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March 21, 1964

Uric Acid Lithiasis

JAMA. 1964;187(12):964. doi:10.1001/jama.1964.03060250082036

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John Freke (1688-1756), counter of calculi at St. Bartholomew's Hospital, London (who was not cited in the bibliography), would have been delighted with this monograph on uric acid lithiasis. The clinical study is based upon 210 patients with urate lithiasis, of whom 53 admitted a history of gout; the others were classed as idiopathic stone formers. I doubt if this reflects the ratio in the unselected population in America. Nor is the incidence recorded, that 75% of gouty patients form stones, consistent with what other observers report. These items are minor and probably reflect the difference in diet, fluid intake, and total fluid output between residents of Israel and the United States.

My skepticism centers about the optimistic observations on the citric acid-sodium citrate solution (described by Fuller Albright in the 1930's, but not attributed by the authors to this source), recommended in prevention and treatment of uric acid lithiasis.

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