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

  • Arthur P. Luff
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Gout: its pathology 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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    accordingly as the morbid changes are produced by the presence of a soluble urate or not. 1. Necrotic changes in the affected tissues regarded as the primary cause of gout, the necrosis being due to the presence of dissolved urates.—Ebstein,* who has devoted a considerable amount of time to the experimental study of the causation of gout, is the great exponent of this view. His theory is that a destructive or, as he terras it, a necrotising process is produced in the cartilages or other implicated tissues by uric acid in one form of combination, and that, following this, the uric acid in another form of combination is deposited in the necrosed areas. In other words, that a destructive process always precedes the process of deposition, both processes being due to uric acid, but in different states of combination. Ebstein maintains that uratic crystals only form in necrotic tissues, never in healthy ti.ssues. He regards the necrosis of tissue and the subsequent uratic deposits as together constituting the characteristic ensemble of the gouty process. His theory assumes that the irritant is the neutral sodium urate in the dissolved state, and that the first step in the gouty process consists in a stasis of the lymph stream, followed by the infiltration of the ti.ssue in circumscribed areas by the lym])h containing the dissolved neutral umte. The neutral urate, according to his view, acts as a chemical irritant, and sets up a necrotising j)rocess in the implicated tissues, * “ I)io Xatur und Bcliaiidlung dcr Giclit,” 1882.