226 MARRIAGE AND DISEASE. 



age, whose health has been good with the exception 

 of attacks of gout, which commenced at the age of 

 thirty-six in one great toe. The attacks gradually 

 became more frequent and more prolonged, so that 

 he was scarcely ever free from them." Of this man's 

 family he says : * The father had very severe gout ; 

 the mother, when seventy years of age, began to 

 suffer from it ; he has had six brothers, of whom one 

 died of very severe gout, and was crippled from chalk 

 deposits in both upper and lower extremities ; another 

 had severe gout and chalk-stones, and died of albumi- 

 nuria ; a third had gout and paralysis, of which he 

 died ; a fourth had gout, and died of erysipelas ; 

 a fifth died of gout, complicated with some urinary 

 affection ; and a sixth is alive, but suffers from gout 

 in the same way as the patient himself." * Here Sir 

 Alfred's patient was only forty-eight years of age, yet 

 he had suffered for twelve years, and was " scarcely 

 ever free from attacks," while of his brothers five were 

 dead of gout, and the only one living was crippled 

 like himself '. 



In those of the gouty diathesis, death often occurs 

 early in life from an attack of some of the acute 

 inflammatory disorders, to all of which the gouty are 

 specially susceptible. Later in life death is common 

 from organic disease of the kidneys, from heart disease, 

 asthma, and apoplexy, the rottenness of the blood- 

 vessels in the brain rendering the gouty more liable 

 to this last-named affection than any other class. 

 * Op cit. 



