Uric Acid Gravel.
THIS form of deposit passes indifferently under the name of uric acid gravel, or lithic acid gravel. The person who is in the habit of passing this kind of deposit largely, is said to have the lithic or uric acid diathesis or condition.
The urine of persons in this state lets fal4 after it has stood awhile, a reddish sediment, like brick dust. This consists chiefly of urate of ammonia (Figs. 116 and 117), tinged with certain coloring matters. This coloring substance may be more or less abundant, and give to the deposit various shades, as dirty white, yellow, pink, and red. The pure uric acid sometimes appears as fine sand, or large crystals (trig. 118). The urine is of a dark copper color, about like brown sherry, and is more scanty than in health. It is also highly acid, giving to litmus paper a deeper shade of red.
Persons who pass this kind of gravel largely are apt to be troubled with inflammatory complaints; with acidity of the stomach and heartburn; and some of them with gout and rheumatism.
Placed under a blowpipe, uric acid is decomposed, and gives out an odor like that of burnt feathers, combined with the oil of bitter almonds. It is dissolved by liquor potassa, from which muriatic and nitric acids precipitate it; and by sulphuric acid, from which it is precipitated by water. Acetic, nitric, and muriatic acids, alcohol, ether, and water, do not dissolve it.
Causes. Uric acid is the form in which nitrogen and the effete compounds which contain it are got out of the body. It is the result of the decomposition of the tissues of the body. Its gravelly particles are the sands of life daily washed out of us, reminding us always that we are wasting away. Whatever causes the body to waste rapidly, produces it in excess. We find it, therefore, in the urine of those who suffer from gout, rheumatism, dyspepsia, fevers, debility of the genital organs, straining of the loins, etc., which produce loss of flesh.
Treatment. The remedies for this uric acid gravel are the alkalis, bicarbonate of potash, bicarbonate of soda and magnesia. The first named is generally the best. It may be used in the form of the neutralizing extract, especially if there be costiveness. If the bowels do not need physic, let the potash be taken in the shape of lye made from hardwood ashes (300). Fluid magnesia is an excellent remedy; so is liquor potassa, taken in twenty or thirty drop doses. The urine must be watched, and these remedies discontinued when it becomes alkaline. Black coffee drunk freely every day is an excellent remedy.
At the same time the stomach should be supported by some bitter tonic, as the infusion of quassia, gentian, columbo, Peruvian bark, etc.
Iron is, in many cases, not to be overlooked. If the patient be pale and bloodless, some of the preparations of this metal win be needed (61), (73), (74). Acid must be carefully avoided, both in food and drink.
The diet must be plain, digestible and nourishing, and quite moderate in amount. The quality is of less consequence than the quality.
Exercise is of great consequence, and must be regular, and, if possible, in the open air.
The skin must receive daily attention in the shape of an alkaline sponge bath, with friction. This will throw upon the skin much of the labor done by the kidneys. Poland Spring water used in large quantities is good.
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