18025] 
Although gout is a difeafe of very rare 
occurrence at the difpenfary, feveral une- 
guivocal inftances of it have recently fallen 
un@er the obfervation of the writer of this 
article. 
The nature, and of courfe the proper 
treatment of this difeafe, it the Reporter 
be right, has, in general, been radically 
mifunderfiood. There czn be no doubt 
that gout is as decidedly hereditary, as 
any of thofe dilorders which are called fo. 
No difcafe, however, is, in ftriét accuracy, 
hereditary ; fince if it were, it muft inva- 
riably defcend from parent.to child, which 
is notorioufly not the cafe with any one. 
of the numerous maladies that afflict the 
human conftitution. It is the predi/pofition: 
only, or propenfity to difeafe that can be 
inherited. 
It is a common, but certainly not a juft 
Opinion, that low living aéts as an almoft 
infallible prefervative againft the gout. 
Gout is, in every inftance preceded by 
fymptoms of indigeftion, and,- of courfe, 
mutt be occafioned by any caufe moral or 
phyfical, that weakens the {rength, or 
that has a tendency to relax the tone of 
the ftomach. Such an effeét is as likely 
to be produced by a courfe of fevere abiti- 
nence, as by one of luxurious excels. But 
for the moft part, a paroxyfm is induced 
not by babits of living, but by occafional 
deviations. 1f for inftance a man whofe 
daily regimen is confined to unfeafoned 
food, and who in general refrains altoge- 
ther from fermented liquors, were upon an 
extraordinary occafion to partake liberally 
of a turtle feaft, and to fwallow a bottle 
of wine after it, in order to digeft what 
he had already {wallowed,, he would, pro- 
vided his conftitution were hereditarily 
tainted, be almoft fure, before the next 
morning, to be brought to repentance by 
the agonies of a cruelly torturing diforder. 
Ad in like manner if a gouty Alderman 
were fuddenly to adopt the plain and fim- 
ple diet of a hermit, he could net fail, in 
_a few days, to feel the punifhment that 
‘was due to fo violent and unwholefome a 
tranfition. | 
The cafe of one of the Jate private pati- 
ents of the Reporter, affords trong confir- 
mation to feveral of the preceding obfer- 
vations, and gives pra¢tical proof of what 
might otherwife be flighted merely as 
{cholaftic theory and hypothefis. The pa- 
tient, in confequence of an inflammation of 
the fauces, was induced to live for a whole 
week almoft entirely upon water gruel and 
lemonade, although he had been previoufly 
accaftomed to a fulland generous diet ; and 
at the conclufion of this period of unufual 
~MOonrtuLy Maa, No. 86, 
Lift of Difeafes 
381 
abftinence, he was attacked for the firft 
time, although arrived at nearly the fortieth 
year of his life,'with a violent paroxyim of 
the gout. This was in a very few days 
temoved by the application of ftrong iti- 
muli, both internally and externally admi-: 
niftered. Since his recovery he has rot 
fuffered any inconvenience from wine and 
highly flavoured food, but has in feveral 
inftances, been threatened by incipient 
fymptoms of a relapfe, in confequence of 
having barely taffed a vegetable acid. 
The catalogue, at the head of this arti- 
cle, fhews that, the humbler claffts claim 
the privilege of imitating the fafhicnable 
world in their difeafes, although they are 
unable to cope with them in their manners, 
their luxuries, or their vices. What are_ 
too vaguely called nervous diforders, com- 
pofe a large proportion of the diforders of 
the poor. Nor ought thefe complaints, in 
any rank of fociety, to be treated with 
levity and indifference, from an idea that 
they are merely fanciful, and altogether 
under the controul of the will. They have 
in general been confidered as imaginarys 
bur in faét they are as real and even phy 
Jical dileafes as gout, rheumatifin, or ca- 
tarrh.* Sa 
The praétice too prevatent of laughing 
at or fcolding an hypochondriacal or byt- 
tcrical patient, is equally cruel and ineffec- 
tual, No perfon was ever laughed or 
fco'ded out either of hyfteria or hypochen- 
driafis, It is fearce'y likely that you 
fhould elevate a perfon’s {pirits by infult- 
ing his underftanding. ‘The temporary 
external exoreffion of fuch diforders, may 
be checked by the coercive influence of 
fhame or fear; but in doing this, the fame 
kind of rifque is incurred as arifes fromthe ~ 
repelling of a cutaneous eruption, which, 
although it conceal the outward appear- 
ance, never fails itill farther to eitablith the 
internal ftrength, to increafe the danger, 
*In this remark far it is from the with on 
the intention of the writer, to inculcate, or 
even to grant the fainteft countenance to, the 
degrading and immoral doétrine of the mifera- 
ble materalift ; who, in oppofition to the high 
dignity, and to the only valuable expectations 
of man, ftruggles to perfuade himfelf, that 
the mind of which he is confcious, is no- 
thing more than one of the various properties 
of his material and perifhable frame. Such 
an hypothefis betrays a direct and glaring 
tendency to undermine the bafes, and to an- 
nihilate the excellence of virtue. Virtue, 
according to this theory, is a mere affeCtion 
of the nerves, and benevolence is réduced to 
the level of a fecretion. 
and 
3D 
