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August 24, 1935


JAMA. 1935;105(8):602. doi:10.1001/jama.1935.02760340048018

Although the association of gout with a disturbance of purine metabolism has been known for a long time, this relationship has recently become the subject of further investigation. Hench and his co-workers,1 who compared 100 cases each of gout, rheumatic fever and infectious arthritis, point out that the first difficulty encountered in the study of gout is the correct diagnosis. The criteria for the diagnosis of gout in their study were a history of joint disease together with 5 mg. or more of uric acid in each hundred cubic centimeters of blood or in tophi or both. According to these observers the clinical course of gout differs from the other disorders in that it is marked by paroxysmal and intermittent attacks associated with complete remissions before the stage of chronic gout is reached. The appearance of the objective signs of gout is so inconsistent and may be so delayed

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