458  Pharmacologic  Superstitions.  i^olt&e/iw' 
that  the  statement  is  untrue,  the  hypophosphites  passing  through  the 
system  and  being  eliminated  by  the  kidneys  as  any  foreign  salt. 
An  unbiased  study  of  the  evidence,  it  seems  to  me,  must  in- 
evitably lead  to  the  conclusion  that  any  therapeutic  virtue  in  the 
compound  syrup  of  hypophosphites  is  due  to  the  sugar  it  contains. 
Some  skeptical  empiricist  rises  up  to  ask,  If  this  mixture  is  so 
impotent  why  is  it  so  widely  employed?  The  reasons  for  its  popu- 
larity are  two :  First,  and  most  important,  the  persistent  advertising 
methods  of  the  manufacturers  of  certain  brands  of  the  compound 
syrup  of  hypophosphites,  and  secondly,  its  innocuous  character.  It 
is  better  to  do  nothing  than  to  do  the  wrong  thing,  and  when  the 
patient  insists  on  having  some  form  of  medicine  and  the  physician 
knows  of  no  drug  which  is  likely  to  be  beneficial,  he  satisfies  the 
longing  of  the  sick  man  by  ordering  the  compound  syrup  of  hypo- 
phosphites, and  salves  his  conscience  with  the  thought  that  at  least 
he  has  done  no  harm. 
Lithia. 
The  use  of  salts  of  lithium  in  the  treatment  of  gout  was  intro- 
duced by  Garrod.11  He  based  his  application  of  this  remedy  on  the 
hypotheses  that  the  gouty  paroxysm  is  due  to  the  deposit  of  urates  in 
the  joint,  that  this  deposit  is  brought  about  by  a  diminished  alkalinity 
of  the  blood  which  lessens  the  solubility  of  the  salts  of  uric  acid,  and 
that  lithia  by  a  solvent  action  on  the  uric  acid  prevented  the  deposit. 
In  support  of  the  latter  view  he  quotes  the  experiments  of  Bins- 
wanger,  who  found  that  one  part  of  lithium  carbonate  in  120  of 
water  would  dissolve  four  parts  of  uric  acid  at  the  body  temperature, 
and  of  Ure,12  who  showed  that  1  grain  of  lithia  in  an  ounce  of  water 
would  dissolve  2.3  grains  of  uric  acid. 
Neither  his  theory  concerning  the  causation  of  the  gouty  attacks 
nor  his  explanation  of  how  lithium  would  prevent  them  can  be  ac- 
cepted. In  the  first  place,  Magnus-Levy13  measured  the  alkalinity 
of  the  blood  of  twelve  patients  before,  during  and  after  the  gouty 
paroxysm,  and  failed  to  find  any  distinct  change  in  its  alkalinity. 
In  the  second  place,  conditions  accompanied  with  severe  reduction  of 
the  bodily  alkalinity,  such  as  diabetic  coma  or  leukemia,  do  not  lead 
to  the  deposit  of  urates.  In  the  third  place,  acidulating  the  blood 
cannot  change  the  solubility  of  sodium  urate  without  transforming 
11  Garrod,  A.  B. :  Gout  and  Rheumatic  Gout,  London,  1861. 
12  Ure :  Pharm.  Jour.,  August,  1843. 
13  Magnus-Levy :  Harvey  Lecture,  1910,  p.  269. 
