Uric Acid Variations in Chronic Gout

It must never be forgotten that the elimination of uric acid displays wide variations, this even when the subject under investigation is on a constant diet. Consequently, as Folin has pointed out, “even in the case of gout, which is distinctly associated with uric acid, it is an extremely difficult matter to prove by means of urine analyses that the uric acid elimination is not entirely normal.” And he adds, “If it had not been for the fact that uric acid, because of its insolubility, is so easily found in the joints, it would unquestionably have been a very long time before any definite relationship between uric acid and gout could have been established.”

None can gainsay the truth of these reflections, for, when placed on a fixed diet, the uric acid output in the victims of chronic gout differs but little from that of normal individuals on a similar regime; save in this respect, that, following the intake of purin-containing substances, the period of augmented uric acid excretion that ensues is prolonged as compared with the normal.