114 PRACTICE OF PHYSIC. 



" Upon many occasions we have observed the affection of the 

 kidneys supervening shortly after the gout had finished its 

 course in the extremities. I knew of a gentleman who never 

 missed to have regularly a nephritic fit after an attack of the 

 gout. Where the gout seems to have run its course, if it is 

 determined to the kidneys, it ceases in the other parts. On the 

 other hand, in persons grievously affected with nephritic com- 

 plaints, these are relieved if the gout supervenes. I had once 

 an extraordinary instance of this kind in a gentleman who had 

 laboured under the gout for more than twenty years ; and at a 

 time when otherwise, from the decline of life, the gout was less 

 vigorous in point of inflammation he was for two or three years 

 troubled with nephritic affections ; and when these were frequent 

 he never had the gout. The nephritic affections were followed by 

 various consequences : the whole urinary passages from the kid- 

 neys along the ureters, were affected with inflammation and 

 scirrhosity, and with various ulcerations. In this situation, 

 when a strangury almost constantly troubled him, and he had 

 fallen into a hectic fever in consequence of internal suppuration, 

 and was reduced to the lowest degree in point of strength and 

 vigour, a fit of the gout actually came on in one foot, then went 

 into the other, kept its ordinary duration, and went back again 

 into the first. The consequence was, that during this fit of the 

 gout, he was free from the whole symptoms of the urinary pas- 

 sages, and made urine freely, and with much less discharge of 

 that mucus which otherwise accompanied his urine."" 



This also may be observed, that children of gouty or ne- 

 phritic parents commonly inherit one or other of these diseases, 

 but whichever may have been the principal disease of the pa- 

 rent, some of the children have the one, and some the other. 

 In some of them the nephritic affection occurs alone without 

 any gout supervening ; and this happens to be frequently the 

 case of the female offspring of gouty parents. 



DXVIII. In the whole of the history already given, I have 

 described the most common form of the disease ; and which 

 therefore, however diversified in the manner I have said, may 

 be still called the regular state of the gout. Upon occasion, 

 however, the disease assumes different appearances ; but, as I 

 suppose the disease to depend always upon a certain diathesis 



