“Now, if the excretion of the uric acid always took place easily, we should not have much trouble about its formation, but it is this excretion which constitutes the difficulty. Uric acid and the acid salts of the uric acid dissolve with difficulty in cold water; but more easily in warm; still, one gramme of uric acid requires from 7 to 8 litres of water at the temperature of the body for its solution. The acid urate of soda dissolves in 1100 parts of cold and 124 parts of boiling water. The ammonia salts and the salts of the alkaline earths do not dissolve nearly so easily.
“The ‘warm water’ which keeps the uric acid and the uric acid salts dissolved in the body is the blood and tissue fluids. Serious disturbances must take place if this fluid becomes cooler or diminished in quantity; for a deposit of crystalline uric acid would occur in the body.
“A person who has to daily excrete 2 grammes of uric acid, is constantly liable to this precipitation, as he may at any time lose large quantities of water through perspiration. It is, therefore, undoubtedly safer to have the uric acid combined with soda, as an acid urate; but where is soda to be obtained if it is absent from the blood, owing to dysæmia?
“The more acid the urine is, the more easily will a precipitation of the uric acid occur in the organism—for instance, in the kidneys or bladder. The urine of a person eating flesh contains a large amount of uric acid, as we have seen before; it is also strongly acid in reaction whereas the urine of herbivorous animals is generally alkaline in reaction....
“A very acid urine rich in uric acid is also produced by salt meat and salt fish, because in the process of salting, the basic salts (basic alkaline phosphates and carbonates) pass into the pickle water and neutral common salt takes their place. Russian physicians have told me that in certain parts of Russia, where the people eat a great deal of salt fish, urine stones are frequent.... Now, if we wish to prevent by the use of alkalies the formation of uric acid sediments, or gradually to dissolve such concretions as have already formed in the bladder, it is certainly more rational to prescribe a diet of fruits and potatoes than to order alkaline mineral waters—which, when taken constantly, may produce all sorts of disturbances.
“If, then, it is true that our ordinary diet consists chiefly of foods rich in albumen and phosphoric acid but poor in soda, and that in consequence of this a tendency towards the accumulation of uric acid in the body is pretty generally found, the very slightest extra strain on the system will be sufficient to cause a precipitation of uric acid and uric acid salts in the body. This result is very often brought about by a chronic acid catarrh of the stomach, which in its turn depends upon dysæmia, and is in 95 out of 100 cases the predecessor of gout. The fermentation acids, especially oxybutyric acid (which is found in the urine both in acid catarrh of the stomach and in diabetes mellitus), combine with some of the alkalies of the blood, and thus lessen its alkalescence (basic character); and as catarrh of the bowels and periodic diarrhœas are frequently associated with acid catarrh of the stomach, these bases may be even directly excreted in the stools, and thus the quantity of alkalies in the blood be further diminished.
“Now we find that men consuming vegetable food form only small quantities of uric acid, herbivorous animals as well as carnivorous hardly any, but men living on flesh-food very large quantities, we must come to the conclusion that men cannot properly manage flesh-food. The organism of the flesh-eating animal has the faculty of completely digesting flesh-food, whereas the organism of man is unable to accomplish this. Consequently man cannot be classed as carnivorous and cannot eat flesh unpunished....
“To illustrate this further, we may mention another important point here. Carnivorous animals have atrophied, inactive sweat glands, whilst man and herbivorous animals possess well-developed sweat glands. There is no doubt, therefore, that the herbivora must have preceded the carnivora in point of time—the carrion feeders being the connecting link between them.[12] The carnivora have retained the sweat glands as atrophied (rudimentary) organs, and as a sign of their origin, but have given up the habit of sweating, or, in other words, have adapted their skin to the changed conditions of feeding. An animal whose food contains large quantities of urea as well as of creatin, creatinin, xanthin, hypoxanthin, guanin, etc. (the early stages of uric acid), and thus increases the quantity of urea and uric acid already present in the body, must take care always to keep these substances in solution. But the urea and uric acid can only be dissolved in comparatively large quantities of warm water (blood). Such an animal must, therefore, be exempt from the possibility of suddenly losing a large part of its blood and tissue fluid by sweating—or else a precipitation of the above substance will take place. Nor should an organism allow of any sudden cooling down of portions of the skin—such as might be caused by evaporation of the sweat, or else a precipitation would again take place. In a word, such an animal must not be subject to sweating, or else it would be troubled with acute and chronic rheumatism, gout, etc....
“Now as man is subject to sweating, it is evident that he was not intended to live on flesh, but on vegetables, or rather on fruits, for he was never meant to live on cereals.... Man may eat a limited amount of meat and cereals without doing himself much harm; but he must always remember that they ought never to form his principal food.
“As soon as it is really understood that we were never intended to live on flesh and cereals, the uric acid diathesis as a trouble of mankind will disappear. We must, of course, not forget to restrict the consumption of common salt and to use such vegetable foods as are rich in food salts, and not those which are rich in albumen; for a diet consisting of bread, pulses, and cereals, and potatoes will tend to produce gout just as much as a diet consisting of flesh, fish and caviare....”[13]