The severe headaches of nephritis and gout, when not the result of vascular disease, are generally regarded as manifestations of intoxication, which usually is indicated by retention of one or more nitrogen compounds. The effect of this form of endogenous intoxication is widespread and consequently disturbances in the function of the central nervous system rarely exist as isolated symptoms. In nephritis there are other clinical signs of renal disease, such as hypertension, cardiac hypertrophy, visual changes, eczema, gastro-intestinal disturbance or changes in the composition of the urine, while in gout any of these findings may be associated with the presence of tophi and arthritic changes. Despite a steadily increasing fund of knowledge of the metabolic changes in these two diseases, the toxin or toxins responsible for the great variety of symptoms remain unknown. Although we are ignorant of their structure, number, and very largely of their mode of action we
Holmes WH. HEADACHE AND VERTIGO IN URICACIDEMIA: REPORT OF TWO CASES WITHOUT CLINICAL SIGNS OF NEPHRITIS OR GOUT. Arch NeurPsych. 1924;11(2):195–200. doi:10.1001/archneurpsyc.1924.02190320089008
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