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A Neurochemical Mechanism for Exceptional Achievement in Gout

Norman Sher, MD
JAMA. 1980;243(17):1711. doi:10.1001/jama.1980.03300430013004.
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To the Editor.—  Gout is a disease noted to have a "unique place in social and political history. It stands as the one medical disorder in which a biochemical abnormality seems to be associated with exceptional achievement."1 The achievement can be in a variety of fields. Among the sufferers from gout are Alexander the Great, Martin Luther, Leonardo da Vinci, Isaac Newton, Goethe, and Benjamin Franklin. Hitherto, the association of gout with wide-ranging achievement has remained unexplained.Gout is a disorder of purine metabolism associated with hyperuricemia. The uric acid elevation may be due to decreased renal excretion or increased purine synthesis, with formation of increased amounts of the precursors of uric acid. Among these precursors are inosine, adenosine, guanosine, and hypoxanthine.Progress in psychopharmacology in the past few decades has brought us the advent of antianxiety pharmaceutical agents. Among the most used of these are the benzodiazepines, particularly


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