A gentlemen who had suffered intensely, both from rheumatism and gout, made quite an appropriate comparison between the two. "Apply," he says, a "thumbscrew to the thumb, and turn it until the pain is as severe as can possibly be endured, and that is rheumatism. Now give it one more turn, and you have gout."

The nature of the inflammatory action, both in gout and rheumatism, is undoubtedly the same. An attack of gout is almost always preceded, or accompanied by gastric derangement, and sometimes diarrhoea. The inflammation may attack any of the small joints, although it is generally situated in the ball of the great toe. The integuments are swollen, the pains severe, of a darting, throbbing, burning or aching character, increased by contact and movement. The pains are aggravated at night; the urine is passed in small quantities, is highcolored, and becomes turbid on standing, the patient is exceedingly restless and irritable. When the paroxysms of gout are of frequent occurrence, a thickening of the articular membrane is produced, calcareous deposits are formed about the joints, and the disease is liable to assume a chronic form.

The disease, as a general thing, though not in all cases, may be looked upon as hereditary. The exciting causes are, high living, abuse of stimulants, particularly wines, want of sufficient exercise, loss of rest and irregularities in eating. It is generally confined to middle age, or more advanced life.

Treatment

Those in whom there is a strong predisposition to the disease, should be careful to avoid the causes which are liable to produce it. The treatment in all its stages, is similar to that indicated in rheumatism. Consult that disease.