230 Gout. 



more or less prominent arthritic swelling and are unfit either for standing 

 or walking. Sometimes there is also a swelling of the wing joints, and 

 in case of chickens, a strong bluish-black discoloration of the comb becomes 

 apparent. At autopsy of birds dead from the affection after a course 

 of some weeks or months, there is at times found within and about the 

 joints a deposit of white, chalky, mortar-like material; and the serous 

 membranes (membranes of thoracic and peritoneal air chambers and peri- 

 cardium), the epicardium and the liver are apt to be found the seat of 

 similar deposits, as though powdered with plaster of Paris. The kidneys 

 are thickly beset with white points and sometimes the ureter is completely 

 filled with white plugs. Microscopic examination shows the condition 

 .to consist of a deposit of and infiltration with crystals of sodium urate 

 (plates and needle-shaped crystals grouped in stellate bunches). 



As far as the causative conditions and nature of the metabolic dis- 

 turbances, fundamental to the affection, are concerned, but little has been 

 definitely established in case of human beings. Practically all that is known 

 is that certain kinds of food (large amounts of albuminates, highly sea- 

 soned meats [meats rich in nucleo-proteids], alcohol), lead-poisoning and 

 a predisposition of the individual play a part. It has been established 

 in case of avian gout, by the highly interesting investigations of Ebstein, 

 Kionka and Kossa, that a number of poisons which injure the renal 

 tissue and, too, exclusive meat diet are capable of inducing in experimental 

 cases the characteristic features of gout. As early as 1766 Galvani pointed 

 out that chickens became gouty after ligature of both ureters, an ob- 

 servation which has been repeated by Zaleski, Colasanti, Schroder and 

 others. Ebstein injected subcutaneously in chickens neutral chromate of 

 potassium in separate doses of 0.32 gram, with the idea of impairing the 

 excretion of uric acid by producing serious renal lesions ; with this dosage 

 the birds lived for some weeks, and, as a matter of fact, Ebstein estab- 

 lished that they undoubtedly became gouty. The same results were obtained 

 by v. Kossa in chickens by intramuscular injections of solutions of oxalic 

 acid, phenol, acetone, aloin, corrosive sublimate and, too, cane sugar. 

 Kionka drew attention to the fact that carnivorous birds are the ones 

 which are especially subject to gout, and from a series of studies estab- 

 lished the fact that chickens on exclusive meat diet (160 grams a day), 

 to which they may become accustomed, may become gouty in the course 

 of a few weeks or several months and then die of the affection. The 

 large, heavy breeds showed greater tendency in this direction than the 

 commoner small chickens. There were noted a great increase in the 

 production of uric acid with this diet and a correspondingly high dis- 

 charge of uric acid (8-9.5 grams each day) and of nitrogen (3-4-5 grams 

 a day) in the excreta. Since M. Kochmann has shown that in dogs, also, 

 when fed exclusively with horse flesh, the renal and hepatic parenchyma 

 suffers a change (parenchymatous nephritis and hepatitis), and the poisons 

 above mentioned give similar results, v. Kossa looks upon the nephritis 

 as the cause of the toxic gout interfering with the elimination of urates 

 just as if the ureters were ligated. Under natural conditions almost every 

 chronic nephritis in birds may be followed by gout. Ziirn once observed 

 the affection after feeding ustUago maidis to chickens. The common 



