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March 5, 1904


JAMA. 1904;XLII(10):636-638. doi:10.1001/jama.1904.92490550003002a

That the pathology of gout has not kept pace with the lines of distinction that have clinically been drawn, is much to be regretted, but we do know that it is the fibrous element which is most affected in chronic rheumatism, the synovial membrane with degeneration later on in the cartilage and bone in arthritis deformane, and the kidneys and blood primarily in gouty affections causing deposits of urates in the joints. If one should say that it was the uric acid in excess in the blood, in the form of urates, that was the cause of gout, he would very rightly be met with the assertion that there were other diseases with excess of urates in the blood and which did not have the manifestations of gout. A similar wrong conclusion would be to attribute the cause of arthritis deformane to micro-organisms, for it is known that the investigators

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