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July 31, 1897


JAMA. 1897;XXIX(5):222-223. doi:10.1001/jama.1897.02440310020001e

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Murchison and Sir Dyce Duckworth, among other students of the subject, have associated the excessive formation of uric acid and the development of gouty attacks with disturbances of the liver. Under the name of lithemia or latent gout, Murchinson described a set of symptoms very commonly met with in this country; among the conspicuous symptoms is the appearance of uric acid, urates and calcium oxalate crystals in the urine in abnormal amount.

These cases of lithemia show evidence of disturbed primary digestion, congestion of the liver, headache, lassitude, malaise, but rarely evidences of deposits, arthritic or otherwise, that are characteristic of true gout.

The question has been raised, and I think justly, is lithemia gout or is it the expression of a toxemia resulting from habitual disorder of the digestive organs including the liver? Before answering the question it may be well to turn to some later views regarding the

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