Uric acid theory

Woods Hutchinson declined to apologize for mounting yet another attack on the uric acid theory because, he warned, "if we do not take it, it will take us." (43) The fact that other medical celebrities, including Lafayette Mendel, (44) Lewellys Barker, (45) and J. J. R. Macleod, (46) took the time to second... 

As the last example suggests, the publicity given the uric acid theory also set off an epidemic of self-diagnosis by the public. "Indeed," a Chicago physician complained, "among the laity it is the almost universal belief that a joint pain, myalgia, neuritis, neuralgia, etc. are due to uric acid-----How... 

As such attacks continued, uric acid s standing with the profession as a whole was steadily lowered. By 1915, physicians could joke that, "There was as much to be said for uric acid as there is for intestinal toxemia [the invalid theory of ptomaine poisoning] it cured for a time its thousands, but the theory built about it caught cold and died." (67) Already the year before, an American journal had concluded its brusque review of Kenneth Haig s Health Through Diet with the prediction that "the uric acid fad has had its day, and...the present volume will not resuscitate it." (68)... 

According to the precipitation theory, the urine becomes supersaturated with salts, which finally results in the precipitation of crystals that grow and form stones in the urinary tract (Fig. 2). The urinary pH may play an important role in this process. For example, normal urine specimens are supersaturated with uric acid at a pH below 5.5-5.7 (S5). At higher pH values, the solubility increases remarkably. At a pH of approximately 7, the solubility would increase about 10 times. However, a low pH cannot be the sole explanation for uric acid lithiasis, because comparably low urinary pH values are found in healthy subjects (F2). This leads to the second theory on urolithiasis, namely, the theory of the lack of inhibitors. 

Whatever the theory, in cases of patients with uric acid as well as calcium oxalate stones who suffer, in addition, from hyperuricemia or hyperuricosuria it is vital to apply a Zyloric treatment to lower the increased serum and especially also the urine uric acid concentration. 

Rodents are known to possess the enzyme uricase and are therefore able to carry purine catabolism one step further than man. Preliminary results suggest that uricase is restricted to but a few rodent tissues and is absent from lines of cultured rodent cells. Hence, it may be that in each vertebrate species only the final enzyme of purine catabolism is tissue restricted it is feasible to test this generalization further. In any case, the presence of xanthine oxidase and the absence of uricase in lines of cultured rodent cells may make them useful in testing, by microbiological methods, theories about cellular factors which influence the rate of uric acid synthesis. 

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