GOUT. 219 



counties of England, where ages of security and com- 

 parative prosperity have made them what they are ; or 

 among the Northern Germans and the Dutch, whose 

 pleasures of life are largely made up of eating and 

 drinking. 



There is no disease the hereditary character of 

 which is more fully and generally recognised than 

 gout ; in many families it is looked upon as an 

 heirloom. Sir Alfred Garrod said he could trace 

 direct heredity in 50 per cent, of all cases ; Sir 

 Dyce Duckworth gives 50 to 75 as the percentage 

 of cases he found hereditary ; while Sir 0. Scudamore 

 (even the medical men who make a speciality of the 

 treatment of gout become aristocratic) traced direct 

 heredity in 60 per cent, of all his cases. Many 

 observers put the influence of family taint at a figure 

 even higher than any of the above, while some have 

 gone so far as to declare the disease purely heredi- 

 tary (Dr. Cullen). And probably this is true in a 

 certain sense, for although no ancestor may ever 

 have actually had gout, the predisposition may have 

 been building up for some considerable time. Rarely, 

 I believe, is gout built up in a single generation, 

 and when it is, it is not likely to be well developed 

 until late in life, hence little would be conveyed to 

 the children. I think it is certain that well-marked 

 predisposition to gout is in every case the work of 

 several generations. 



In many rich families the disease has been handed 

 down through great numbers of generations. A 



