CLINICAL SYMPTOMS 



253 



itary character, and even so careful an observer as Potain believes : " Ce n' est 

 pas telle ou telle forme de rheumatisme qui se transmet, mais une predisposi- 

 tion generate exposant a un groupe commun d'affections dans laquelle il faut 

 meme ranger la goutte." 



On this point it is difficult to arrive at a definite conclusion. When we 

 read the clinical reports of German, French, English and American authors 



Fig. 7. — Patellar Cartilage of a Young Man who, .^fter Passing Through an Attack 

 OP Gout, Succumbed to Croupous Pneumoni.a. The cartilage shows a velvety fibrilla- 

 tion of the matrix similar to the condition in chronic arthritis. The joints contained no 

 deposits of urate salts. 



we receive the impression that certain forms of chronic polyarthritis frequently 

 attack debilitated persons. One author has, however, gathered his clinical 

 material in the hospital, among feeble, anemic, poorly nourished patients, 

 cases of true arthritis pauperum, whereas the cases of others were among those 

 living in affluence, the portion of the population debilitated by luxury and 

 close intermarriage. 



Under such conditions we cannot regard the simultaneous appearance of 

 two or more diseases as a proof of their identity, and since decisive statistics 

 are not to be had, the critical skepticism of A. Hotfmann and other German 

 authors is certainly justified. 



Yet the relation of arthritis to apparently dissimilar affections — and here 

 I must mention psoriasis — becomes constantly more obvious. Adrian has re- 

 cently reported 94 cases of this combination, which has been knowTi in France 

 for some time. Gerhardt was the first to observe the condition in Germany, 



