The Chemistry of Food and Nutrition by A. W. Duncan

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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.

The opinion of the majority of eminent medical men, during recent years,
is that uric acid is not a cause, but a symptom of gout, that uric acid is
not an irritant to the tissues, and that it is readily excreted in the
healthy subject. Some of the reasons for this latter and against the
previously stated hypothesis, are as follows:--Birds very rarely suffer
from gout--the nodular concretions, sometimes found about their joints and
which have been ascribed to gout, are of tuberculous origin--yet their
blood contains more uric acid than that of man, and the solid matter of
their excretion is mainly urates. If uric acid caused gout we should
expect the disease to be common in birds. It is a remarkable fact that the
waste nitrogen should be excreted in the form of uric acid or urates from
such widely differing classes of animals as birds and serpents. Birds
have a higher body temperature than man, they are very rapid in their
movements and consume a large amount of food proportionate to their
weight. They live, as it were, at high pressure. Serpents, on the other
hand, have a low body temperature, they are lethargic and can live a long
while without food. There is no obvious reason why some animals excrete
urea and others uric acid. As uric acid is a satisfactory and
unirritating form in which waste nitrogen is expelled from the body of the
active alert bird, as well as from the slow moving reptile, it is
surprising if a very much smaller quantity acts as a poison in man. Many
physicians are convinced that uric acid is absolutely unirritating. Uratic
deposits may occur to an enormous extent in gouty persons without the
occurrence of any pain or paroxysms. Urates have been injected in large
amounts into the bodies of animals as well as administered in their food
with no toxic result whatever, or more than purely local irritation. The
most careful investigations upon the excretions of persons suffering from
gouty complaints, have failed to show uric acid in the excretions in
excess of that in normal individuals, except during the later stage of an
acute attack. There is an excess of uric acid in the blood of gouty
subjects; some eminent medical men say it is in the highest degree
probable, that this excess is not due to over production or deficient
destruction, but to defective excretion by the kidneys. The excess may
arise from failure of the uric acid to enter into combination with a
suitable substance in the blood, which assists its passage through the
kidneys. Under the head of gout are classed a number of unrelated
disturbances in the gastro-intestinal tract and nutritive organs, whose
sole bond of union is that they are accompanied by an excess of urates,
and in well developed cases by deposits in the tissues. This is why there
are so many different causes, curative treatments, theories,
contradictions and vagaries in gout. There are good reasons for believing
that uric acid is not in the free state in the body. In the urine it is in
combination with alkalies as urates, perhaps also with some organic body.
It has been shown that the blood of the gouty is not saturated with uric
acid, but can take up more, and that the alkalinity of the blood is not
diminished. The excess over the normal is in many cases small; it is said
to be absent in some persons, and rarely, if ever reaches the quantity
found in leukaemia. Leukaemia is a disease marked by an excessive and
permanent increase in the white blood corpuscles and consequent
progressive anaemia. Neither does the uric acid of gout reach the quantity
produced in persons whilst being fed with thymus gland (sweetbread), for
medical purposes. In neither of these cases are any of the symptoms of
gout present. In the urine of children, it is not unusual to find a
copious precipitate of urates, yet without any observed effect on them.

The symptoms of gout point to the presence of a toxin in the blood, and it
is this which produces the lesions; the deposition of urates in the joints
being secondary. This poison is probably of bacterial origin, derived from
decomposing faecal matter in the large intestine. This is due to faulty
digestion and insufficient or defective intestinal secretions and
constipation. This explains why excessive feeding, especially of proteid
food, is so bad. The imperfectly digested residue of such food, when left
to stagnate and become a mass of bacteria and putrefaction, gives off
poisons which are absorbed in part, into the system. This bacterial poison
produces headache, migraine, gouty or other symptoms. Because of the
general failure of gouty persons to absorb the proper amount of nutriment
from their food, they require to eat a larger quantity; this gives a
further increase of faecal decomposition and thus aggravates matters. The
voluminous bowel or colon of man is a legacy from remote pre-human
ancestors, whose food consisted of bulky, fibrous and slowly digested
vegetable matters. It was more useful then, than now that most of our food
is highly cooked. About a third part of the faecal matter consists of
bacteria of numerous species, though chiefly of the species known as the
_bacillus coli communis_, one of the less harmful kind which is a constant
inhabitant of the intestinal tract in man and animals. This species is
even thought to be useful in breaking down the cellulose, which forms a
part of the food of the herbivora. Flesh meat leaves a residue in which
the bacteria of putrefaction find a congenial home. Poisons such as
ptomaines, fatty acids and even true toxins are produced. It is believed
that there exists in the colons of gouty persons, either conditions more
favourable to the growth of the bacteria of putrefaction, or that they are
less able to resist the effect of the poisons produced. It has generally
been found that milk is a very good food for gouty patients. This seems
due to its being little liable to putrefaction, the bacterial fermentation
to which it is liable producing lactic acid--the souring of milk. The
growth of most bacteria, particularly the putrefactive kinds are hindered
or entirely stopped by acids slightly alkaline media are most favourable.
This explains how it is that milk will often stop diarrhoea.

Dr. Haig condemns pulse and some other vegetable foods, because, he says,
they contain uric acid. Pulse, he states, contains twice as much as most
butcher's meat. Vegetable foods, however, contain no uric acid and meat
but a very small quantity. The proper term to use is purins or nucleins.
Dr. Haig has used a method of analysis which is quite incapable of giving
correct results. Many vegetarians have accepted these figures and his
deductions therefrom, and have given up the use of valuable foods in
consequence. We therefore give some of the analyses of Dr. I. Walker Hall,
from "The Purin Bodies in Food Stuffs." The determination of the purins
has proved a very difficult process. Dr. Hall has devoted much time to
investigating and improving the methods of others, and his figures may be
accepted with confidence.

The first column of figures indicates purin bodies in parts per 1,000, the
second column purin bodies in grains per pound:--

Sweet bread 10.06 70.4
Liver 2.75 19.3
Beef steak 2.07 14.5
Beef Sirloin 1.30 9.1
Ham 1.15 8.1
Chicken 1.3 9.1
Rabbit 0.97 6.3
Pork Loin 1.21 8.5
Veal loin 1.16 8.14
Mutton 0.96 6.75
Salmon 1.16 8.15
Cod 0.58 4.07
Lentils and haricots 0.64 4.16
Oatmeal 0.53 3.45
Peameal 0.39 2.54
Asparagus (cooked) 0.21 1.50
Onions 0.09 0.06
Potatoes 0.02 0.1

The following showed no traces of purins: white bread, rice, cabbage,
lettuce, cauliflower and eggs. Milk showed a very small quantity, and
cheese consequently must contain still less.

The researches of Dr. Hall show that the purins of food are metabolised or
broken down by gouty patients, almost as well as by normal individuals,
any slight retention being due to increased capillary pressure. A portion
of the purins remain undigested, the quantity depending upon the
particular purin and the vigour of the digestive organs. Two rabbits had
the purin hypoxanthin given to them daily, in quantities which if given to
a man in proportion to his weight, would have been 17 and 3 grains
respectively. These rabbits showed malnutrition, and after death
degenerative changes were visible in their liver and kidneys. Dr. Hall has
made a large number of personal experiments, and says that when he has
taken large doses of purin bodies--such as 7 grains of hypoxanthin, 15 to
77 grains of guanin or 7 to 15 grains of uric acid, apparently associated
symptoms of general malaise and irritability have frequently appeared. In
gouty subjects such moderate or small quantities of purins which are
without effect on the healthy subject, may prove a source of irritation to
the already weakened liver and kidneys.

Professor Carl von Noorden says of gout, "with regard to treatment we are
all agreed that food containing an excess of purin bodies should be
avoided, and those words embody almost all there is to be said as to
dietetics. Alcohol is very injurious in gout. Salicylic acid is a
dangerous remedy. Alkalies in every form are utterly useless." Dr. J.
Woods-Hutchinson says, "the one element which has been found to be of the
most overwhelming importance and value in the treatment of gout and
lith3/4mia, water, would act most admirably upon a toxic condition from any
source; first, by sweeping out both the alimentary canal primarily, and
the liver, kidneys and skin secondarily; and secondly, by supplying to the
body cells that abundant salt-water bath in which alone they can live and
discharge their functions." Dr. Woods-Hutchinson proceeds to state, that
the one active agent in all the much vaunted mineral waters is nothing
more or less than the water. "Their alleged solvent effects are now known
to be pure moonshine." The value consists in "plain water, plus
suggestion--not to say humbug--aided, of course, by the pure air of the
springs and the excellent hygienic rules."

It is a common experience amongst rheumatic patients, that they cannot
take lentils, haricots and some other foods; sometimes, even eggs and milk
are inadmissible. This is not for the alleged reason that they contain
purins, or as some misname it, uric acid; but because the digestive organs
are unequal to the task. It will be seen, that although Dr. Haig's
hypothesis of uric acid as a cause of gout and some other diseases is
disputed by many eminent physicians, his treatment by excluding flesh and
other foods which contain purins, and also pulse, which is difficult of
digestion by the weakly, is a wise one. It has proved of the greatest
value in very many cases.

Digestion and nutrition is a complex process, and it may be faulty at
various stages and in several ways; there may be either deficient or
excessive secretions or inaction. Thus there are exceptions, where gouty
symptoms, including an excessive quantity of urates in the urine, have
only been relieved by the giving up of milk foods or starch foods (see
_Lancet_, 1900, I., p. 1, and 1903, I., p. 1059).

Those particularly interested in the subject of the purins and gout are
referred to the lecture on "The meaning of uric acid and the urates," by
Dr. Woods-Hutchinson, in the _Lancet_, 1903, I., p. 288, and the
discussion on "The Chemical Pathology of Gout" before the British Medical
Association at Oxford (see _British Medical Journal_, 1904, II., p. 740).

Dr. George S. Keith, in "Fads of an Old Physician," has a chapter on
rheumatic fever; he says that the disease is much more common than it was
fifty years ago. He has never met with it in the young or old except when
the diet had consisted largely of beef and mutton, and this although he
has been on the outlook for at least forty years for a case of the disease
in a child or youth who had not been fed on red meat. He speaks of it as
being exceedingly common in Buenos Ayres and Rosario in the Argentine
Republic, amongst the young; and that it leads to most of the heart
disease there. The amount of meat, especially of beef, consumed by old and
young is enormous. The main evils there, were anaemia in children and
neuralgia both in old and young. Dr. Haig relates how he suffered from
migraine all his life, until the time of his discontinuing butchers' meat.
As meat contains a comparatively large quantity of purins and other bodies
called extractives, it is probable that such quantities have an injurious
effect, quite apart from the question of uric acid production. That an
excessive meat diet lessens the vitality of the body and pre-disposes to
disease is undoubted, but opinions differ as to how the injury is brought
about.

On thorough Mastication.--We have written at some length on the quantity
and constituents of food required per day and have criticised the usually
accepted standards. We have since read a valuable contribution to the
subject by Mr. Horace Fletcher in his book, "The A.B.-Z. of our own
nutrition" (F.A. Stokes & Co., New York). Ten years previous to the
writing of the book, when of the age of 4, he was fast becoming a physical
wreck, although he was trained as an athlete in his youth and had lived an
active and most agreeable life. He had contracted a degree of physical
disorder that made him ineligible as an insurance risk. This unexpected
disability and warning was so much a shock, that it led to his making a
strong personal effort to save himself. He concluded that he took too much
food and too much needless worry. His practice and advice is, be sure that
you are really hungry and are not pampering false appetite. If true
appetite that will relish plain bread alone is not present, wait for it,
if you have to wait till noon. Then chew, masticate, munch, bite, taste
everything you take in your mouth; until it is not only thoroughly
liquefied and made neutral or alkaline by saliva, but until the reduced
substance all settles back in the folds at the back of the mouth and
excites the swallowing impulse into a strong inclination to swallow. Then
swallow what has collected and has excited the impulse, and continue to
chew at the remainder, liquid though it be, until the last morsel
disappears in response to the swallowing impulse. In a very short time
this will become an agreeable and profitable fixed habit. Mr. Fletcher has
been under the observation of several eminent scientific men. Professor
R.H. Chittenden, of Yale University, in his report refers to the
experiments of Kumagawa, Siven, and other physiologists; who have shown
that men may live and thrive, for a time at least, on amounts of proteid
per day equal to only one-half and one-quarter the amount called for in
the Voit standard (see p. 32), even without unduly increasing the total
calories of the food intake. Such investigations, however, have always
called forth critical comment from writers reluctant to depart from the
current standards, as extending over too short periods of time.

Dr. Chittenden writes that he has had in his laboratory, for several
months past, a gentleman (H.F.) who for some five years, practised a
certain degree of abstinence in the taking of food and attained important
economy with, as he believes, great gain, in bodily and mental vigour and
with marked improvement in his general health. The gentleman in question
fully satisfies his appetite, but no longer desires the amount of food
consumed by most individuals. For a period of thirteen days, in January,
he was under observation in Professor Chittenden's laboratory. The daily
amount of proteid metabolised was 41.25 grammes, the body-weight (165
pounds) remaining practically constant. Analysis of the excretions showed
an output of an equivalent quantity of nitrogen. In February a more
thorough series of observations was made. The diet was quite simple, and
consisted merely of a prepared cereal food, milk and maple sugar. This
diet was taken twice a day for seven days, and was selected by the subject
as giving sufficient variety for his needs and quite in accord with his
taste. No attempt was made to conform to any given standard of quantity,
but the subject took each day such amounts of the above foods as his
appetite craved. The daily average in grammes was, proteid 44.9 (1.58
ounces), fats 38.0, carbohydrates 253.0, calories 1,606. The total intake
of nitrogen per day was 7.19, while the output was 6.90. It may be asked,
says Professor Chittenden, was this diet at all adequate for the needs of
the body--sufficient for a man weighing 165 pounds? In reply, it may be
said that the appetite was satisfied and that the subject had full freedom
to take more food if he so desired. The body-weight remained practically
constant and the nitrogen of the intake and output were not far apart. An
important point is, can a man on such food be fit for physical work? Mr.
Fletcher was placed under the guidance of Dr. W.G. Anderson, the director
of the gymnasium of Yale University. Dr. Anderson reports that on the four
last days of the experiment, in February, 1903, Mr. Fletcher was given the
same kind of exercises as are given to the 'Varsity crew. They are drastic
and fatiguing and cannot be done by beginners without soreness and pain
resulting. They are of a character to tax the heart and lungs as well as
to try the muscles of the limbs and trunk. "My conclusion, given in
condensed form, is this: Mr. Fletcher performs this work with greater ease
and with fewer noticeable bad results than any man of his age and
condition I have ever worked with." "To appreciate the full significance
of this report, it must be remembered," writes Professor Chittenden, "that
Mr. Fletcher had for several months past taken practically no exercise
other than that involved in daily walks about town." Sir Michael Forster
had Mr. Fletcher and others under observation in his Cambridge
laboratories, and in his report he remarks on the waste products of the
bowel being not only greatly reduced in amount, as might be expected; but
that they are also markedly changed in character, becoming odourless and
inoffensive, and assuming a condition which suggests that the intestine is
in a healthier and more aseptic condition than is the case under ordinary
circumstances. If we can obtain sufficient nourishment, as Mr. Fletcher
does, on half the usual quantity of food, we diminish by half the
expenditure of energy required for digestion. By thorough mastication the
succeeding digestive processes are more easily and completely performed.
What is also of great importance is that there is not the danger of the
blocking up of the lower intestines with a mass of incompletely digested
and decomposing residue, to poison the whole body. Even where there is
daily defaecation, there is often still this slowly shifting mass; the end
portion only, being expelled at a time, one or more days after its proper
period. All this improved condition of the digestive tract, leaves more
vitality for use in other directions, a greater capacity for work and
clearness of brain.

Professor R.H. Chittenden, in "Physiological Economy in Nutrition,"
writes:--"Our results, obtained with a great variety of subjects, justify
the conviction that the minimum proteid requirements of the healthy man,
under ordinary conditions of life, are far below the generally accepted
dietary standards, and far below the amounts called for by the acquired
taste of the generality of mankind. Body weight, health, strength, mental
and physical vigour and endurance can be maintained with at least one-half
of the proteid food ordinarily consumed."

From these and other considerations, we see that it is not only
unnecessary, but inadvisable to diet ourselves according to any of the old
standards, such as that of Voit, or even to any other standard, until they
have been very thoroughly revised. We shall probably find that as the body
becomes accustomed to simpler food, a smaller quantity of the food is
necessary. The proportion of proteids to other constituents in all the
ordinary, not over manfactured vegetable foods, such as are generally
eaten, may be taken as sufficient. Several cookery books have been
compiled in conformity with certain proteid standards and also with some
more or less fanciful requirements; these give the quantities and kinds of
food which it is imagined should be eaten each day. Theoretically, this
should be calculated to accord with the weight, temperament, age and sex
of the eater and the work he or she has to perform. The dietaries that we
have seen have their proteid ratio placed unnecessarily high. This high
proteid ratio can be got by the use of the pulses, but except in small
quantities they are not generally admissible, and in some of the dietaries
they are ruled out. The difficulty is got over by the liberal use of eggs,
cheese and milk. To admit a necessity for these animal products is to show
a weakness and want of confidence in the sufficiency of vegetable foods.
Some of these cookery books are of use in sickness, especially as
replacing those of the beef-tea, chicken-broth, jelly and arrowroot order.
They provide a half-way stage between flesh and vegetable food, such as is
palatable to those who have not quite overcome a yearning for flesh and
stimulating foods. The liberal use of animal products is less likely to
excite the prejudice of the ordinary medical practitioner or nurse.
Possibly, also, a higher quantity of proteid may be required on first
giving up flesh foods.

The Use of Salt.--One of the most remarkable habits of these times is
the extensive use of common salt or sodium chloride. It is in all ordinary
shop bread, in large quantity in a special and much advertised cereal
food, even in a largely sold wheat flour, and often in pastry. It is added
to nearly all savoury vegetable food, and many persons, not content, add
still more at the time of eating. No dinner table is considered complete
without one or more salt-cellars. Some take even threequarters of an
ounce, or an ounce per day. The question is not, of course, whether salt
is necessary or not, but whether there is a sufficient quantity already
existing in our foods. Some allege that there is an essential difference
between added salt and that natural to raw foods. That the former is
inorganic, non-assimilable and even poisonous; whilst the latter is
organised or in organic combination and nutritive. The writer is far from
being convinced that there is a difference in food value. Some herbivorous
animals are attracted by salt, but not the carnivora. This has been
explained by the fact that potassium salts are characteristic of plants,
whilst sodium chloride is the principal saline constituents of blood and
of flesh. In their food, the herbivora take three or four times as much
potash salts as the carnivora. Of course, the sodium chloride in the flesh
of the herbivora and frugivora is obtained from the vegetable matter
forming their food, and very few of them have the opportunity of obtaining
it from salt-licks and mineral sources. They must have the power of
storing up the sodium chloride from plants in sufficient quantity, whilst
the potash salts pass away. There is no justification for saying that they
are worse off by being deprived of salt. If the ape tribe can thrive
without added salt why should not man? Bunge considers that a restriction
to vegetable food causes a great desire for salt. Opposed to this, is the
fact that certain tribes of negroes who cannot obtain salt, add to their
vegetable food wood ashes or a preparation of wood ashes; this is chiefly
potash. One preparation used in British Central Africa was found to
contain about 21 per cent. of potassium chloride to only 0.5 per cent. of
sodium chloride. It has been said that vegetarians consume more salt than
those who take flesh food. We doubt this; we know of many vegetarians who
have a strong objection to added salt, and have abstained from it for
years. Some find that it predisposes to colds, causes skin irritation and
other symptoms. At many vegetarian restaurants the food is exceedingly
salty; the writer on this account cannot partake of their savoury dishes,
except with displeasure. Nearly all who patronise these restaurants are
accustomed to flesh foods, and it is their taste which has to be catered
for. Flesh, and particularly blood, which of course, is in flesh, contains
a considerable quantity of sodium chloride; and most flesh eaters are also
in the habit of using the salt cellar. These people are accustomed to a
stimulating diet, and have not a proper appreciation of the mildly
flavoured unseasoned vegetable foods. Only those who have, for a time,
discontinued the use of added salt, and lost any craving for it, can know
how pleasant vegetables can be; even those vegetables which before were
thought to be nearly tasteless, unless seasoned, are found to have very
distinct flavours. It is then perceived, that there is a much greater
variety in such foods than was previously imagined. It is commonly urged
that salt and other condiments are necessary to make food palatable and to
stimulate the digestive functions. We, on the contrary, say that
condiments are the cause of much over-eating; and that if food cannot be
eaten without them, it is a sign of disorganisation of the digestive
system, and it is better to abstain from food until the appearance of a
natural and healthy appetite. An excess of salt creates thirst and means
more work for the kidneys in separating it from the blood prior to its
expulsion. Even should it be admitted, that certain vegetables contain too
little sodium salts, a very little salt added to such food would be
sufficient; there is no excuse for the general use of it, and in such a
great variety of foods. It is thought that some cases of inflammation of
the kidneys originate in excessive salt eating; certain it is that
patients suffering from the disease very soon improve, on being placed on
a dietary free from added salt and also poor in naturally contained sodium
and potassium salts. It is also possible to cause the swelling of the legs
(oedema), to which such invalids are subject, to disappear and reappear at
will, by withdrawing and afterwards resuming salt-containing foods. The
quantity of one-third of an ounce, added to the usual diet, has after a
continuation of several days, produced oedema. In one patient, on a diet
of nearly two pounds of potatoes, with flesh, but without added salt, the
oedemia disappeared and the albumin in the urine diminished. As potatoes
are particularly rich in potash salts, this case is significant, as
showing contrary to expectations, that such quantity as they contained had
not the irritating effect of added common salt. Salt and other chlorides
have been shown by several observers, to be injurious, not only in
diseases of the kidneys, but also of the liver and heart. In these
diseases the excess of salt is retained in the tissues, it causes a flow
of fluid into them, and so produces oedema and favours the increase of
dropsy. The good effect of milk in such diseases has long been known; it
is probably due to its relative poverty in sodium and potassium chlorides.
Even in the case of three healthy men, by an abrupt change from a diet
extremely rich in chlorides to one deficient, they were able to reduce the
body-weight by as much as two kilos. (4 lbs. 6 oz.); this was by the loss
of an excess of water from their connective tissues. Sodium chloride
diminishes the solvent action of water on uric acid and the urates; but
potassium salts, on the contrary, do not, they may even increase the
action. Although nearly all the medical experience recorded has to do with
diseased persons, such cases are instructive; it is only reasonable to
suppose, that more than a very small quantity of salt in excess of that
natural to the food, is a source of irritation in the body, even of the
ordinarily healthy individual.

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