CLASS IV. i . 2. 1 5. OF ASSOCIATION. 3 79 



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

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

 of its fituation from one limb to another. The reafons, which 

 induce me to fufpeft the liver to be firft affedted, are not only 

 becaufe the jaundice fometimes attends the commencement of 

 gout, as defcribed in Seel:. XXIV. 2. 8. but a pain alfo over the 

 pit of the ftomach, which I fuppofe to be of the termination of 

 the bile-duel: in the duodenum, and which is erroneouily fup- 

 pofed to be the gout of the ftomach, with indigeftion and flatu- 

 lency, generally attends the commencement of the inflamma- 

 tion of each limb. See Arthritis ventriculi, Clafs I. 2. 4. 6. 

 In the two cafes, which I faw, of the gout in the limbs being 

 preceded by jaundice, there was a cold fhivering fit attended the 

 inflammation of the foot, and a pain at the pit of the ftom- 

 ach ; which ceafed along with the jaundice, as foon as the 

 foot became inflamed. This led me to fufpect, that there was a 

 torpor of the liver, and perhaps of the foot alfo, but neverthe- 

 lefs the liver might alfo in this cafe be previoufly inflamed, as 

 obferved in Sett. XXIV. 2. 3. 



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

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

 are more habituated to extenfion and contraction than other 

 parts of the fkin in their vicinity ; I fuppofe them to be more 

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

 quiefcence ; and are thence more fufceptible of inflammation, 

 than fuch parts as are lefs expofed to great variations of heat 

 and cold, or of extenfion and contraction. 



When a ftone preffes into the fphineler of the bladder, the 

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

 its greater fenfibility, than the fphineler of the bladder ; and > 

 when this pain commences, that of the fphindler ceafes, when 

 the ftone is not too large, or pufhed too far into the urethra. 

 Thus when the membrane, which covers the ball of the great 

 toe, fympathizes with fome membranous part of a torpid or in- 

 flamed liver ; this membrane of the toe falls into that kind of 

 action, whether of torpor or inflammation, with greater energy, 

 than thofe actions excited in the difeafed liver ; and when this 

 new torpor or inflammation commences, that with which it fym- 

 pathizes ceafes ; which I believe to be a general law of aflbciat- 

 ed inflammations. 



The paroxyfms of the gout would feem to be catenated with 

 folar influence, both in relpect to their larger annual periods, 

 and to their diurnal periods See Set. XXXVI. 3. 6. -as the 

 former occur about the fame feafon of the year, and the latter 

 commence about an hour before fun-rife 5 neverthclefs the an- 

 nual 



