← Table of contents
Gout, with a section on ocular disease in the gouty

INDEX

Reading edition

A-amino-acids, 61

Aborigines, gout unknown among, 2

Abscess formation in peri-tophal tissues, 234

skin resembling, in acute gout, 212

“Accessory food factors” in diet of gouty, 339

Adenase, 100, 101

Adenine, 73, 75, 77, 98

Aetius’s views on gout, 6

Age factor in gout, 40

influence of, on diet, in acute stage of gout, 333

Agotan in treatment of acute gout, 379

Aix massage baths, 427

Alanine, uric acid excretion augmented by, 89

Albuminuria, diet in, 358

Alcohol and gout, 48

hypersensitiveness of gouty to, 365

in febrile stage of sthenic gout, 333

in gout, 361

in subjects of gouty glycosuria, 237

modus operandi of, in induction of gout, 49

plus overeating, cause of gout, 49

Alcoholism, chronic, purin metabolism in, 115

Alexander of Tralles’s views on gout, 5

Alimentary canal, condition of, and gout, 174

disorders, effects of radio-active waters on, 439

tract, functional derangements of, in diagnosis of articular gout, 249

X-ray examination of, in treatment of gout, 336

Alkalies in inter-paroxysmal periods of gout, 392

in treatment of acute gout, 383

in treatment of chronic gout, 399

Alkaline waters, simple, spas for, 441

Alkapton in urine, 59

Alkaptonuria, 69

Allantoin, 104

Alternatives in treatment of chronic gout, 401

Alveolus, senile atrophy of, 329

Amberg and Jones’ scheme of formation of uric acid, 104

America, United States of, gout in, 47

Amino-acetic-acid, 64

Amino-acids and dicarboxylic amino-acids, 89

deaminisation of, 62, 63

fate of, 62

in portal blood, 62

in relation to gout, 64

Amino-purins, as source of uric acid, 84

Amylaceous dyspepsia, diet in, 351, 352

Anacritical stage of depression, 211

Anæmia in cases of long-standing gout, treatment of, 406

retention capacity of tissues for uric acid in, 158

Anatomical alterations in articulations, 54

Anglo-Saxon period, prevalence of gout in, 2

Animal cells, nucleic acid derived from, 98

Animals, various, uric acid blood content of, 135

Ankylosis in chronic gout, 287

Anodyne preparations in treatment of acute gout, 384, 385

Anodynes in acute gout, 383

Antiquity of gout, 1

Anuria, hysteria in, 126

Aponeuroses, gouty polyarthritis in, 214

Appendicitis, septic foci of, 184

Appendix-dyspepsia, 184

Arab physicians’ views on gout, 6

Aretæus the Cappadocian’s views on gout, 4, 5

Arterio-sclerosis, associated with gout, 245

blood-content in, 127

spa treatment of, 451

Arthralgia, fleeting, 193

Arthritic attacks, tophi formation preceding, 164

iritis, 315

Arthritides, specific infective, and gout, analogies between, 194

Arthritis deformans, cleavage into two types, 18

differentiation of, from chronic gout, 16

rheumatoid, and osteoarthritis, 20

Arthritis, gonococcal, acute, differential diagnosis from acute gouty polyarthritis, 270

from gout, 259

of tarsus and metatarsus, differential diagnosis from gout, 263

gouty, 39

definition of, 20

frequency of tophi in, 255

relation to local foci of infection, 185

Greek designation, 3

hæmophilia, differential diagnosis from chronic gout, 285

infective, of undifferentiated type, differential diagnosis from acute polyarticular gout, 272

skiagraphy in differential diagnosis of, 290

non-gouty, hyper-uricæmia in, 140

rheumatoid, 17

differential diagnosis from chronic gout, 284

local character of joint swellings, 284

or atrophic, acute, differential diagnosis from acute gouty polyarthritis, 272

skiagraphy in differential diagnosis of, 291

syphilitic, differential diagnosis from chronic articular gout, 277

secondary, differential diagnosis from acute gouty polyarthritis, 271

tophi in relation to, 254

Arthropathies, nerve, differential diagnosis from chronic gout, 284

Articular gout, chronic, medicinal and other modes of therapy, 397

etiological diagnosis, 247

Articular lesions in chronic gout, distribution of, 226

Asphyxias, local, of hands, in gout, 45

Atophan, effect of, on exogenous purins, 110

on uric acid excretion, 119

indicated when gout attack imminent, 395

in treatment of acute gout, 379

in treatment of chronic gout, 403

Auricular tophi, 202

Auto-intoxication theory of gout, 182

Auto-toxæmia theory of gout, 182

Avicenna’s views on gout, 6

Bacillus coli communis as causative agent in gout, 175

Bacterial flora, intestinal, modifications in, 182

Bacteriological examination in diagnosis of articular gout, 251

Baillon’s dissociation of rheumatism from gout, 15

Banting method in reduction of obesity, 357

Barclay’s theories of ætiology of gout, 23

Bath as residence for gouty, 419

Bath waters, Sir W. Ramsay’s analysis of, 435

Baths in treatment of gout, method of application, 427

Beaumont, W. M., ocular disease in the gouty, 308

Beauvais’s work on gout, 17

Beer as beverage in gout, 362

Benzoates in treatment of chronic gout, 401

Berkart’s theory of ætiology of gout, 27

views on gout, 56

Beverages in gout, 359

Bismuth carbonate in inter-paroxysmal periods of gout, 392

Biurate of soda in gouty tophi, 151

Blisters in treatment of acute gout, 386

Blood, changes in, in acute gout, 210

in chronic articular gout, 226

in gouty polyarthritis, 216

content in gout, 189

count in acute gout, 211

Blood, examination of, in diagnosis of articular gout, 251

Blood, human, relationship between amounts of uric acid, urea and non-protein nitrogen in, 122

in chronic interstitial nephritis, urates in, 120

in disease, uric acid of, 137

portal, amino-acids in, 62

routine examination of, in diagnosis of articular gout, 249

uric acid as normal constituent of, 135

uric acid content of, and gout, relation between, 143

effect of diet upon, 141

effect of exogenous purins on, 137

estimation of sources of fallacy, 145

in gout, 133, 139

uric acid in, 24, 34, 78

discovery of, 21

Folin and Denis’s method of determination, 133

forms of, 145

Gudzent and Schade’s theories, 79

non-protein nitrogen and urea nitrogen in (table), 136

variations in uric acid content independently of diet, 142

Bodily conformation, and gout, 44

Boils, gout following, 53, 178

Bone, conditions of, revealed by skiagraphy, in diagnosis of gout, 286

Bones, changes in, in gout, 53

focal areas of rarefaction in, revealed by skiagraphy, 286, 287

Brandy in gout, 371

Bruce’s modes, 286

Bunion, inflamed, differential diagnosis from gout, 261

Burian and Schur’s researches on sources of uric acid, 83

Bursæ, involved in gout, 195

tophi in, 233

Bursitis, olecranon, gouty, 215

post-calcaneal, in referred pain in heel, 265

Cælius Aurelianus’s views on gout, 5

Caffeine, 85

Calcium carbonate in inter-paroxysmal periods of gout, 392

salts in gouty tophi, 151

Calculus, urinary, 29

Carbohydrates in diet of gouty, 347

Carbuncles, gout following, 53, 178

Cartilage, morbid changes in, 53

uratic deposits in, 52, 153

in nephritis, 128

Cataphoresis in treatment of chronic articular gout, 407

Cell protoplasm, chemistry of, 176

Celsus’s views on gout, 4

“Chalk-stones,” 150

Chalybeate waters, spas for, 442

Champagne in gout, 368

Charcot’s discovery of nerve arthropathies, 18

joint, differential diagnosis from chronic articular gout, 277

Chemistry of uric acid and purin bodies, 75

Chilblains confused with early stages of tophi formation, 164

Chirargra, Greek designation, 3

Cholecystitis, 184

Cider as beverage in gout, 363

Claret in gout, 369

Climate and gout, 45

and residence in treatment of gout, 418

Climato-therapy in gout, 418

Clothing, importance of, 421

Cocoa as beverage in gout, 361

Coffee as beverage in gout, 361

Colchicine in treatment of acute gout, 378

Colchicum in acute gout, 192, 374, 375, 378

contra-indicated, alkalies as substitute, 383

method of administration, 376

preparations and dosage of, 376

used by Aetius, 6

Colitis, mucous, initial manifestations of gout, 175

Colloids in gouty tophi, 152

Collosol iodine in treatment of chronic gout, 402

Colorimetric method of determining uric acid in blood, 133

Colour reaction test in blood analysis, 133

Condiments in diet of gouty, 350

Constipation, effect in gout, 337

in acute gout, treatment of, 373

in chronic gout, treatment of, 400

in inter-paroxysmal periods of gout, treatment of, 393

Constitutional disturbance in gout, 188

influences in formation of tophi, 161

Corpora cavernosa of penis, tophi in, 235

Cramps in acute gout, 210

Cream, effect of, on uric acid output, 348

Creatine, 63, 67

in urine of children, 68

Creatinine, 61, 63, 67, 68

in blood in gout and nephritis (table), 121

Crystalline deposits in synovial fluid, 54

Crystalloids in gouty tophi, 152

Cytosine, 98

Cullen’s differentiation of varieties of rheumatism, 16

theory of ætiology of gout, 21

Cutaneous disorders in gout, 240

gravel, 203

Cuticule, desquamation of, typical of gout, 191

Cystin in urine, 59

Cystinuria, 69

Cystoid degeneration in gout, 56

Deaminisation of amino-acids, 62, 63

Deficiency diseases and accessory food factors, 340

Degeneration, theories of, 25, 27

Desquamation in acute gout, 212

Diabetes, glycosuria and, 60

Dicarboxylic amino-acids, 89

Diet, effect of, on blood content of uric acid, 141

Diet on excretion of uric acid, 83

Diet in acute paroxysms of gout, 332

in albuminuria, 358

in amylaceous dyspepsia, 351, 352

in chronic gout, 334

in glycosuria, 357

in hyperchlorhydria, 353

in hyperuricæmia, 354

in hypochlorhydria, 354

in inter-paroxysmal periods of gout, 391

in reduction of obesity, 357

in treatment of gout, 332

“accessory food factors,” 339

carbohydrates, 347

collaboration of clinician and bio-chemist, need for, 337

condiments, 350

fats, 347

fish, 346

fruits, 349

idiosyncrasies of, 343

physical examination necessary before, 336

proteins, 345

regulations of, 342

vegetables, 348

variations of blood content of uric acid independently of, 142

Dietaries, fixed, fallacy of, in treatment of gout, 335

Digestion, disturbances of, prevention of, in treatment of gout, 335

Digestive glands, rôle of, in uric acid excretion, 88

Diocletian, edict by, re gout, 5

Dislocations, signalising attack of gout, 53

Douches, 428

Dover’s powder, with aspirin and phenacetin, in treatment of acute gout, 383

Drink and gout, 48

“Drug dyspepsia,” 391

Drugs influencing excretion of endogenous uric acid, 96

Duckworth’s classification of arthritic type of gout, 36

theory of ætiology of gout, 33

Dyschezia and gout, 337

Dysenteric arthritis, differential diagnosis from acute gouty polyarthritis, 272

Dysentery, complicated by arthritis and myalgias, 194

Dyspepsia, amylaceous, diet in, 351, 352

atonic, muriated waters in treatment of, 444

chronic, gout associated with, 178

“drug,” 391

gouty, no specific form of, 350

intestinal, preceding gout, 182

mineral waters in treatment of, 443

spas in treatment of, 442

Dyspeptic symptoms of acute localised gout, 201

Ear, pricking or tenderness in, 203

tophus in, 202

Ears, tophi in, antedating articular outbreaks, 203

Ebstein and Sprague’s analysis of tophi, 150

Ebstein’s theory of ætiology of gout, 25

Ecchymoses, local, in acute gout, 212

Eczema, gouty, spa treatment of, 451

treatment of, 416

in gout, 241

Egypt, osteoarthritis in, in ancient times, 1

Endemic areas of gout, 46

Endogenous purins, 87

origin of, 83

source of, 88

uric acid excretion, 91

factors influencing, 93

increased by purin-free proteid food, 89

pathological states influencing, 94

periodic variations of, 94

physiological conditions, 93

Environment in gout, 40

Enzymes, distribution of, 99

in intestinal juices and wall, 100

Epistaxis, gout following, 178

Epithelial cells, nucleus in gouty tophi, 151

Erysipelas, gouty arthritis simulating, 215

Erythromelalgia, differential diagnosis from gout, 266

Etiological diagnosis of articular gout, 247

Exercise in gout, importance of, 421

relation of, to gout, 337

Exogenous origin of purins, 83

purins as source of uric acid, 84

uric acid excretion, 85

Exudative diathesis, 116

Eye, deposition of urates in, 309

gout in, evidence of, 309

gouty diathesis in regard to, 310

Eyelids, uratic deposits in, 235

Fæces, examination of, in diagnosis of articular gout, 250

in treatment of gout, 337

Fasciæ, involved in gout, 195

“Fat soluble A,” 340

Fats in diet of gouty, 347

Feet, incidence of tophi in, 162

plantar surface of, tophi in, 235

Fibrosis, interstitial, chronic, 186

of visceral organs in gout, tendency to, 186

Fibrositis associated with acute articular gout, 195

associated with gout, treatment of, 411

gouty, acute brachial, treatment of, 412

incidence of gouty stigmata in types of, 221, 222

muscular, in gouty, massage in, 423

spa treatment of, 450

Fingers, deformed, in chronic gout, 230

pulps of, tophi in, 235

Fischer’s researches on protein molecule, 61

Fish in diet of gouty, 346

Flatfoot, pains in, differential diagnosis from gout, 263

“Flying gout,” 193

Foci of infection in gouty, 53

local, in gout, 177

Foci, relation to gouty synovitis and arthritis, 185

Folin and Denis’s method of determination of uric acid in blood, 133

researches into urea formation, 63

Food, cooking of, in diet of gouty, 344

influence on gout, 48

Foods, various, exogenous urinary purin in, amount of, 85

Foot deformities, static, differential diagnosis from gout, 261

“Fot-adl,” Anglo-Saxon name for gout, 3

Fractures, signalising attack of gout, 53

Fruits in diet of gouty, 349

Function, gout a disorder of, 200

Functional disturbances in gout, 201

Galen’s views on gout, 2, 4

Gall-stones, gout associated with, 184

Gall-bladder dyspepsia, 184

Garrod’s discovery of uric acid in blood of gouty persons, 21

pathogeny of gout, growing scepticism as to, 32

theory of ætiology of gout, 22

views on gout in the eye, 320

Gastralgias in gouty, 351

Gastric catarrh, chronic, gout associated with, 351

chronic, mineral waters suitable for, 445

glands, diseased conditions of, and gout, 173

insufficiency, muriated waters in treatment of, 444

Gastro-intestinal asepsis, importance of, in gout, 332

derangements in acute paroxysms of gout, 333

disorders and gout, 180

attributed to gout, 299-302

chronic, spas in treatment of, 442

mineral waters in treatment of, 443

tract, derangement of, cause of gout, 170

Genito-urinary passages, infection of, examination for, in diagnosis of articular gout, 249

tract, examination of, in treatment of gout, 331

Geographical distribution of gout, 45-48

Gin in gout, 371

Glandular affections in gouty subjects, 179

Glaucoma, gout and, 324

Glycocine and urea, interaction between, 84

Glycocoll, rôle of, 64

theory of gout, 65

uric acid excretion augmented by, 89

Glycosuria and diabetes, 60

associated with gout, treatment of, 414

diet in, 357

examination for, in treatment of gout, 337

gout and, co-existence of, 185

gout in relation to, 236

“gouty,” 182

spa treatment of, 449

Glyoxylic acid in gouty urine, 65

Gonococcal arthritis of tarsus and metatarsus, differential diagnosis from gout, 263

infection, articular involvement, with muscular and nervous lesions, 194

differential diagnosis from gout, 259

exclusion of, in diagnosis of articular gout, 248

Gore, Ringrose, theory of pathology of gout, 173

Gout, acute, colchicum in, 375

definitely paroxysmal, 191

general phenomena of, 210

ionisation in treatment of, 387

local phenomena, 211

localised, clinical account, 200

dyspeptic symptoms of, 201

premonitory articular pains, 204

prodromal symptoms, 200

locality of, 208

medicinal treatment of, 372

onset of, 207

pain in, 208

paroxysm of, analysis of, 188

diet in, 332

symptoms of, 205

uric acid variations in, 117

surgical methods considered, 388

treatment of, alternative remedies in, 381

local measures, 384

uric acid excretion in, 117, 211

uric acid variations in, 108, 117

ætiology of, histogenous theories of, 23

nervous theories, 31

summary of, 44

theory of antecedent structural changes, 25

age factor in, 40

alcohol in, 361

amino-acids in relation to, 64

and fibrositis, incidence of, 221

and granular kidney, clinical associations of, 130

and immunity, early fallacies regarding, 10

and nephritis, 242

and other diseases, affinities between, 236

and rheumatoid arthritis, resemblance between, 113

and specific infective arthritides, analogies between, 194

antiquity of, 1

arterio-sclerosis associated with, 245

articular, acute, differential diagnosis, 259

localised, clinical diagnosis, 258

chronic, 225

alkalies in treatment of, 399

blood changes in, 226

clinical diagnosis of, 275

distribution of, 226

local measures in, 407

medicinal and other modes of therapy, 397

progress of disease, 228

surgical treatment, 409

classification of, author’s division, 38

clinical diagnosis of, 252

etiological diagnosis, 247

manifestations of, 195

as an infection, 177

auto-intoxication theory, summary, 182

beverages in, 359

blood content in, 127

uric acid and, relation between, 143

choice of spa in treatment of, 440

chronic, ankylosis in, 287

confusion with chronic villous synovitis, 279

diet in, 334

differentiation of, from arthritis deformans, 16

joint deformities of, 229

of oligo-articular distribution, 278

polyarticular, clinical features, 282

polyarticular, differential diagnosis, 282

tardy dissociation of, from chronic rheumatism, 15

uric acid variations in, 109

classification of, 35, 36

climate and residence in treatment of, 418

climato-therapy in, 418

clinical account of, 200

clothing and, 421

collateral phenomena of, 219

constipation and, 337

cutaneous disorders in, 240

definition of, 35

author’s, 36

derangement of gastro-intestinal tract as cause of, 171

elimination of infective arthritides from domain of, 19

endemic areas in, 46

etiology of, 39

evolution and life history of, 193

excretion in, anomalies of, 112

exercise in, importance of, 421

false, ocular symptoms, 322

glycocoll theory of, 65

Greek physicians’ views of pathology of, 3

growing infrequency and attenuation of, 12

guanine, in swine, 100

heredity and, 41

hydrotherapy, general, in treatment of, 424

local, in treatment of, methods of, 428

hyperpyræmia in ætiology of, 30

in big toe, differential diagnosis, 259

infantile, 116, 305

infective theory of, rise of, 171

summary, 182, 183

inflammatory phenomena in, cause of, 165

initial attacks usually monarticular, 207

initial outbreaks of, anomalous sites for, 267

sites of, 37

in relation to glycosuria, 236

in relation to phlebitis, 239

in the heel, 264

in the instep, 262

in the sole, 265

inter-paroxysmal period, treatment in, prophylactic measures, 389

introduction of word, 6

irregular, 293

conclusions regarding, 304

isolation of acute articular rheumatism from, 15

lead workers predisposed to, 50

leanness in, 337

leucocytosis in, 172, 189

life history of, 193

local foci of infection, 177

treatment of, radical, 327

local syncopes and asphyxias of hands in, 45

long-continued, favouring onset of pre-senilism, 398

lumbago associated with, 221

massage, general, in treatment, 423

metabolic phenomena correlated with postulated infective element, 195

mineral springs in treatment of, 431

monarticular, chronic, differential diagnosis of, 276, 277

morbid anatomy of, 39, 53

morbid conditions associated with, treatment of, 411

obesity in, reduction of, 356

ocular disease in, 308

frequency a factor in diagnosis, 316

onset of, symptoms, 188

organic predisposition to, 43

other conditions classified as, in early times, 12

pathogenesis of, earlier theories of, 21

pedigree of, 14

periodicity of, 191

phenomena of, detailed account of, 207

predisposing causes of, summary of, 52

prevalence of, in Anglo-Saxon period, 2

prognosis in, 244

renal theory of, 117

restriction of, by elimination of other disorders, 19

retarded purin elimination in, 118

retention capacity of tissues for uric acid in, 158

retrocedent, 39, 296

irregular manifestations of, 299

sex incidence of, 41

skiagraphy in diagnosis of, 286

specific organism suggested, 175

sthenic, febrile stage of, alcohol and, 333

structural changes, 54

sub-infection theory, summary, 182, 183

subjective phenomena of, in relation to blood content and excretion of uric acid, radium emanations and, 438

“the honour of,” 8

theory of hepatic inadequacy, 28

tophaceous, 39

treatment of, 327

diet in, 332, 342

fallacy of fixed dietaries, 335

gastro-intestinal asepsis in, 332

hyperæmia, 429

physical examination necessary before dieting, 336

prevention of digestive disturbances, 335

uratic deposits in, 54

differentiation from nephritis, 129

localisation of, 153

uratosis in relation to, 149

urea excretion in, 66

uric acid content of blood in, 139

uric acid excretion in, 108

anomalies in, 117

uric acid in relation to, 107

uric acid theory of, 21

uric acid, urea and creatine in blood in (table), 211

uricæmia in, 125, 133

not cause, but result, of, 148

variations in excretion in, diagnosis of, 60

Gouty arthritis, definition of, 20

phlebitis, 240

polyarthritis, acute, 214

stigmata in types of fibrositis, 222

“Gravel, cutaneous,” 203

immunity from, 29

Greek physicians, terms used for forms of gout, 3

views of pathology of gout, 3

Guaiacum in treatment of chronic gout, 403

resin, effects on urine, 405

Guanase, 100, 101

Guanine, 73, 75, 77, 98

gout in swine, 100

Gudzent and Schade’s theories of uric acid in blood, 79

Gummata, peri-bursal, 281

peri-synovial, 281

Gums, recession of, early, 45

Hæmatemesis, gout following, 178

Hæmo-analysis, 147

Hæmophilic arthritis, differential diagnosis from chronic gout, 285

Hæmorrhage, retinal, and gout, 322

Hair, premature whitening of, 45

Hallux rigidus, differential diagnosis from gout, 262

valgus with inflamed bunion, differential diagnosis from gout, 261

Haly Abbas’s views on gout, 6

Hand, gouty polyarthritis in, 214

Hands, deformed, in chronic gout, 230

incidence of tophi in, 162

local syncopes and asphyxias in gout, 45

palms of, tophi in, 235

Hare’s theory of ætiology of gout, 30

Heart affections in gouty subjects, 302

Heberden’s differentiation of rheumatoid arthritis from gout, 17

nodes, 41, 283

Heel, gout in, 264

referred pain in, differential diagnosis in, 264

local sources of fallacy, 265

Hepatic derangement in acute paroxysms of gout, 333

inadequacy theory of ætiology of gout, 28

Heredity in gout, 8, 28, 40, 41, 214

Herpes in acute gout, 241

Hexose group in vegetable nucleic acids, 98

Hippocrates, aphorisms of, on gout, 4

Histogenous theories of ætiology of gout, 23

Historical survey, 1

Horbaczewski’s experiments on uric acid, 73

Hot-air baths, 429

contra-indications to use of, 429

Hutchinson on gout and rheumatism, 15

Hydrarthrosis, bilateral, 281

in chronic articular gout, 278

Hydrochloric acid, secretion of, and gout, 173

strong or fuming, in inter-paroxysmal periods of gout, 393

variations in, and gout, 181

Hydro-therapy, general, in treatment of gout, 424

in acute gout, 385

in treatment of gout, contra-indications and untoward complications, 425

methods of application, 427

prophylactic measures, 424

local, in treatment of gout, 428

Hyperacidity due to organic acids, 351

in inter-paroxysmal periods of gout, 393

Hyperæmia, treatment of gout by, 429

Hyperchlorhydria, 181, 351

associated with gout, treatment of, 415

complicating gout, salt in diet contra-indicated, 350

diet in, 353

mineral waters suitable in treatment of, 446

Hyperpyræmia in ætiology of gout, 30

Hyperuricæmia, diet in, 354

in gout, 140

in non-gouty arthritis, 140

ocular symptoms in, 321

Hypochlorhydria, 351

diet in, 354

Hypoxanthine, 73, 75, 77

Indigestion, intestinal, in gouty subjects, 181

Infantile gout, 116, 305

Infection in gout, local foci of, 177

examination for in diagnosis of articular gout, 248

theory of gout, 182, 183

Infections, differential diagnosis from acute localised articular gout, 259

specific, arthritic muscular and nerve lesions associated with, 195

diagnosis of, 19

Infective element in gout, correlated with metabolic phenomena, 195

Inflammation and tophi formation, 164

gouty, pus formation and, 191

Inflammatory phenomena in gout, cause of, 165

Influenzal arthritis, differential diagnosis from acute gouty polyarthritis, 272

Immunity conferred by gout, early fallacies regarding, 10

Inosinic acid, 93

Instep, gout in the, 262

Intestinal canal, source of microbe or toxin in gout, 181

derangements, mineral waters suitable in treatment of, 448

dyspepsia preceding gout, 182

indigestion in gouty subjects, 181

irrigation with radio-active waters, 439

juices and wall, enzymes in, 100

Iodides in treatment of chronic gout, 401

value of, in renal and vascular changes, 403

Iodine-albumen compounds in treatment of chronic gout, 402

Iodo-glidine in treatment of chronic gout, 402

Iodo-protein in treatment of chronic gout, 402

Ionisation in treatment of acute gout, 387

in treatment of chronic articular gout, 407

Iritis, “arthritic,” 315

diseases commonly associated with, 313

gouty, “not” a clinical entity, 316

in gout, 308

relative incidence of, 313

Irregular gout, 293

Isomeric forms of uric acid, 81

Isomers of purins, 81

of pyrimidins, 81

Jaw, formation of, 45

Jaws, radiographs of, in treatment of gout, 328

Joint cartilage, murexide reaction in, 153

deformities of, chronic gout, 229

Joints, diaphyses of, cystic changes in, 56

rheumatism of, 14

stiffness of, after acute attacks of gout, 212

swellings, local character of, in osteo-arthritis, 283

local character of, in rheumatoid arthritis, 284

tophi in, 233

Juices, gastric and intestinal, gout and, 173

Kidney and kidneys, capacity of for eliminating uric acid, 125

condition of, effect in blood content of uric acid, 138

disease of, granular, and gout, clinical, association, 130

joint examination in, results of, 129

disease of, and gout, 242

functionally deficient in late stage of gout, 119

functional disorders of, 27, 28

functional efficiency of, tests for, 338

gouty, histological changes in, 127

guanase in, 100

uric acid elimination in, 119

Knee, gouty polyarthritis in, 214

site of primary attack of gout, 267

Kossel’s discovery of purin bases, 73

Labile protein, 59

Latham’s theory of hepatic origin of gout, 29

“Lead gout,” 50

Lead, elimination by iodides, 403

poisoning, blood content in, 122, 123, 127

ocular symptoms in, 321

purin metabolism in, 115

workers, predisposed to gout, 50

Leanness in gout, 337

Lehmann’s analysis of tophi, 150

Leucocytosis, 24, 27

during acute attacks of gout, 172

in gout, 189

in gouty polyarthritis, 216

relation to uric acid excretion, 95

Leucopenia, 96

in gout, 189

Leukæmia, blood content in, 122, 123

ocular symptoms in, 321

uric acid in urine in, 95

Levy’s (Magnus) researches on gout, 107

Limbs, integument of tophi in, 235

Lime salts, focal absorption of, in bones, 288

Liniments in treatment of acute gout, 386

Literature of various periods, references to gout in, 3

Lithæmia, 294

tendency to, 28, 33

Lithiasis, 29

Lithium salts in treatment of chronic gout, 400

Lithuria, 29

Liveing’s theory of ætiology of gout, 31

Liver, diseases of, amino-acids in, 59

disorders of, functional, mineral waters suitable in treatment of, 447

enzymes in, 99

functional efficiency of, tests for, 338

glycogenic distension of, 31

guanase in, 100

main centre of production of urea, 63

Living, style of, effect on incidence of gout, 2

Locality, factor in gout, 45

incidence of, in acute gout, 208

Lucian of Saramosta’s views on gout, 4

Lumbago, associated with gout, 221

treatment of, 411

Lung, guanase in, 100

Lymph spaces, purins in, 146

stream, sodium ions in, 146

Lymphangitis, co-existent with gout, 58

in gout, 190

Lymphatic gland, enlargement of, in gout, 190

Lymphatics, purins in, 146

Malt liquors in gout, 362

Marchand’s analysis of tophi, 150

Massage, general, in treatment of gout, 423

in after-treatment of acute gout, 385, 387

McCarrison’s views on effect of absence of vitamines on functional efficiency, 340

McClure and McCarty’s researches on bone conditions as revealed by skiagraphy, 288, 289

Meat, over-eating of, functional damage resulting from, 65

Meningococcal arthritis, differential diagnosis from acute gouty polyarthritis, 272

Menstruation, effect of, on incidence of gout, 41

Mental over-exertion and gout, 51

Metabolic phenomena of gout correlated with postulated infective element, 195

Metabolism, alterations in, 30

inborn errors of, 69

nuclein, 71

protein, 59, 61

Metastasis in relation to ocular gout, 314

gouty, 297

Metatarsalgia, differential diagnosis from gout, 262

Methyl-purins as source of uric acid, 85

Microbic theory of gout, 175

Miescher’s researches on spermatozoa, 72

on the nucleus, 71

Milk diet in acute paroxysms of gout, 332

Mineral springs, 431

waters as beverage in gout, 360

Monarticular gout, differential diagnosis of, 276, 277

Morphia, hypodermic injections of, in acute gout, 383

Mouth, examination of, in diagnosis of articular gout, 248

in treatment of gout, 328

local foci of infection, results of, 184

Murchison’s theory of ætiology of gout, 28

Murexide reaction in joint cartilage, 153

Muriated chloride waters, spas for, 441

sulphated waters, spas for, 442

Muscles, affections of, in gout, 195

voluntary, relation of creatinine to, 68

Muscular exercise, uric acid excretion increased by, 93

Myeloma, waste of albumoses in, 59

Nails, striated, fluted and brittle, 45

Nasal affections, radium emanations for, 438

disorders, gout and, 178

Naso-pharynx, examination of, in treatment of gout, 328

foci of infection, 53

Necrosis, local, in uratic deposition, 152

relationship to gout, 25

Nephritis, acute and chronic, blood content in, 127

chronic, spa treatment of, 452

complicating gouty polyarthritis, 219

early, blood content of uric acid, urea and creatine, similarity to gout, 120

gout and, 242

gouty, treatment of, 416

uratic deposits in, 128

differentiation from gout, 129

uric acid, urea and creatine in blood in (table), 121

uricæmia in, 120

uricæmia not peculiar to, 124

Nerve arthropathies, differential diagnosis from chronic gout, 284

Charcot’s discovery of, 18

Nervous phenomena of gout, 188, 304

system, effect of gout on, 219

theories of ætiology of gout, 31

Neuralgia, plantar, differential diagnosis from gout, 266

Neuritis, alcoholic peripheral, 238

glycosuric peripheral, 238

Neuro-lymphatismus, 116

Neuro-retinitis in the gouty, 324

Neurosis, gouty, 31

Neuroses, paroxysmal, of gout, 188

Nose, alæ of, tophi in, 235

Nuclease, 100

Nucleic acid, 72, 77

characteristic constituents of, 78

disruption of, 100

in body, 74

formation of uric acid from, 98

isolation of, 71

metabolism of, in gout, 69

molecules, 101

of animal origin, structural formula of, 99

physiological derivation of uric acid from, 73

uric acid a derivative of, 73

Nucleic-acidase, 100

Nuclein, discovery of, 72

metabolism, 71

chemistry of, 60

Nucleins, 77

phosphoric acid group in, 112

Nucleo-proteins, 77

Nucleosidases, 101

Nucleosides, 87, 100

Nucleotidase, 100

Nucleotides, 100

Numbness after acute attacks of gout, 212

Obesity and gout, 245

Ebstein’s views of affinity, 280

in gout, 337

reduction of, 356

Occupation and gout, 48

Occupations predisposing to gout, 50

Ocular disease in gout, 308

Œdema in acute gout, 212

in gouty conditions, 191

Olecranon bursa, involved in gout, 215

tophi in, 233, 235

Oligo-articular distribution of chronic gout, 278

Oral sepsis in gouty subjects, 179

radium emanations and, 438

treatment of, in gout, 330

Ord’s theory of ætiology of gout, 25

Osler’s views on gout, 36

Osteoarthritis, acute, differential diagnosis from gout, 261

and chronic articular gout, 275, 276

co-existing with gout, 19

differential diagnosis from chronic articular gout, 278

differential diagnosis from chronic gout, 283

in ancient civilisations, 1

local characters of joint swellings, 283

of hip, with auricular tophi, 226

skiagraphy in differential diagnosis of, 291

Overeating and gout, 48

plus alcohol, cause of gout, 49

Oxaluria associated with gout, treatment of, 413

examination for, in treatment of gout, 337

spa treatment of, 449

Oxidation of purin, products of, 77

Oxy-purins as source of uric acid, 84

formation of, 102

Pain and tophi formation, 164

in acute gout, 208

in auricular tophi, 233

referred, in heel, differential diagnosis of, 264

Pains, premonitory articular, in acute localised gout, 204

Painters, predisposed to gout, 50

Pancreas, enzymes in, 99

Pancreatic inefficiency, evidence of, in diagnosis of articular gout, 250

Pancretin, 392

Papain, 392

Parke’s theories of ætiology of gout, 23

Parotitis, acute, gout following, 53

in gout, 179

Patella, tophi in, 235

Pathological states influencing endogenous uric acid excretions, 94

Paulus Ægineta’s views on gout, 6

Pedigree of gout, 14

Pentosuria, 69

Peri-bursal gummata, 281

Perineum, uratic deposits in, 235

Periodic variations in excretion of endogenous uric acid, 94

Periodontitis, chronic, 329

Peri-synovial gummata, 281

Pes planus, differential diagnosis from gout, 263

Pharyngeal affections, radium emanations for, 438

Pharyngitis, acute and chronic, in gouty subjects, 179

acute, gout following, 53

Pharynx, examination of, in diagnosis of articular gout, 249

Phlebitis, gout in relation to, 239

gouty, treatment of, 415

in limb in articular gout, 190

spa treatment of, 450

treatment of gout and, 328

Phospho-nuclease, 102

Physical examination, necessity for, before dieting, in treatment of gout, 336

over-exertion and gout, 51

Physiognomy of the goutily disposed, 44

Pinna, small red swellings on, 204

Planchon’s views on gout, 6

Plantar neuralgia, differential diagnosis from gout, 266

Pleurodynia associated with gout, treatment of, 412

Plumbers, predisposed to gout, 50

Plumbism and gout, 60

purin metabolism in, 115

Pneumococcal arthritis, differential diagnosis from acute gouty polyarthritis, 272

Podagra, 12

Greek designation, 3

Polyarthritis, articular, acute, differential diagnosis of, 269, 270

gouty, acute, 214

clinical diagnosis of, 268

diet in, 334

blood changes in, 216

distribution of, 214

effect on nervous system, 219

simulating erysipelas, 215

non-gouty, uric acid blood content in, 141

Polyarticular distribution of gout, 214

Poly-nucleotides, 100

Port wine in gout, 364, 368

Portal blood, amino-acids in, 62

Post-critical stage of depression, 211

Potash compounds in treatment of chronic gout, 400

Potassium in gouty tophi, 151

Prescriptions for use in acute gout, 375, 377, 378, 379, 380, 386, 391

for use in chronic gout, 401, 405, 406

for use in inter-paroxysmal periods of gout, 391, 392, 393, 394

Pre-senilism, long-continued gout favouring, 398

Protamine, 72

Protein, amino-acids in, number of, 64

chemistry of, 60

labile, 59

metabolism, 59, 61

urine content of urea, etc., in, 59

tissue, 59

Proteins and their derivatives, 88

in diet of gouty, 345

Pulse quickened in gout, 189

Purgatives in treatment of acute gout, 374

Purin bases, toxicity of, discussed, 168

bodies, 34, 48, 63

chemistry of, 75

diet, uric acid excretion in, 86

“free” diet, 355

uric acid blood content in, 137

uric acid excretion in, 86

elimination, retarded, in gout, 118

metabolism, chemistry of, 60

in chronic alcoholism, 115

in other disorders, 113

in plumbism, 115

nuclease, 102

nucleus, arrangement of atoms, 76

oxidation of, products of, 77

scheme illustrating probable stages in passage through body, 101

synthesis in mammals, 97

unexcreted, fate of, 87

Purins, discovery of, 72

endogenous, 83, 87

source of, 88

exogenous, 83

as source of uric acid, 84

effect of atophan on, 110

effect on uric acid blood content, 137

isomers of, 81

of vegetable origin, 77

Pus formation, non-existence of, in gouty inflammation, 186, 191

Pyæmia, differential diagnosis from gout, 259

Pyæmic conditions confounded with gout, 191

Pyorrhœa alveolaris, and gout, 178

and treatment of gout, 329

exclusion of, in diagnosis of articular gout, 248

Pyrexia in acute gout, 210

in gout, 189

Pyrimidine bases, 77

Pyrimidins, isomers of, 81

Quadriurate in blood, 78, 79

Quinic acid in treatment of acute gout, 383

Quinine in treatment of acute gout, 383

Race incidence of gout, 45-48

Radio-active properties of thermal waters, 427

waters, physical properties of, 434

Radium emanation, increased excretion of uric acid through, 437

influence on uric acid metabolism, 436

physiological action of, 435

subjective phenomena of gout in relation to blood content and excretion of uric acid and, 438

therapeutic action and application, 438

Regular gout, 13

Renal changes in gout, 54

defect, uricæmia not necessarily due to, 123

depression, functional, 119

disease, abnormal protein loss in, 59

theory of gout, 117

uric acid infarcts, 151

Residence, choice of, 420

Respiratory disorders, spa treatment of, 450

organs, affections of, in gout, 303

Retinitis, nephritic, 324

Retrocedent gout, 39, 296

Rhazes’s views on gout, 6

Rheumatism, acute articular, differential diagnosis from acute gouty polyarthritis, 269, 270

isolation from gout, 15

muscular and nervous lesions associated with, 194

confused with gout, 215

chronic, tardy dissociation of, from chronic gout, 15

differential diagnosis from gout, 259

early use of term, 14

muscular, identification of, 16

Rheumatoid arthritis, 17

and gout, resemblance between, 113

differential diagnosis from chronic gout, 284

disturbance of purin metabolism in, 112

or atrophic arthritis, differential diagnosis from acute polyarticular gout, 272

Roberts’, Sir William, views on gout, 36

Salicylate group as alternative remedy in treatment of acute gout, 381

of colchicine in treatment of acute gout, 379

Salicylates in treatment of acute gout, contra-indicated, alkalies as substitute, 383

in treatment of chronic gout, 401

Salisbury diet in hyperchlorhydria, 353

method in reduction of obesity, 357

Salt in diet of gouty, 350

Scapular region, uratic deposits in, 235

Scheele’s discovery of uric acid, 8

Schnee four-cell bath in ionisation, 408

Sciatica associated with gout, treatment of, 411, 412

Scudamore’s definition of gout, 35

Seneca’s views on gout, 5

Septic conditions confounded with gout, 191

Serapion’s views on gout, 6

Serous membranes, uratic deposits in, in nephritis, 128

Sex incidence in gout, 41

Shivering at onset of acute paroxysm of gout, 188

Sidonal in treatment of acute gout, 383

Silk as underwear, 421

Sinusitis, latent, cause of systemic infections, 331

Skiagraphy in diagnosis of gout, 286

in diagnosis of villous synovitis, 281

in differential diagnosis of hypertrophic or osteo-arthritis, 291

in differential diagnosis of infective arthritis, 290

in differential diagnosis of rheumatoid or atrophic gout, 291

Skin, action of, consideration of, in treatment of gout, 337

appearances of, and gout, 45

defective elimination by, in chronic gout, treatment of, 400

Sodium biurate crystals in synovia, 52

ions in lymph stream, 146

mono-urate compound, 81

salicylates of, in treatment of acute gout, 382

Sole, gout in, 265

Solubilities of uric acid and urates in gouty blood, 82

Sool-Bader baths, 427

Spa, choice of, in treatment of gout, 440

treatment, duration of course of, 453

in acute gout, 385

of gout, principles of, 434

remarks on, 452

Spas from a national aspect, 454

Spermatozoa, Miescher’s researches in, 72

Spirits in gout, 370

Spleen, enlargement of, in gout, 190

enzymes in, 99

functional efficiency of, tests for, 338

Starchy foods in diet of gouty, 347

Static foot deformities, differential diagnosis from gout, 261

Stone in Norfolk, 29

Streptococci in tonsils, 183

Sub-infection theory of gout, 182, 183

Sub-thermal baths, 428

Succus entericus, action on nucleic acid, 100

Sugar in diet of gouty, 347

Sulphated alkaline waters, spas for, 442

waters, 441, 442

Sweetbreads in diet of gouty, effect of, 345, 346

Swine, guanine gout in, 100

Sydenham’s differentiation of rheumatism from gout, 15

views on gout, 7

Syncopes, local, of hand, in gout, 45

Synovia, appearance in, in acute gout, 52

Synovial fluid, reaction of, 52

Synovitis, gouty, relation to local foci of infection, 185

gummatous, differential diagnosis from chronic articular gout, 277

of knees, differential diagnosis from gout, 264

of tendo Achilles in referred pain in heel, 265

perforative, 57

villous, chronic, confusion with chronic gout, 279

clinical symptoms of, 280

static and non-gouty in origin, 280

Synthetic formation as source of uric acid, 84

of uric acid, 96

Syphilis, articular, muscular and nerve lesions associated with, 194

Syphilitic arthritis, secondary, differential diagnosis from acute gouty polyarthritis, 271

disease of tarsal joints, differential diagnosis from gout, 263

Taka-diastase, 392

Tarsal joints, gonococcal arthritis of, differential diagnosis from gout, 263

involved in gouty polyarthritis, 214

tuberculous and syphilitic disease of, differential diagnosis from gout, 263

Tartareous nature of tophi, views on, 8

Tea as beverage in gout, 361

Teeth, characteristic, in gout, 45

conditions in gout, 178

devitalised, examination of, in treatment of gout, 328

foci of infection, 53

Temperament, and gout, 44

Temperature curve of gout, 188

Tendo Achilles, involved in gout, 215

Tendon sheaths, involved in gout, 195

Tendons, gouty polyarthritis in, 214

uratic deposits in, 153

Test meals for HCL variations, 336

Tests, modern, for uric acid determination, disabilities of, 147

Theobromine, 85

Theophyllin, 85

Throat, gouty, 45

Thymine, 98

Thyminic acid, 80

in treatment of acute gout, 383

Thymus, enzymes in, 99

gland, nucleic acid derived from, 98

in diet of gouty patients, effect of, 345, 346

Tibia, tophi in skin over, 235

Tissue affinities for uric acid, 157

protein, 59

Tissues, human, concentrations of uric acid in, 159

retention capacity of, for uric acid, 158

effect on blood content, 138

Toe, big, gout in, differential diagnosis of, 259

initial outbreak of gout in, 37, 188

Tonsil, site of infection in gout, 180

Tonsillar sepsis, gout and, 178

Tonsillitis, acute, gout following, 53

in gouty subjects, 179

treatment of, in gout, 330

Tonsils, examination of, in diagnosis of articular gout, 249

foci of infection, 53

streptococci in, 183

Tophaceous deposits in chronic articular gout, 227

gout, 39

Tophi, analysis of, 150

antedating articular attacks, 202

auricular, 202

pain in, 233

clinical evolution of, 162

constitution of, 149

constitutional influences in, 161

diagnostic status of, 252

difficulty in detecting, 256

early stages of, confused with chilblains, 164

early views as to nature of, 7

evolution and distribution of, 231

formation preceding arthritic attacks, 164

frequency of, in gouty arthritis, 255

gouty, causation of, 154

formation of, 151

localisation of, 153

radiating, concentric and laminated structure of, 152

urate of soda, 150

importance of, in diagnosis of acute gouty polyarthritis, 269

in diagnosis of gout, 38

in eyes, significance of, 311

inflammatory nature of swellings in, 163

in relation to arthritis, 254

in relation to uricæmia, 155

sites of, 233

stage of small red swellings, 163

treatment of, in chronic articular gout, 407

Tophus formation in acute gout, 212

premonitory symptoms of, 203

in ear, sign of gout, 202

Trauma, local, effect on gout, 53

Traumatic lesions, differential diagnosis from gout, 260

Trousseau’s views on gout, 36

Tuberculous disease of tarsal joints, differential diagnosis from gout, 263

joint disease, differential diagnosis from chronic articular gout, 277

Toxæmia, alimentary, hydrochloric acid, 394

chronic, 182

Toxicity, low, of chemical products, in gout, 69

non-, of uric acid, 166

Ulna, tophi in skin over, 235

Uracil, 98

Urate of soda in gouty tophi, 150

Urates, deposition of, in eye, 309

Uratic depositions as criterion of gout, 37

deposits in gout, 54

in gout and nephritis, differentiation of, 129

in gout, localisation of, 153

in nephritis, 128

Uratosis in gout, 149

Urea and glycocine, interaction between, 84

end-product of protein metabolism, 63

excretion in gout, 66

excretion of ammonia as, 63

formation of, 62

Folin and Denis’s deductions, 64

seat of, 63

in blood in gout and nephritis (table), 121

Ureters, ligature of, 26

Uric acid, 75, 77

a normal constituent in blood, 135

an end-product, 70

as a derivative of nucleic acid, 73

blood content of, in various animals, 135

variations independently of diet, 142

chemical constitution of, 75

concentrations in human tissues, 159

content of blood and attacks of gout, relation between, 143

in gout, 139

deposition of, 22, 34

destruction of, 98, 104

determination of, disabilities of modern tests, 147

diathesis, 294, 295

discovery of, by Scheele, 8

estimation of, sources of fallacy, 145

excretions of, amount of, 75

exogenous, 85

in acute gout, 211

in gout, 108

anomalies in, 117

increased by radium emanation, 437

relation of leucocytosis to, 95

exogenous purins as source of, 84

formation of, Amberg and Jones’s scheme of, 103, 104

from nucleic acid, 98

gravel, spa treatment of, 451

in the blood, 78

forms of, 145

in gout and nephritis (table), 121

of gouty patients, discovery of, 21

organic combinations of, 79

infarcts, renal, 151

in relation to gout, 107

isomeric forms of, 81

kidney capacity for eliminating, 125

metabolism, influence of radium emanations on, 436

non-toxicity of, 166

of blood in disease (table), 137

output, endogenous, lowered, 111

exogenous, retarded, 109

physical properties of, 78

retention, capacity of tissues for, 158

solubilities of, 154

sources of, 83

synthetic formation of, 84, 96

theory of gout, 21

tissue affinities for, 157

variations in acute gout, 108

variations in chronic gout, 109

Wollaston’s researches on, 8

Uric-acidæmia, 295

Uricæmia and gout, 125

in gout, 133

in nephritis, 120

not cause, but result, of gout, 148

not necessarily due to renal defect, 123

not peculiar to nephritis, 124

significance of, 145

tophi in relation to, 155

Uricase, 87, 104

absence of, in man, 104

Uricolysis, 104

Uricolytic enzyme, 105

ferment, absence or diminution of, 106

Urine, alkapton in, 59

analysis of, in metabolism of gout, 113

in treatment of gout, 337

children’s, creatine in, 68

cystin in, 59

effects of guaiacum resin on, 405

examination of, in diagnosis of articular gout, 250

gouty, glyoxylic acid in, 65

human, daily excretion of uric acid, amount of, 83

scanty, before paroxysm of gout, 205

Urosin in treatment of acute gout, 383

Vaccine therapy in treatment of gout, 331

Vapour baths, 428

Vegetable cells, nucleic acid derived from, 98

Vegetables in diet of gouty, 348

Veins, engorged, before paroxysm of gout, 205

Venesection, 4

gout following, 178

Vichy bath, 428

Vidal’s atrophic form of arthritis deformans, 18

Vinegar in diet of gouty, 350

Viscera, functional capacity of, tests of, 338

Visceral organs, tendency to fibrosis in gout, 186

Vitamines, 340

Volumetric method of determination of uric acid in blood (Curtman and Lehrman), 134

Vomiting in acute paroxysms of gout, 333

Wade’s theory of nervous origin of gout, 32

Water, hot, advantages of, 360

value of, as beverage in gout, 359

“Water-soluble B,” 340

“Water-soluble C,” 340

Watson’s (Chalmers) researches on gout, 107, 172

Weir-Mitchell method in reduction of obesity, 357

Whisky in gout, 364, 370

Wines as beverages in gout, 364

general rules, 367

individual and, 365

importance of quality of, 366

Wollaston’s researches on uric acid, 8

Wrist, site of primary attack of gout, 267

Xanthine, 75, 77

Xanthine-oxidase, 99

Xanthosine-hydrolase, 102

X-ray examination of alimentary tract in treatment of gout, 336

Yeast, nucleic acid derived from, 98

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