Gout and goutiness : and their treatment / by William Ewart.

  • Ewart, William, 1848-1929.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Gout and goutiness : and their treatment / by William Ewart. Source: Wellcome Collection.

    19/612 (page 3)
    merely as ' uric acid in the wrong place,' and which excludes the latent constitutional factor on the principle, * without uric acid, no gout.' The interdependence of gout and of uratic deposits has been less in question than the precise nature of their relations. Gout is really made up of the ' uric acid trouble' and of ' something else,' or, rather, in the order of the events, of something concerning which we should like to know more than we do, and, in the second place, of the uric acid complication. Not many years ago tubercular phthisis, in spite of our familiarity with it in every phase and variety, was an unsolved problem. The results of the disease were obvious ; its essence entirely unknown. This is almost exactly our present position towards gout—much fami- liarity with, and some knowledge of its manifestations, but nothing knov.n of their original cause, from which they may differ as much as tubercle and its life-history differ from Koch's bacillus. What we commonly under- stand by ' declared gout' may represent late results only, having little in common with the fans et origo mall. Phthisis was adduced merely to illustrate the needful distinction between the morbid agencies of a disease and their manifest products. Nothing leads us to suspect in gout a parasitic element, though others besides Boerhaave (1668—1738) entertained the view that it was sometimes contagious; indeed, whilst recognising gouty morbid actions totally distinct from the precipitation of uric acid with its long train of symptoms, we hardly trace in gout the complete outline of a disease. Neither need we assume any foreign morbid material. A simple deviation of the natural constituents of the body from their normal