," Chicago, 1905 ; 

 this will also be found as a series of editorials under the same title in the 

 Journal of the Amer. Med. Assoc., 1905 (44), from Jan. 14 to May 13. F. H. 

 McCrudden, "Uric Acid," New York, 1906. Other complete reviews are 

 given by Wiener, Ergebnisse der Physiol., 1902 (1), 555; ibid., 1903 (2), 377; 

 Burian and Schur, Pfluger's Arch., 1900 (80), 241; 1901 (87), 239; Walker 

 Hall, "The Purin Bodies of Food-stuffs," 1903. 



2 Boston Med. and Surg. Jour., 1905 (153), 179. 



3 Journal Amer. Med. Assoc., 1906 (46), 843. 



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