The view that the human body is constantly evolving, under the aegis of precise and finely balanced mechanisms, from infancy to old age— from epoch to epoch—might well be stressed in the considerations of gout affecting the kidney structure. Indeed, this attitude is important in our attempts to narrow the range of questions of pathogenesis, significance, influences, and complications.
The salient features of tophaceous gout have been revealed graphically through the centuries and in the modern clinical laboratory. Uric acid crystals were recovered from a male mummy entombed in Nubia more than 7,000 years ago. Similarly, a mass of the great toe of a male skeleton unearthed in upper Egypt was found to contain urates on chemical examination. Heredity, masculinity, and tophaceous formations have been established as integral aspects of gout, substantiated by the studies of uric acid metabolism. However, the exact status of the kidney as a contributing cause