124 PRACTICE OF PHYSIC. 



tone of the extremities and of the whole system is restored, and 

 the patient returns to his ordinary state of health (DXL). 



DXXXIV. This is the course of things in the ordinary 

 form of the disease, which we name the regular gout; but 

 there are circumstances of the body in which this course is in- 

 terrupted or varied. Thus, when the atony (DVI. and DVII.) 

 has taken place, if the reaction (DIX.) do not succeed, the 

 atony continues in the stomach, or perhaps in other internal 

 parts, and produces that state which we have, for reasons now 

 obvious, named the atonic gout. 



DXXXV. A second case of variation in the course of the 

 gout is, when, to the atony, the reaction and inflammation have 

 to a certain degree succeeded, but, from causes either internal 

 or external, the tone of the extremities, and perhaps of the whole 

 system, is weakened ; so that the inflammatory state, before it 

 had either proceeded to the degree, or continued for the time 

 requisite for restoring the tone of the system, suddenly and en- 

 tirely ceases. Hence the stomach, and other internal parts, re- 

 lapse into the state of atony ; and perhaps have this increased 

 by the atony communicated from the extremities : all which ap- 

 pears in what we have termed the retrocedent gout. 



DXXXVI. A third case of variation from the ordinary 

 course of the gout, is, when to the atony usually preceding, an 

 inflammatory reaction fully succeeds ; but has its usual deter- 

 mination to the joints by some circumstances prevented, and is 

 therefore directed to an internal part, where it produces an in- 

 flammatory affection, and that state of things which we have 

 named the misplaced gout. 



DXXXVI I. We have thus offered an explanation of the 

 circumstances of the system in the several states of the gout ; 

 and this explanation we suppose to be consistent with the phe- 

 nomena of the disease, and with the laws of the animal economy. 

 There are indeed, with respect to the theory of the disease, sev- 

 eral questions which might be put ; to which we have not given 

 any answer. But, though perhaps we could give an answer to 

 many of these questions, it does not here appear necessary ; as 

 at present we intend only to establish such general facts, with 

 regard to this disease, as may lay a foundation for the cure of 

 it, so far as experience has enabled us to prosecute it. Pro- 





