thing in the system which we express by the term hereditary and constitutional tendency, can be laid bare to the senses, or whether it must be for ever veiled from our eyes; but at present it is undoubtedly one of those mysteries of science requiring implicit belief, on which our keenest study has not yet shed one ray of light.

It is, notwithstanding, very certain that the blood of those persons who fare too sumptuously, and lead indolent lives, is in a less healthy condition than that of those whose indulgence is moderate, and whose occupations are active and salutary. So far, indeed, am I of a humoralist a to believe that chemical researches will lay before us more morbid changes in the fluids than the increase and diminution of sugar, urea and urates, of albumen and fibrin, according to the varying condition of the system. These changes will, no doubt, prove explanatory of phenomena which yet perplex us, and they may also become concurrent causes with plethora of the fluids and rupture of vessels, in explaining the paroxysm of gout; but even so, I should not depart from the opinion I have expressed that they are all of them only signs of that state of the system indispensable for the production of the local phenomena which distinctly characterise the disease. It is unquestionable that, though revealing itself by the outward manifestations

I have described, gout is due to a particular tendency of the constitution, of which no explanation can yet be given, which may never disclose itself, and whose nature and essence will, in all probability, remain for ever shrouded in that deep obscurity in which organized and formative structure takes its vital impulse and individual existence.

CHAPTER XII.

CURABILITY OF GOUT--ITS ORIGIN IN INFANCY-DIET OF INFANTSOF YOUTHS-OF ADOLESCENTS-NUTRITION NECESSARY TO GOUT -SUBSIDIARY FORCES OF CIRCULATION-EXHALATION OF PLANTS AND ANIMALS-SIR D. BARRY'S OPINION OF RESPIRATIONEFFECT OF MUSCULAR EXERTION-USE OF EXERCISE-SYDENHAM'S OPINION OF MORBID MATTER-LOW DIET INADMISSIBLE— MILK DIET-VEGETABLE DIET-CURE DES RAISINS-DRINK OF THE GOUTY-BEER-WINE-SPIRITS-MEAT-IDIOSYNCRASIES

DELIRIUM TREMENS,

THE curability of gout has been subject of dispute. Some physicians, following the example of Sydenham, have nearly abstained from remedies; contented with palliating a few symptoms and obviating some inconveniences, they have left the disease to follow an uninterrupted course, while others, relying on some of the strongest drugs in the armoury of physic, have sought not only to put an end to the paroxysm, but to extirpate the disease. Such errors as the last will rarely be found among old practitioners. Gout certainly has been, and ever will be, the opprobrium medicorum, if extirpation of the malady by means of the medicines of the pharmacopoeia be aimed at. The fit may be mitigated, shortened,

often cut asunder by drugs, but nothing beyond temporary relief, can, from this source, be looked for. Hence the triumph of the quack, who always steps in to take the place vacated by the honest physician. Our admitted inability is his opportunity. He points to the errors of physicians, and the uselessness of medicine, and, at the same time, to his own great secret. This has been the case in all ages, and ever will be. But the professional impostors are not the only or the worst offenders in gout. There is hardly a family in the kingdom, afflicted with the disease, which has not its favorite remedy, with which even the ladies practise on all comers, to their very serious injury.

I have not a doubt of the perfect curability of gout in its earlier stages, though not through what is vulgarly called physic, yet through the physician.

If the argument I have used in the preceding pages has any force of conviction, it must be seen that a simple process of starving, instead of curing, will aggravate some of the worst forms of gout. It is, notwithstanding, by dietetic and hygienic means that much is to be accomplished. More, however, is necessary, as will presently appear.

Van Swieten mentions the case of "a priest, who, in the enjoyment of a fat benefice, and suffering from inveterate gout, was captured by pirates, and compelled to work hard at the oar for

the space of two years, with this good effect, that, when redeemed from captivity, he was freed from his cumbrous and superfluous bulk, nor was he ever afterwards affected by gout, though he survived several years."

Musgrave has the following case: -A gentleman, who had spent his youth in gluttony and wantonness, was seized, "at middle age, with an attack of gout, whose violence was proportioned to his previous excesses." He underwent severe and frequent attacks, by which his health was destroyed. "His joints were covered with many and large chalk-stones. But this vile glutton, in process of time, ruined his fortune, and reduced himself to poverty; he then betook himself to the laborious occupation of brickmaking, and led a life of much fatigue. He greatly profited thereby. His appetite returned, while his scanty means denied him all indulgence; he got rid of his superfluous flesh; his body became athletic; his chalkstones all disappeared, and he lived many years thereafter with great labour and moderate fare." This was a very advanced case. Such rude treatment applied to the majority of gouty subjects would, probably, be attended by very pernicious consequences. But these instances serve the more effectually to prove how much may be done if the vital functions of the body are not too seriously injured.