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.

    35/272 (page 23)
    Dr. P. W. Latham* regards some change in the nervous system as the most important factor in the etiology of gout. He thinks that such change is localised in the medulla oblongata, or in the spinal cord, or in both, and that this nervous disorder may be either hereditary or acquired. He argues that if a portion of the medulla oblongata involving some of the roots of the vagus be the part affected, the metabolism of the liver may be interfered with, and so lead to the formation of uric acid. He also considers that if, from any cause, uric acid is cir- culating in the blood, it would act as a poison upon any weak spot in the nervous system, and that it is intelligible that it might act upon portions of the spinal cord which control the nutrition of the joints, and so cause nutritive changes or inflam- mation in the joints connected with that portion of the cord. In consequence of the inflammation or nutritive changes in the joints, sodium biurate becomes deposited in them, or in the tissues around the affected joint. Dr. Latham explains the phe- nomena of a gouty paroxysm by direct stimulation of sensory nerves by uric acid. He considers that the gout associated with chronic lead poisoning may be explained by the lead acting in such cases more particularly on those portions of the spinal cord which are concerned in gout. Dr. lialfe held the view that the accumulation of uric acid in the blood in gout was due to non- conversiou into urea of the uric acid normally formed in the tissues, and he considered that the * Croonian Lectures, 1S86.