AVERAGE DAILY EXCRETION THROUGH THE URINE FOR FIVE MONTHS—Soldier Detail.
| Name. | Body- weight. | Total Nitrogen. | Uric Acid. | Ratio of Uric Acid to Nitrogen. | Uric Acid per kilo of Body- weight. | Phosphoric Acid P₂O₅. |
|---|---|---|---|---|---|---|
| kilos | grams | gram | grams | grams | ||
| Oakman | 62 | 7.42 | 0.405 | 1:18 | 0.0065 | 1.39 |
| Morris | 59 | 7.03 | 0.450 | 1:15 | 0.0076 | 1.25 |
| Broyles | 60 | 7.26 | 0.398 | 1:18 | 0.0066 | 1.41 |
| Coffman | 58 | 8.17 | 0.379 | 1:21 | 0.0065 | 1.23 |
| Sliney | 60 | 8.39 | 0.647 | 1:13 | 0.0107 | 1.32 |
| Steltz | 53 | 7.13 | 0.416 | 1:17 | 0.0078 | 1.24 |
| Henderson | 71 | 8.91 | 0.488 | 1:18 | 0.0068 | 1.42 |
| Fritz | 72 | 7.84 | 0.642 | 1:12 | 0.0089 | 1.58 |
| Cohn | 62 | 8.05 | 0.512 | 1:15 | 0.0082 | 1.28 |
| Loewenthal | 59 | 7.38 | 0.372 | 1:19 | 0.0063 | 1.28 |
| Zooman | 55 | 8.25 | 0.457 | 1:18 | 0.0083 | 1.19 |
| Bates | 65 | 8.08 | 0.387 | 1:20 | 0.0059 | 1.23 |
| Davis | 57 | 8.61 | 0.414 | 1:20 | 0.0072 | 1.42 |
These figures are interesting in many ways. First, they make clear that on the diet prescribed, these men were manufacturing or excreting about the same amount of uric acid per kilo of body-weight as the men of the two preceding groups, living more or less with free choice of food. In other words, all these men, with one and possibly two exceptions, were practically throwing out only uric acid of endogenous origin, i. e., that which came from the breaking down of the man’s own tissue cells. Second, it is to be noted that the ratio of uric acid to nitrogen in the men of this group varies only within narrow limits.
It is very evident from these figures, reinforced by those of the previous groups, that we can diminish greatly the output of uric acid by simply restricting the extent of proteid katabolism, through reduction in the amount of proteid food. Further, we now know that this general lowering of proteid metabolism can be accomplished not only without danger to the body, but with a distinct betterment of the physical condition.
Just here I should like to emphasize one point that appears to me of primary importance in any consideration of the influence of diet in gouty affections, and in so doing I merely echo a statement made by Sir Dyce Duckworth[53], viz., “that the subject of gout, either by inheritance or acquirement, is so far peculiar in his constitution that he reacts differently to various agencies, such as climate, food, etc., from persons not so disposed.” In this connection, let me refer again to the foregoing table of results obtained with the soldier detachment, remembering that these thirteen men were living under exactly the same conditions and consuming the same kind of food each day, and in essentially the same amounts. Yet notice the striking variation in the output of uric acid by one of these men (Sliney),—a variation which shows itself especially when the uric acid is calculated per kilo of body-weight. How can this variation be accounted for except on the assumption that there may be personal idiosyncrasies, personal coefficients of nutrition, natural or acquired, that modify to some extent the production of uric acid, the oxidation of uric acid, or the elimination of uric acid from the body?
Lastly, in advocating the possible systemic value of a lowered proteid metabolism as of value in the prevention of gout, and of other disorders which have their origin in perverted nutrition, I am inclined to emphasize the desirability of using common-sense in the application of dietetic rules, remembering that man is an omnivorous animal, and that Nature evidently never intended him to subsist solely on a “cereal diet,” or on any specific form of food to the exclusion of all others. On matters of diet every man should be a law unto himself, using judgment and knowledge to the best of his ability, reinforced by his own personal experiences. Vegetarianism may have its virtues, as too great indulgence in flesh foods may have its serious side, but there would seem to be no sound physiological reason for the complete exclusion of any one class of food stuffs, under ordinary conditions of life. Far more rational is temperance in place of prohibition, and I am inclined to emphasize the systemic value of a daily diet so reduced in quantity that the metabolic processes may be largely decreased, in closer harmony with true physiological needs, especially those which involve the breaking down of proteid matter; and in making this suggestion I can add the assurance, based upon these observations on many individuals, that there is not only perfect safety but gain to the body, in diminishing proteid metabolism to a level somewhere near the actual requirements of the individual.