In regard to the ultimate cause of gouty disease and the manner in which the fate of uric acid is determined thereby, we know essentially nothing. For the present we are limited in our studies of gout to deliberations relative to the metabolism of uric acid. It will be found that in gouty subjects as a rule symptoms of uric acid retention make their appearance, although this phenomenon does not always become manifest throughout the whole long course of the disease.

1. Preliminary Considerations

In addition to uric acid, its congeners the xanthine bases that accompany it wherever it appears in the body must be discussed. Both together, that is, uric acid plus xanthine bases, are included under the name of alloxuric bodies or better purin bodies. At one time it appeared that one of the peculiarities of gout was a change in the normal quantitative relation existing between uric acid and the xanthin bases. This view, however, was based upon inexact analytic methods and soon had to be abandoned. From a practical standpoint xanthin bases are unimportant. One should know, however, that the uric acid that is eliminated from the body is invariably accompanied by xanthin bases, the latter constituting from 10 to 12% of the excreted uric acid by weight. It is also important to know that the xanthin bases and uric acid both originate from the same source.