The Management of Gout

The management of gout is reviewed with reference to both the treatment of the acute attack and the long-term prevention of acute attacks by lowering the urate concentration of body fluids. The value of the urinary excretion of uric acid as an indication of urate production is discussed, as well as the desirability of using allopurinol in the control of overproduction of urate and of using uricosuric agents in the management of that type of under-excretion of urate which is not due to renal glomerular disease. Possible hazards associated with long-term therapy with these agents are considered, as well as alternative means of reducing the serum urate level which do not involve the administration of drugs.