It may be recalled that Wiechowski and others observed that in man, of parenterally introduced uric acid, 80-90 per cent. reappears in the urine. Accordingly, Schittenhelm and Wiener argued that, if uric acid is indestructible in the human body, then, given retarded elimination, the tissues should contain considerable quantities thereof. Subsequently, in 1914, they sought to investigate human tissues as to their content of uric acid. Their studies were conducted on three examples, a case of anuria, one of pernicious anæmia, and one of gout.
The case of anuria occurred in a male, aged sixty-two, in sequence to thrombosis of both renal veins following operation. Two-hundred gram samples of the following tissues, lung, heart, spleen and liver, were examined for uric acid with wholly negative results. The residue of the organ was worked up together, but only 0·01 gram of uric acid was isolated.
In the case of pernicious anæmia no uric acid was demonstrable. The gouty subject had for twenty-five years suffered from typical attacks and exhibited many auricular tophi. The following organs, in their entirety, were analysed, the liver (1,550 gram), no uric acid; spleen (290 gm.), 10 mg. uric acid (3·5 mg. per 100 gm.); kidney (270 gm.), no uric acid; lung (930 gm.), 15 mg. uric acid (1·6 mg. per 100 gm.); muscle (440 gram), no uric acid; and intestine (420 gram), no uric acid.
It will be seen that uric acid was either absent or present in minimal amounts, and these results Schittenhelm and Wiener interpreted as confirming their long advocated contention as to the destructibility of uric acid in the human organism.
Morris S. Fine, from the results of similar investigations, considered the failure of these observers to isolate uric acid in these cases of anuria and gout as most remarkable. He considers “their results may in part be ascribed to the use of hot sodium hydroxide previous to the precipitation of the proteins in the extraction of the tissues, as the instability of uric acid in alkaline solutions is a well-known property.”
In this criticism Fine would appear to be fully justified, in view of the marked contrast between the findings of Schittenhelm and Wiener, and his own data is recorded in the tables on p. 159.
While it is unfortunate that Fine’s theory contained no instances of gout, his findings are a definite proof that, to quote his own words, uric acid can be demonstrated in considerable concentrations in human tissues. Incidentally, also, his tissue analyses are flatly contradictory to Schittenhelm and Weiner’s persistent contention, viz., that the human organism can decompose uric acid.
Gideon Wells states that in normal individuals the tissues contain but little uric acid, and this not in quantities sufficient to permit readily of its isolation in a pure state. Albeit, Wells found considerable amounts of uric acid in the tissues of a young woman who, in sequence to poisoning with HgCl₂, died after complete suppression of urine for nine days.
Table I.—Concentration of Uric Acid in Human Tissues and Fluids per 100 Grams of Material
| Case. | E. E. Uremia. | T. D. Uremia. | S. H. Uremia. | M. F. Diabetes. | C. M. Diabetes. | S. T. Amputation. | H. J. Pneumonia. |
|---|---|---|---|---|---|---|---|
| mg. | mg. | mg. | mg. | mg. | mg. | mg. | |
| Blood | 15·4 | 14·3 | 17·0 | 0·7 | 0·7 | 0·7 | |
| Pleural fluid | 16·7 | 15·9 | |||||
| Ascitic fluid | 18·0 | ||||||
| Pericardial fluid | 14·3 | 18·0 | |||||
| Subcutaneous fluid | 18·0 | ||||||
| Spinal fluid | 2·8 | 2·0 | 4·7 | ||||
| Skeletal muscle | 8·0 | 3·9 | 5·8 | 0·7 | 2·6 | 2·0 | |
| Heart muscle | 10·0 | 7·3 | 8·8 | 1·2 | |||
| Liver | 18·0 | 15·6 | 11·5 | 5·0 | 4·0 | ||
| Spleen | 12·6 | 14·3 | 9·1 | 1·2 | Trace | ||
| Skin | 13·0 |