179 



hereditarily predisposed it may manifest itself at a much 

 earlier period. Gout is not only a very serious malady in 

 itself, but may become the parent of grave constitutional 

 and functional disorders and diseases. Of these the following 

 may be here enumerated viz., of the digestive organs : 

 gastritis, neurotic disturbance, dysphagia, intestinal colic, 

 diarrhoea, and hepatic derangement ; of the nervous system : 

 headache, vertigo, mental disturbance, delirium, mania, 

 epilepsy, neuralgia, cramp, local paralysis, meningitis; of 

 the heart : slow, rapid, weak, irregular, or intermittent 

 action, syncope, collapse, and various painful and disagree- 

 able sensations ; of the lungs : asthma, bronchial catarrh, 

 and pulmonary congestion ; of the urinary organs : chronic 

 cystitis, urethritis, gravel, and calculi. In addition to the 

 foregoing, there is also the terrible haemophilia, now regarded 

 as a result of gout ; apoplexy due to rotten blood-vessels ; 

 and the cirrhotic, fibrotic, or gouty form of Bright's disease. 

 In this extensive category might also be added eczema and 

 various other forms of skin disease. 



We thus see how compound and complex is the inheritance 

 of gout in all its terrible totality ! A typical case of gout, 

 whether inherited or not, is easily recognised, and that 

 it is generally hereditary is freely admitted ; but when we 

 see, as experience leads us to expect, severe digestive, 

 nervous, cardiac, pulmonary, and genito-urinary symptoms 

 developed in gouty subjects, we should regard them as 

 revealing symptoms, and remember always that these, too, 

 may be perpetuated hereditarily, either in similar or dis- 

 similar forms, in accordance with the law of variability 

 one series of the phenomena of which is represented by the 

 so-called metamorphoses in transmission. Taken either singly 

 or together, all these symptoms reveal the gouty diathesis 



