Lastly, inasmuch as uratosis stamps the seal of specificity upon gout, it follows, from this and the above considerations, that there is a more intimate relation between gout and uratosis than between gout and hyper-uricæmia, and that the factors which make for uratosis have a more intimate bearing upon the pathogeny of gout than those which lead to hyper-uricæmia.
Constitution of Tophi
“Et tophus scaber, et nigris exesa chelydris Creta.”
Virgil, Georg., ii., 214.
The view that tophi were composed of chalk prevailed for centuries. As we see such was the conception of Virgil, and in our own country John Hunter entertained the same erroneous notion, while amongst the laity this view as to their nature is held widely even to-day as it was in the time of Dryden.
“Knots upon his gouty joints appear,
And chalk is in his crippled fingers found.”
Dryden, Pers.
Albeit, the term “chalk-stones” is a misnomer, as tophi, when pure, may be wholly devoid of lime. Modern analyses, too, have failed to demonstrate the presence of calcium carbonate, the essential ingredient being urate of soda.
On the authority of Rendu, we have it that Tennant and Pierson were the first to demonstrate the presence of uric acid in gouty deposits, which discovery was later confirmed by Fourcroy and Wollaston (1797), these latter observers showing that they consisted almost exclusively of urate of soda.