Gout : its pathology and treatment / by Arthur P. Luff.

  • Arthur P. Luff
Date:
1898
Catalogue details

Licence: Public Domain Mark

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

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    have previously begun to degenerate. Dr. Berkart * considers that the severity of the local symptoms attending an attack of acute gout are inconsistent with the assumption that they are produced by a primary chondritis, clue to irritation set up by the deposition of sodium biurate in the articular carti- lages. He considers that the role of the uric acid is one of a humbler kind than that which has hitherto been attributed to it. In his opinion the uratic deposits are most frequently connected with a form of panarthritis, or a general inflammatory affection of the joints, which chiefly affects the smaller joints of the extremities. Without assum- ing any identity between arthritis deformans and gout, he considers that in both instances the disease probably originates in some kind of atrophy of the substance of the bone, that the degenerative process then attacks the cartilages and fibrous tissues of the joints, and that following on this there occurs a necrosis of the tissues close to or within the joint. This necrosis, he considers, is the primary cause of the pain, hyperemia, collateral cedema, and de- squamation of the skin of the affected joint. The degeneration and necrosis ot the tissues are the result of a profound disturbance of nutrition. Dr. Berkart attributes the presence of the urates in the blood in part to leucocytosis, and in part to the formation of uric acid from the disintegration of the tissues; so that he regards the uratic deposits as an epiphenomenon. and not as the cause of the gouty paroxysm. * Brit. Mvd. Joum., 1895, vol. i., p. 243.