GOUT. 309 



There can be but little doubt that the explanation is that amongst the former ale 

 and porter are the popular beverages, whilst the latter confine their attention almost 

 exclusively to whisky. In many of the large cities on the Continent, where the 

 1 filter kinds of claret form almost the sole alcoholic beverage, gout is very 

 uncommon. 



It is a well-known fact that excessive indulgence in food, more particularly in 

 animal food, is very favourable to the production of gout. It has been noticed that 

 those who live upon an exclusively vegetable diet hardly ever suffer from this 

 disease. Sedentary and luxurious habits are favourable to its development. 



Many people seem to imagine that it is a mark of distinction to have had the 

 gout, something to be proud of and to boast about. This absurd notion evidently 

 originated in the fact that it is essentially a disease of the upper and middle classes, 

 and that it is peculiarly incidental to the wealthy and indolent. We sometimes 

 hear of " poor man's gout," but this, in nine cases out of ten, means rheumatism. 

 When, we find a case of gout in any of our hospitals, the patient will generally prove 

 to l>e a servant in a gentleman's family people who are seldom total abstainers. 



Brewers' draymen are not uncommonly attacked, and usually attribute their 

 sufferings to the "smell of the beer." Gout is also fairly common among the 

 M linllasters" on the Thames, but as they habitually consume two or three gallons of 

 porter daily the cause is not very far to seek. 



Painters, plumbers, and others whose occupations expose them to the influence 

 of lead and lead-poisoning, often become the subjects of gout. It has even been 

 found that the prolonged medical use of sugar of lead, as in cases of bleeding from the 

 nose or stomach, or other part, may, in people of a gouty habit, occasion an attack. 



A fit of gout may be brought on by various circumstances. An unusually severe 

 debauch may act as the exciting cause. Depressing emotions, and over-fatigue, 

 particularly when produced by too long a walk, may be followed by the same result. 

 In fact, anything which depresses the general bodily health favours in a gouty subject 

 the production of an attack. 



The influence of climate and season on the production of gout is well marked 

 The complaint is far less prevalent in hot than in cold or temperate regions. A 

 gouty individual may often escape his accustomed winter attacks by spending the 

 colder months of the year in Egypt or Malta. The increased functional activity of 

 the skin in hot climates is in all probability the cause of this exemption. 



An acute attack of gout in one of the joints is probably never fatal, but when the 

 disease becomes chronic it has an undoubted tendency to shorten life. The appear- 

 ance of gout is always a serious matter, and should never, as some people seem to 

 think, be regarded as a matter for congratulation. The earlier the age at which gout 

 first makes its appearance, the more serious are his future prospects, particularly 

 when the complaint is hereditary. The appearance of chalk-stones, even in the most 

 trivial form, is an unfavourable sign. 



Can gout be cured 1 We believe that if the patient will only take warning by 

 his first attack, and make a thorough alteration in his habits and mode of living, the 

 disease may be entirely eradicated from the system, and will never return. We know 

 of no drug or combination of drugs which, unaided, is capable of effecting this result. 



