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The deposit of urates in the synovial membrane is attended with effusion into the joint and the formation of adhesions, while in the ligaments and peri-articular structures it leads to the formation of scar tissue. The metatarso-phalangeal joint of the great toe, on one or on both sides, is that most frequently affected.
Armstrong says that in almost all cases at the time of the menopause the amount of urine passed is below normal, the specific gravity is increased, and that the urine contains urates and almost always uric acid in excess.
As a colour, the red is almost that of the Spurge Caterpillar, but it is the result of a dye on which nitric acid has no effect as a detector of urates. The same chromatic principle must certainly exist in a more elaborate form and under a different molecular arrangement in the skin of the abdomen and the wing-cases which will presently replace white by red.
The accumulation of urates may result in the formation of visible nodular swellings, varying in size from a pea to a cherry, attached to the tendon and moving with it. They may be merely unsightly, or they may interfere with the use of the tendon. Recurrent attacks of inflammation are prone to occur. We have removed such gouty masses with satisfactory results. Suppurative Teno-synovitis.
These waste-stuffs, called urea and urates, are formed in the liver and brought in the blood to the kidneys. These lie on either side of the backbone, opposite the small of the back, their lower ends being level with the highest point of the hip-bones, nearly six inches higher than they are usually supposed to be.
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