The North American Practitioner (Volume 10 ) (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated.1898 Excerpt: ... Medical Progress. MEDICINE SERVICE OF JOHN A. ROBISON, A.M., M.D. PRESBYTERIAN HOSPITAL. The Pathology And Treatment Of Gout. Dr. Arthur P. Luff read a paper before the Harveian Society in London, Jan. 6, as reported in the Medical Press, in which he said: After considering the various views as to the causation of gout, he stated the reasons for believing that the presence of uric acid in the blood in gout was due to absorption of that body from the kidneys owing to deficient secretion of it by those organs. He maintained that if uric acid be normally produced in the liver, spleen, or tissues generally, then it must be conveyed in the blood to the kidneys to be excreted, and therefore ought to be capable of detection in the blood of healthy persons. He referred to a number of experiments showing that exhaustive examinations of the blood of healthy human beings, of other mammals, and of birds, failed to show the least trace of uric acid. Dr. Luff therefore considered that the first step in the pathogenesis of gout was a failure on the part of the kidneys, from functional or organic mischief, to perfectly excrete the uric acid formed in them, and that, consequently, absorption of the non-excreted portion takes place from them into the general circulation, where it at first exists in the form of sodium quadriurate, and so forms the source from which the gouty deposit is derived. His view was that uric acid was formed in the kidneys by the combination of urea with glycocirte, or with one of the derivatives of the latter body. He brought forward evidence to show the erroneous nature of the views held as to a diminution of the alkalinity of the blood promoting uratic deposition, whilst increased alkalinity of the blood is supposed to cause solution of the deposit...