308 THE TREATMENT OF DISEASES. 



intense quickly and abruptly subsides, its disappearance being accompanied with 

 disturbance of the stomach, usually indicated by sickness, vomiting, and pain or 

 spasm of that organ. There is a very prevalent opinion that if a person be exposed 

 to a chill or catch cold whilst suffering from gout, the disease is " liable to be driven 

 inwards," and there is 110 doubt that under these circumstances very disagreeable, or 

 even dangerous, symptoms may arise. 



In certain rare cases, apoplexy, epilepsy, and mania have resulted from gout. 

 Neuralgia and sciatica are far more common under these circumstances. Skin 

 eruptions are very common in gouty people, and in many instances the skin and 

 joint affection are suffered fro'rn alternately. Gravel and stone are also common ; 

 but, possibly as a set-off against this long string of evils, the gouty very rarely suffer 

 from consumption. 



There are few diseases which are more distinctly hereditary than gout. Its 

 tendency to run in families must have been noticed by the most casual observer. 

 It is certainly true, as regards this malady, that the sins of the fathers are visited 

 upon the children to the third and fourth generation. It is said that gout frequently 

 skips a generation, and that it more commonly attacks the grandchildren than the 

 children. The explanation of this is in many cases sufficiently simple. Frequently 

 the child of a very gouty father, having his bad example constantly before his eyes, 

 would lead such an abstemious life as to keep the foe -at bay ; but the grandchildren, 

 being fully under the hereditary influence, but not having the advantage of the 

 "frightful example," take no special precautions, and veiy soon fall victims to their 

 ever- watchful enemy. 



Gout is almost exclusively a disease of the male sex. This exemption, or rather 

 comparative exemption, is probably dependent more upon certain periodical func- 

 tional peculiarities of the female sex than upon any essential difference in their 

 mode of life. It has been frequently noticed that women who suffer from gout are 

 robust, full-blooded, and of a masculine turn both of body and mind. Gout, when 

 it does occur in women, very rarely makes its appearance till after the age of 

 forty-five. 



Gout is rarely met with in either sex in people under thirty. To this rule there 

 are, however, exceptions, for gout has been known to occur in boys of sixteen whilst 

 at school. There can be but little doubt that in these cases a strongly inherited pre- 

 disposition must have been fostered by a mode of life not of the most abstemious. 



It has never been conclusively shown that what we call temperament exerts any 

 special influence on the development of gout, but still there is a very general opinion 

 that it most commonly attacks men of robust and large bodies, and of full and 

 corpulent habits. 



The disposition to gout may be engendered, and when inherited will be infallibly 

 strengthened and developed, by certain habits of life. Excessive indulgence in 

 alcoholic beverages must rank first and foremost amongst the circumstances which 

 are directly under the control of the individual. Distilled spirits, such as gin and 

 whisky and brandy, have less tendency to induce gout than either wine or malt 

 liquors. Among the labouring classes in London, gout is by no means uncommon, 

 whilst in the corresponding class in Edinburgh and Glasgow it very rarely occurs. 



