224 MARRIAGE AND DISEASE. 



gout appears in women, in the vast majority of cases 

 it is not until after the " change of life" or old age, 

 and there is almost invariably a hereditary predis- 

 position present. 



As to gout being a constitutional degeneration 

 affecting the whole system, there is ample proof. In 

 the first place, almost every tissue in the body of the 

 person who has inherited the gouty diathesis is liable 

 to degenerative change. At an early stage of the 

 disease* the kidneys become unfitted for their work 

 because of disease consequent on tissue degeneration. 

 The muscular tissue of the heart as well as its valves 

 is in these persons liable to degenerative change, and 

 the tissues of the blood-vessels, great and small, are 

 more or less diseased in nearly every case. The bones, 

 muscles, connective and cutaneous tissues are also very 

 frequently affected, such persons being liable at all 

 times to inflammations in all parts of the body, to the 

 formation of abscesses and to extensive ulcerations. 

 The disease is not confined to any one, or even two 

 or three, tissues or organs ; the whole constitution is 

 deteriorated, every tissue is to a certain extent robbed 

 of its vitality, and the system may be said to be 

 " below par." The reduced or unhealthy condition 

 of the gouty system is shown in the high mortality 

 which attends ordinary acute diseases, and also by the 

 fact that anything which tends to lower still further 

 the nervous tone, such as sexual excesses, severe study, 

 indigestion, shock, lead-poisoning, &c., will at once 

 bring on an attack of the acute symptoms of gout itself. 



