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March 26, 1955


JAMA. 1955;157(13):1127. doi:10.1001/jama.1955.02950300055012

Twenty years ago gout was referred to as the forgotten disease. Now that it is better understood it is readily recognized even in the absence of tophi, and current progress in its treatment is encouraging. Gutman and Yü (this issue, page 1096) point out that effective treatment is no longer limited to the recurring attacks and that the patient need no longer look forward to a progressive increase in the frequency and severity of the attacks. Although both the acute arthritic and the chronic tophaceous phases are somehow due to faulty purine metabolism, only the chronic phase can be shown to be the direct result of deposits of uric acid in the tissues. Some uric acid is synthesized in normal persons regardless of the type of food eaten, but this synthesis is greatly accelerated in gouty patients. Uric acid is also abundantly formed from foods high in purines or in

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