THE RELATION OF GOUT TO NEPHRITIS

Under the stimulus of the recently developed methods for quantitatively determining the uric acid of the blood, renewed interest has been shown in the diagnosis of gout, based on a retention of uric acid. From the normal variations of from 2 to 3 mg. per hundred c.c. of blood, the uric acid concentrations may be increased to as much as from 4 to 9 mg. in gout. Such increases are common occurrences in gout, but it does not follow, conversely, that these uric acid accumulations are infallible signs of gout. That uric acid, as well as urea, may be retained in nephritis was pointed out many years ago by Garrod,¹this observation being recently confirmed by more exact methods.²It becomes essential, therefore, to eliminate the nephritic element as a factor in the retention of uric acid before the latter can be regarded as an indication of gout.