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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    remarks : “ it will scarcely be contended that necro- tising and necrotic processes can take place in synovia! ” Sir Dyce Duckworth* in a modified sense believes that a soluble urate may act as an irritant. Although he considers that gout is primarily due to a disorder of the nervous system, he entertains the additional view that the urate in solution may set up degeneration and necrotic changes in tissues. This view is expressed as follows : “ It can hardly be doubted that lesions result from the action of uric acid in solution in the tissues, and that thus both acute and chronic inflammatory changes may be set up without the direct influence of uratic deposit as an alleged irritant in joints and in certain viscera, notabl}^ in the kidneys. Degenerative changes and necrosis also appear to be thus induced.” 2. Inflammatory or degenerative changes in the affected tissues regarded as the primary cause of gout, such initial changes not being caused by urates.—Dr. Ord in 1872 considered that gout was due to a special form of degeneration in some of the fibroid tissues, resulting in an excessive formation of sodium urate, which is then discharged into the blood, and is subsccpiently deposited in those parts least freely supplied with vascular and lymphatic structures.' Dr. Ord,Avhose views, in this particular, have been sup])ortcd by l)r. Norman Moore and Mr. Bowlby, also considers that uratic deposits only occur in tissues which * ‘‘A 'I'reatisc on Gout,’’ 1889, p. 53.