RHEUMATISM. 239 



4. Son, died of consumption at thirty years of age ; 

 and 5 . Daughter, eccentric ; has heart disease ; never 

 had rheumatism. 



Eheumatism is so nearly allied to gout that some 

 observers have insisted upon their being identical. 

 Mr. Hutchinson has said : " Gout is chronic rheu- 

 matism made special. . . , Gout is probably chronic 

 rheumatism plus a dietetic derangement. Arguments 

 in favour of this view are found in tracing the family 

 history in cases. In most instances of gout, the 

 family history will show chronic rheumatism in some 

 members, frequently on the female side, the males 

 being liable to the fully developed gout, with chalky 

 deposits." * It is certainly true that these two 

 affections do often thus appear in different members 

 of the same family, yet the diseases are not any 

 more identical than are cancer and insanity, which, 

 as we have seen, also frequently appear in different 

 members of the same family. The appearance of 

 rheumatism and gout in members of the same family 

 is to be explained exactly as is the appearance of 

 cancer and insanity, viz., by the transmutability of 

 diatheses. Rheumatism must not be looked upon 

 as a vulgarised form of aristocratic gout ; it attacks 

 all classes with charming impartiality, and while it 

 is to be found among those who know the meaning 

 of hunger and hardship, it is to be found equally 

 well developed among those who have for generations 

 been fondled in the lap of luxury. 



* British Medical Journal, June 2, 1877. 



