The main point to be emphasized in these results is that they show quite conclusively how greatly the daily output of uric acid may be reduced by diminishing the intake of proteid food, and thereby restricting the extent of the proteid metabolism. The ratio of uric acid to the total nitrogen excreted may or may not be altered; this will depend in large measure upon the character of the diet, the relative proportion of free and combined purin bases introduced with the food, etc. As already stated, we do not know with certainty how far the excreted uric acid represents the formation of uric acid in the body, but presumably there is a more or less close relationship, and hence we are doubtless warranted in saying that the formation of uric acid is diminished, in essentially the same proportion as its excretion is reduced, with a lowered proteid intake. Certain it is that several of the persons under observation, who had troubles of a gouty and rheumatic nature in the past, have during the course of the experiment experienced relief, with complete and permanent abeyance of all symptoms. The writer is firmly of the opinion that ordinary gout and rheumatism are entirely preventable by reasonable care and judgment in the matter of diet. Whether, when once firmly established, in aggravated form, they will prove amenable to dietetic treatment is not so certain, but undoubtedly mild cases will respond to the beneficial influences of a rational diet, reinforced by treatment adapted to the removal of urates already deposited. In any event, due regard for the well known deleterious effects of purin-containing foods as a source of exogenous uric acid, and with restriction of proteid metabolism to the true necessities of the body, should serve as an effective means of preventing all those troubles for which uric acid is generally held responsible.
The two following tables give a summary of results bearing upon the excretion of uric acid and its relation to nitrogen and body-weight, for all the subjects belonging to the “professional group” and the “student group.” Emphasis should be laid upon the fact that these figures represent the average daily excretion for the different individuals through the entire period of the experiment.
AVERAGE DAILY EXCRETION THROUGH THE URINE FOR SEVEN-NINE MONTHS.—Professional Group.
| 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 | ||
| Chittenden | 57.0 | 5.69 | 0.392 | 1:14 | 0.0068 | 0.90 |
| Mendel | 70.0 | 6.53 | 0.419 | 1:15 | 0.0060 | 1.46 |
| Underhill | 65.0 | 7.43 | 0.516 | 1:14 | 0.0079 | 1.28 |
| Dean | 65.0 | 8.99 | 0.386 | 1:23 | 0.0059 | 1.73 |
| Beers | 61.5 | 8.58 | 0.365 | 1:23 | 0.0059 | 1.49 |
AVERAGE DAILY EXCRETION THROUGH THE URINE FOR FOUR-FIVE MONTHS.—Student Group.
| 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 | ||
| Anderson, G. W. | 71.0 | 9.37 | 0.632 | 1:14 | 0.0089 | 1.75 |
| Anderson, W. L. | 61.0 | 10.41 | 0.516 | 1:20 | 0.0084 | 2.14 |
| Bellis | 78.0 | 8.88 | 0.531 | 1:16 | 0.0068 | 1.98 |
| Callahan | 83.0 | 9.04 | 0.624 | 1:14 | 0.0075 | 1.74 |
| Donahue | 62.0 | 7.47 | 0.395 | 1:19 | 0.0063 | 1.79 |
| Jacobus | 56.0 | 7.58 | 0.423 | 1:17 | 0.0075 | 1.67 |
| Schenker | 73.0 | 10.09 | 0.624 | 1:16 | 0.0085 | 2.20 |
| Stapleton | 75.0 | 11.06 | 0.609 | 1:16 | 0.0093 | 2.64 |
Turning now to the third group of men, i. e., the soldier detail, under observation for a period of six months, during five months of which time they lived on a prescribed diet with diminished content of proteid food, but with no exclusion of animal food, the following average results are to be noted:
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 |