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to be vegetable-feeders, and never known the use of wine or 

 beer, we should have had no experience of gout." It has been 

 observed that gouty persons are peculiarly susceptible to the 

 influences of lead in the system, as is proved by the fact 

 that medicinal doses of this metal have often been known to- 

 induce an attack. Unless very strongly hereditary, this 

 diathesis scarcely ever reveals itself before thirty years of 

 age, and seldom 'after sixty-five : males, probably owing to 

 the different habits of the two sexes, are, as a rule, much 

 more predisposed than females. Full-blooded, plethoric 

 persons are said to be predisposed, but it should be remem- 

 bered that these conditions are often produced by the habits 

 which originate acquired gout : formerly this dominus 

 morborum was also regarded as morbus dominorum, from its 

 being confined to the aristocracy, and to those in affluent 

 circumstances, for obvious reasons, but it is now common 

 enough amongst " people of low degree." 



The hamorrhagic diathesis is associated with the gouty 

 as effect and cause. When once established, this diathesis 

 is strongly hereditary. It is confined to man, the lower 

 animals being apparently exempt, and has frequently mani- 

 fested itself during an attack of gout in certain individuals. 

 This diathesis, as Mr. Hutchinson has pointed out, " has 

 its origin in the peculiarities of vascular structure which 

 are developed by gout, and which have become modified 

 and specialised by transmission through many generations." 

 Heredity is,. without doubt, the most striking and important 

 of all the predisposing causes of this diathesis. Grandidier 

 speaks of it Haemophilia as " the most hereditary of all 

 hereditary diseases ; " and so potent is heredity in the per- 

 petuation of this terrible disease, that " it has been possible 

 to construct an actual family tree of the disease, with roots 



