the gout. There are no experiments or observations which shew that the blood, or other humours of gouty persons, are in any respect different from those of other persons. Previous to attacks of the gout, there appear no marks of any morbid state of the fluids; for the disease generally attacks those persons who have enjoyed the most perfect health, and appear to be in that state when the disease comes on. At a certain period of the disease, a peculiar matter indeed appears in gouty persons, (516); but this, which does not appear in every instance, and which appears only after the disease has subsisted for a long time, seems manifestly to be the effect, not the cause, of the disease. Further, though there be certain acrids which taken into the body, seem to excite the gout, (504), it is probable that these acrids operate otherwise in exciting the disease, than by af. fording the material cause of it. In general, therefore, there is no proof of any morbific matter being the cause of the gout.

Secondly, The suppositions concerning the particular nature of the matter producing the gout, have been so various and so contradictory to each other, as to allow us to conclude, that there is truly no proof of the existence of any of them. With respect to many of these suppositions, they are so inconsistent with chemical philosophy, and with the laws of the animal economy, that they must be entirely rejected.

Thirdly, The supposition of a morbific matter being the cause of the gout, is not consistent with the phenomena of the disease, particularly with its frequent and sudden translations from one part to another.

Fourthly, The supposition is farther rendered improbable by this, that, if a morbific matter did exist, its operation should be similar in the several parts which it attacks; whereas it seems to be very different, being stimulant and exciting inflammation in the joints, but sedative and destroying the tone in the stomach: which, upon the supposition of particular matter acting in both cases, is not to be explained by any difference in the part affected.

Fifthly, Some facts, alleged in proof of a morbific matter, are not sufficiently confirmed, such as those which prove the disease to be contagious. There is, however, no proper evidence of this, the facts given being not only few, but exceptionable; and the negative observations are innumerable.

Sixthly, Some arguments brought in favour of a morbific matter, are founded upon a mistaken explanation. The disease has been supposed to depend upon a morbific matter, because it is hereditary. But the inference is not just for most hereditary diseases do not depend upon any morbific matter, but upon a particular conformation of the structure of the body, transmitted from

the parent to the offspring; and this last appears to be particularly the case in the gout. It may be also observed, that hereditary diseases, depending upon a morbific matter, always appear much more early in life than the gout commonly does.

Seventhly, The supposition of a morbific matter being the cause of the gout, has been hitherto useless, as it has not suggested any successful method of cure. Particular suppositions have often corrupted the practice, and have frequently led from those views which might be useful, and from that practice which experience had approved. Further, though the supposition of a morbific matter has been generally received, it has been as generally neglected in practice. When the gout has affected the stomach, nobody thinks of correcting the matter supposed to be present there, but merely of restoring the tone of the moving fibres.

Eighthly, The supposition of a morbific matter is quite superfluous; for it explains nothing, without supposing that matter to produce a change in the state of the moving powers; and a change in the state of the moving powers, produced by other causes, explains every circumstance, without the supposition of a morbific matter: and, to this pur pose, it may be observed, that many of the causes (504) exciting the gout, do not operate upon the state of the fluids, but directly and solely upon that of the moving powers.

Lastly, The supposition of a morbific matter is also superfluous; because, without any such supposition, I think the disease can be explained in a manner more consistent with its phenomena, with the laws of the animal economy, and with the method of cure which experience has approved.

I now proceed to give this explanation; but before entering upon it, I must premise some general

observations.

530. The first observation is, that the gout is a disease of the whole system, or depends upon a certain general conformation and state of the body; which manifestly appears from the facts mentioned from 494 to 497. But the general state of the system depends chiefly upon the state of its primary moving powers; and therefore the gout may be supposed to be chiefly an affection of these.

531. My second observation is, that the gout is manifestly an affection of the nervous system; in which the primary moving powers of the whole system are lodged. The occasional or exciting. causes (504) are almost all such as act directly upon the nerves and nervous system; and the greater part of the symptoms of the atonic or retrocedent gout, are manifestly affections of the same system, (520 and 522). This leads us to seek for an explanation of the whole of the disease in the laws of the nervous system, and particularly in the

changes which may happen in the balance of its several parts.

532. My third observation is, that the stomach, which has so universal a consent with the rest of the system, is the internal part that is the most frequently, and often very considerably, affected by the gout. The paroxysms of the disease are commonly preceded by an affection of the stomach (507); many of the exciting causes (504) act first upon the stomach; and the symptoms of the atonic and retrocedent gout (520 and 522), are most commonly and chiefly affections of the same organ. This observation leads us to remark, that there is a balance subsisting between the state of the internal and that of the external parts; and, in particular, that the state of the stomach is connected with that of the external parts (44), so that the state of tone in the one may be communicated to the other.

533. These observations being premised, I shall now offer the following pathology of the gout.

In some persons there is a certain vigorous and plethoric state of the system (496), which, at a certain period of life is liable to a loss of tone in the extremities (499, 506). This is in some measure communicated to the whole system, but appears more especially in the functions of the stomach (507). When this loss of tone occurs