Gout, its pathology, forms, diagnosis and treatment / by Arthur P. Luff.

  • Luff, Arthur P. (Arthur Pearson), 1855-1938.
Date:
1907
Catalogue details

Licence: In copyright

Credit: Gout, its pathology, forms, diagnosis and treatment / by Arthur P. Luff. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    [Part L tract or produced b}' some alteration of metabolism going on in some of the digestive organs ; that there must be some body formed in the intestinal canal capable both of causing the symptoms of gout and also of so altering the metabolism of the liver as to cause an increased formation of uric acid. He went on to state that he considered a toxin was the cause of the disease, a product of a definite bacillus, and a product of one of the bacilli normally found in the intestinal canal. A little later in the same year Le Gendre read a paper at the International Congress of Medicine in Paris, in which he foreshadowed the possible intestinal origin of gout. A year later Chalmers Watson drew attention to this view of the origin of gout. In 1903 there appeared in the Lancet a most instructive paper by Woods-Hutchinson, in which he stated his view that gout was a toxaemia ; that the source of the toxin was the gastro-intestinal tract ; that owing to some catarrhal or inflamed condition of that tract, possibly secondary to some chemical changes within that tract, a toxin was produced that was absorbed into the circulation ; that if the cells, either the wandering leuco- cytes of the blood and the lymph or the fixed body cells, could successfully combat and neutralise that poison nothing resulted. He thought that probably such was the case in people who suffered from certain intestinal derangements which quickly passed off ; but if the cells were powerless completely to neutralise that toxin, then, as the result of the unaltered toxin that was circulating in the blood and lymph, gout resulted ; that the cells, lymphocytes and fixed body cells, which were able to neutralise part of that toxin suffered degradation and degeneration in neutralising it, and as a result uric and phosphoric acids, the debris of nucleinic substances, were set free, and that that was the origin of uric acid which in certain cases might be deposited as an after-effect in the form of sodium biurate. The selective action of toxins on different tissues is