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La Rivista Italiana della Medicina di Laboratorio 2021 Feb 15

DOI: 10.23736/S1825-859X.21.00090-6


language: Italian

1868: "Usefulness of exact chemical notions in the study of gout". Clinical chemistry of gout

Giuliano DALL’OLIO

Montecchio Maggiore, Vicenza, Italia


Gout, a well-known disease since ancient times, begins to be studied from a chemical point of view at the beginning of the eighteenth century. With methods of analysis used by alchemists, some scholars face the problem of identifying the nature of gout. Michele Pinelli, a roman chemist-alchemist, performs one of the first "chemical analysis" on the content of gouty tophi, while Antoni van Leeuwenhoek makes the first observation under the microscope of the crystals contained in them. Gaetano Tacconi reports a chemical examination of the synovia of gouty patients, advancing his idea on the origin of the disease. Meanwhile, chemist Carl Scheele detects uric acid in urine sediments and bladder stones. Henry Watson, from the chemical examination of the arthritic concretion from a gouty patient, recognizes its similarity with bladder stones. To Smithson Tennant is attributed the priority of identifying a sodium salt of uric acid in gouty tophi, a hypothesis confirmed by Antoine Fourcroy and William Wollaston with a detailed chemical analysis. Murray Forbes, formulates the hypothesis of the presence of uric acid in the blood, a probable cause of gout. In the nineteenth century, the presence of uric acid in gouty patients was confirmed and Marie-Gabriel Masuyer sees, in the reduction of uric acid in the blood, a solution to the treatment of the disease. Alexander Ure detects, in the urine of a gouty patient, an abundant sediment of rhomboid crystals of uric acid and hypothesizes that in the blood this will be in the form of sodium urate, an idea he confirms with careful chemical experiments. Alfred Garrod definitively links gout to an excessive presence of uric acid in the blood, and develops the "thread test" for its determination.

KEY WORDS: Gout; Uric acid; Sodium urate; Gouty tophus; Thread test

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