110 PRACTICE OF PHYSIC. 



those in whom the hereditary disposition is very strong, and to 

 whom the remote causes to be hereafter mentioned, have been 

 applied in a considerable degree. 



" To conclude, it is alleged, that it more frequently attacks 

 the wise than the foolish. Indeed it would require a good deal 

 of discussion to settle the precise state of this fact, or to say 

 how far it is applicable ; but this subject is more curious than 

 useful ; and I shall conclude by quoting Dr. Sydenham, who, 

 in the introduction to the treatise de podagra, says : ' ad haec, 

 isti qui huic morbo sunt obnoxii, crania habent grandinscula, 

 habitu corporis ut plurimum sunt pleniori, humido et laxo : et 

 constitution em habent omnes luxuriantem virosamque, ditissi- 

 ma atque optima vitae stamina.' " 



D. As the gout is a hereditary disease, and affects especially 

 men of a particular habit, its remote causes may be considered 

 as predisponent and occasional. 



DI. The predisponent cause, so far as expressed by external 

 appearances, or by the general temperament, we have already 

 marked ; and physicians have been very confident in assigning 

 the occasional causes ; but in a disease depending so much upon 

 a predisposition, the assigning occasional causes must be uncer- 

 tain, as, in the predisposed, the occasional causes may not al- 

 ways appear ; and in persons not predisposed, they may appear 

 without effect. This uncertainty must particularly affect the 

 case of the gout ; but I shall offer what appears to me most pro- 

 bable on the subject. 



DII. The occasional causes of the gout seem to be of two 

 kinds. First, those which induce a plethoric state of the body. 

 Secondly, those which, in plethoric habits, induce a state of de- 

 bility. 



Dili. Of the first kind are a sedentary and indolent manner 

 of life, a full diet of animal food, and the large use of wine or of 

 other fermented liquors. These circumstances commonly pre- 

 cede the disease ; and if there should be any doubt of their 

 power of producing it, the fact, however, will be rendered suffi- 

 ciently probable by what has been observed in CCCCXCVIII. 



DIV. Of the second kind of occasional causes which indue 

 debility are, excess in venery ; intemperance in the use of intoxi- 



