94 



symptoms, disturbances, and complications. It is distinctly 

 hereditary, and may be acquired. The fundamental fact 

 upon which all theories as to the nature of gout must be 

 founded is that it must be regarded as a constitutional 

 disease depending upon the deposition of urate of sodium 

 in the cartilaginous structures of the joints. The symptoms 

 of gout are too well known to render their recapitulation 

 necessary here, nor do I deem it essential to enumerate the 

 physiognomical peculiarities which may be said to charac- 

 terise its subjects. The etiological sources of the gouty 

 diathesis may be traced to hereditary transmission, certain 

 errors in regard to diet and drink, and the impregnation of 

 the system with lead. In many cases, however, these 

 causes may be more or less combined. Try as we may to 

 eradicate the gouty diathesis, it will be almost inevitably 

 transmitted for several generations, but as the diathesis is 

 generally intensified by pernicious habits of eating and 

 drinking, it will be readily seen why it becomes so frequently 

 a permanent legacy handed down from one generation to 

 another. Heredity may be so strong in its production, that 

 gout may arise without any further cause, and should the 

 predisposition be very marked, it may even be developed in 

 children, and the younger the subject the more probable it 

 is that there is an hereditary taint. The acquired causes of 

 this diathesis are inordinate or erratic eating and drinking, 

 and due want of exercise. Even in cases in which there 

 is hereditary predisposition, these habits will aggravate and 

 intensify the proclivity. Alcoholic intemperance is also an 

 important factor in the development of the gouty diathesis r 

 and is capable of producing the diathesis de novo, in addition 

 to the influence it exerts on any transmitted proclivity, 

 In fact, as Mr. Hutchinson says : " Had mankind continued 



