The uric acid taken in the food consti tutes the bulk of the uric acid elimi nated. The avoidance of animal food containing xanthin compounds or uric acid, and also tea, coffee, and cocoa, whose alkaloids are similar xanthin com pounds, will gradually eliminate excess of uric acid in the system. The time when this may be accomplished may be deter mined by administering a dose of salic ylate of sodium. If any of the excess of uric acid still remain in the system, this drug will cause an immediate great increase of the uric acid as compared with the urea. If anyone taking a dose of salicylate of sodium gets as a result an excretion of uric acid greatly above the relation to urea of 1 to 30, such per son is not free from uric acid. A. Haig (Brit. Med. Jour., Mar. 27, '97).
In various cases of gout the prolonged administration of only red meat and hot water has resulted in marked improve ment, which persists in spite of gradual return to an ordinary dietary. It is the complex chemical changes brought about by the admixture of red meats with car bohydrates and sugar that cause the excessive formation of uric acid. The pa tient is given daily allowance of from 1 to 4 pounds of lean beef-steak, minced and cooked in various ways, the patient drinking from 1 to 5 pints of hot water, and avoiding all starchy, saccharin, and fermentative articles of food. This treat ment is indicated in obstinate chronic gouty arthritis, in recurrent uric-acid calculi, in frequent and intractable mi graine, and in cases of persistent gouty dyspepsia.
This treatment should be prescribed but rarely, and then only under the most careful supervision in cases in which the heart or kidneys are discussed. Used with due care, it is a most efficient and brilliant addition to the therapeutic measmes. Armstrong (Brit. Med. Jour., May 1. '97).
Uric acid is not the materies nwrbi in uric-acid lesions. It acts patholog ically only from its tendency to form concretions. Its formation, far from being a process of autointoxication, is a process of disintoxication. The decrease in the excretion of uric acid observed in some morbid conditions is not due to re tention, but to non-formation. The ma feria veceans in uric-acid lesions are the alloxuric bases. In all so-called uric-acid lesions we find an absolute increase over the normal of the sum of uric acid and alloxuric bases.
The indications obtain—a reduction in nuclein-catabolism and a rising of the processes of oxygenation. Uric-acid cases should be treated as amemic cases in all measures employed to promote the oxygenation powers of the blood. Iron is given usually combined with arsenic. Good results obtained in acute cases by inhalations of oxygen. On six occasions
an attack of gout was cut short by giv ing inhalations of oxygen repeated at short intervals. Uric-acid headaches and attacks of migraine can invariably be relieved, if not cured, by the same treat ment. A. C. Croften (Jour. Amer. Med. Assoc., July 8, '99).
Out of 25 cases of gout in the knees, in 16 grating was obtained on movement. Best results obtained by the administra tion of colchicum, while salicylic acid did not appear to be so useful. Ex amination of the blood of gouty persons before, during, and after an attack never showed diminution in alkalinity, as com pared with the blood of healthy human beings. A. Magnus-Levy (Zeit. f. klin. Med., B. 36, '99).
Conditions under which sodium salic ylate fails, viz.: (1) if given in condi tions of general debility or (2) in se quence to colchicum. Otherwise it is extremely useful in all uric-acid condi tions. Haig (Lancet, Aug. 12, '99).
All sorts of farinaceous aliments, bread, milk, and vegetables of every kind are to be allow-ed.
For gouty patients a diet of fresh vegetables and fruits, with meat spar ingly, and the exclusion of sugars and starches recommended. To remove the diathesis active physical exercise, alka line baths followed by friction, and the use of lithium salts well diluted. Noth nagel (Inter. klin. Blind., Feb. 14, '92).
Administration of milk increases the excretion of xanthin bases and reduces that of uric acid. Increased quantity of liquid (water) in the diet increases the alloxin bodies (uric acid and xanthin bases) in healthy persons. Fatty milk, according to Giirtner's formula, is recom mended as a suitable diet for all cases of gout. Laquer (Berliner klin. Woeh., Sept. 7, '96).
There are three great manifestations of the same condition. These are rheuma toid arthritis; podagra, or true gout; and articular rheumatism. One must not attempt to treat gout, but treat the subject who comes before him. There is no diet for the gout, but there is a diet for the patient. Nevertheless, in the large majority of cases sugars and starches must be cut off. But in spare gouty subjects farinaceous diet may be essential. Milk probably suits the largest number of gouty patients. Pa tients who can take but little exercise at first can gradually be led up to the point of taking a great deal of exercise, and this is essential for prevention of further attacks. Strontium salicylate is less disturbing than salicylate of soda. Tn some instances it agrees better with the patient when combined with digitalis and strychnine. Medicines, however, will not eradicate the diathesis. H. C. Wood (N. Y. Med. Record, July IO, '97).