of the family had invariably been afflicted with gout when 

 he came into possession of the family estate." He also 

 relates the following case, which illustrates the terrible 

 influence of heredity in connection with the disease now 

 under discussion : " A gentleman, forty-eight years of age, 

 whose health has been good with the exception of attacks 

 of gout, which commenced at the age of thirty-six in one 

 great toe. The attacks gradually became more frequent, 

 and more prolonged, so that he was scarcely ever free from 

 them." Dr. Garrod thus sums up the hereditary influence 

 in this case : " The father had very severe gout, the mother, 

 when seventy years of age, began to suffer from it ; he has 

 had six bi others, of whom one died of very severe gout, 

 and was crippled from chalk deposits in both upper and 

 lower extremities ; another had severe gout and chalk-stones, 

 and died of albuminuria ; a third had gout and paralysis, of 

 which he died ; a fourth had gout, and died of erysipelas ; a 

 fifth died of gout, complicated with some urinary affection ; 

 and a sixth is alive, but suffers from gout in the same way as 

 the patient himself." Gout occurs much more frequently 

 in men than in women, who seldom suffer from it until 

 after the menopause ; the predisposition is, therefore, more 

 frequently inherited from the father's side, than from that 

 of the mother ; moreover the tendency may often be traced 

 to the grandparents, while the parents themselves remain 

 free, especially if they have been careful to avoid the exciting 

 causes of the gouty attacks. Heredity also influences the 

 time of life at which the gouty paroxysms supervene ; thus, 

 in those persons who have an inherited predisposition, the 

 attacks come on at an earlier period than those who have 

 an acquired tendency ; in the latter, gout usually makes its 

 first appearance between thirty and forty, but in those 



