120 PRACTICE OF PHYSIC. 



DXXVIII. Upon this subject, the opinion which has gene- 

 rally prevailed is, that the gout depends upon a certain morbific 

 matter, always present in the body ; and that this matter, by 

 certain causes, thrown upon the joints or other parts, produces 

 the several phenomena of the disease. 



" Stahl is the only writer who has thought that the supposi- 

 tion of a morbific matter was not necessary, and that the disease 

 could be better explained by the state of the motions of the 

 system. I very early adopted this opinion of Stahl ; the contrary 

 however is generally received ; and when persons wished to 

 shew the absurdity of my opinions, they thought that this was 

 the strongest proof of it, that I denied the existence of a mor- 

 bific matter in the gout. But notwithstanding that, the more 

 I have considered the matter, the more I am confirmed. I al- 

 low you to suspect me of what prejudices you please with re- 

 gard to my opinion, but not only with a view to establish my 

 own opinion, but to put you in a condition to judge of this mat- 

 ter, I think it is absolutely necessary to give my reasons for 

 doubting of the common opinion.' 1 



DXXIX. This doctrine, however ancient and general, ap- 

 pears to me very doubtful ; for, 



First, There is no direct evidence of any morbific matter 

 being present in persons disposed to the gout. There are no 

 experiments or observations which shew that the blood, or other 

 humours of gouty persons, are in any respect different from 

 those of other persons. Previous to attacks of the gout, there ap- 

 pear no marks of any morbid state of the fluids ; for the disease 

 generally attacks those persons who have enjoyed the most per- 

 fect health, and appear to be in that state when the disease 

 comes on. At a certain period of the disease, a peculiar matter 

 indeed appears in gouty persons (DXVI.) ; but this, which 

 does not appear in every instance, and which appears only after 

 the disease has subsisted for a long time, seems manifestly to be 

 the effect, not the cause of the disease. Further, though there 

 be certain acrids which, taken into the body, seem to excite the 

 gout (DIV.), it is probable that these acrids operate otherwise 

 in exciting the disease than by affording the material cause of 

 it. In general, therefore, there is no proof of any morbific mat- 

 ter being the cause of the gout. 



