An excess of uric acid is commonly associated with gout and similar diseases.  The morbid phenomena of gout are chiefly manifested in the joints and surrounding tissues.  The articular cartilages become swollen, with ensuing great pain.  There is an accumulation of mortar like matter about the joints.  This is calcium urate (not sodium urate as is generally stated).  These nodular concretions are called tophi or chalkstones.

Very many are the hypotheses which have been propounded on the cause of gout and the part played by uric acid; many have had to be discarded or greatly modified.  Though much light has recently been thrown on the subject, there remains much that is obscure.  The subject is one which is surrounded with great difficulties, and would not be suitable for discussion here, were it not for the following reason:  Certain views on uric acid as the cause of gout and several other diseases, are at the present time being pushed to the extreme in some health journals and pamphlets.  Unfortunately many of the writers have very little knowledge, either of chemistry or physiology, and treat the question as though it were a simple one that had been quite settled.  Our purpose is to clear the ground to some extent, for a better understanding of its fundamentals, and to warn against dogmatism.  Our remarks, however, must be brief.  It is undeniable that great eaters of meat, especially if they also take liberally of alcoholic drinks, are prone to diseases of the liver and kidneys, about or soon after the time of middle life.  Flesh meat contains relatively large quantities of purins.  Purins are metabolised in the body to uric acid, about half of the uric acid produced in the body disappears as such, being disintegrated, whilst the other half remains to be excreted by the kidneys.

One view is that whilst the organs of the body can readily dispose of its endogenous uric acid, or that produced by its own tissue change, together with the small amount of uric acid derived from most foods, the organs are strained by the larger quantity introduced in flesh-food or any other food rich in purins:  that there is an accumulation in the system of some of this uric acid.  Vegetable foods tend to keep the blood alkaline, flesh possesses less of this property; alkalinity of the blood is thought to be favourable to the elimination of uric acid, whilst anything of an acid nature acts contrarily.  Dr. Alexander Haig writes “I consider that every man who eats what is called ordinary diet with butcher’s meat twice a day, and also drinks acid wine or beer, will, by the time he is 50, have accumulated 300 to 400 grains of uric acid in his tissues, and possibly much more; and about this time, owing to the large amount of uric acid in his body, he will probably be subject to attacks of some form of gout or chronic rheumatism.”  Dr. Haig ascribes to the presence of uric acid in the system, not only gout and rheumatism, but epilepsy, hysteria, mental and bodily depression, diseases of the liver, kidneys, brain, etc.