CLASS IV. 1. 2. 15. OP ASSOCIATION. 379 



the liver, which is probably affected with torpor not only previ- 

 ous to the annual paroxysms of the gout, but to every change of 

 its situation from one limb to another. The reasons, which in- 

 duce me to suspect the liver to be first affected, are not only be- 

 cause the jaundice sometimes attends the commencement of gout, 

 as described in Sect. XXIV. 2. 8. but a pain also over the pit of 

 the stomach, which I suppose to be of the termination of the bile- 

 duct in the duodenum, and which is erroneously supposed to be 

 the gout of the stomach, with indigestion and flatulency, gene- 

 rally attends the commencement of the inflammation of each 

 limb. See Arthritis ventriculi, Class I. 2. 4. 6. In the two 

 cases, which I saw, of the gout in the limbs being preceded by 

 jaundice, there was a cold shivering fit attended the inflammation 

 of the foot, and a pain at the pit of the stomach; which ceased 

 along with the jaundice, as soon as the foot became inflamed. 

 This led me to suspect, that there was a torpor of the liver, and 

 perhaps of the foot also, but nevertheless the liver might also in 

 this case be previously inflamed, as observed in Sect. XXIV. 2. 8. 



Now as the membranes of the joints of the feet suffer greater 

 variations of heat and cold than the membranes of the liver, and 

 are more habituated to extension and contraction than other parts 

 of the skin in their vicinity; I suppose them to be more mobile, 

 that is, more liable to run into extremes of exertion or quiescence; 

 and are thence more susceptible of inflammation, than such parts 

 as are less exposed to great variations of heat and cold, or of ex- 

 tension and contraction. 



When a stone presses into the sphincter of the bladder, the 

 glans penis is affected with greater pain by sympathy, owing to 

 its greater sensibility, than the sphincter of the bladder; and when 

 this pain commences, that of the sphincter ceases, when the stone 

 is not too large, or pushed too far into the urethra. Thus when 

 the membrane, which covers the ball of the great toe, sympathizes 

 with some membranous part of a torpid or inflamed liver; this 

 membrane of the toe falls into that kind of action, whether of 

 torpor or inflammation, with greater energy, than those actions 

 excited in the diseased liver; and when this new torpor or in- 

 flammation commences, that with which it sympathizes ceases; 

 which I believe to be a general law of associated inflammations. 



The paroxysms of the gout would seem to be catenated with 

 solar influence, both in respect to their larger annual periods, and 

 to their diurnal periods See Sect. XXXVI. 3. 6. as the former 

 occur about the same season of the year, and the latter com- 

 mence about an hour before sun-rise; nevertheless, the annual 



