Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    855/976 (page 835)
    Causes of Gout.—The causes of Gout may be conveniently treated of under two heads : first, those depending on the age, sex, hereditary and other peculiarities of the individual; secondly, those independent of the affected subject. Causes Dependent on the Individual. Hereditary Influence.—Some individuals are undoubtedly more disposed to Gout than others, and in such the disease is liable to be induced by agencies which would be comparatively harmless if applied to other people. There is, in short, a proclivity to Gout which may be inherited; and it is certainly true as regards this malady, that the sins of the fathers are visited upon the children to the third and fourth generation. Instances illustrating the hereditary predisposition to Gout are so frequently met with, that no one who has had the least acquaintance with this disease can have failed to have observed it. My own experience would show that more than half the gouty subjects can distinctly trace their ailment to hereditary taint; and if patients in the upper class of society are exclusively selected, the percentage is found to be considerably greater. There exists a popular idea that Gout frequently slaps over a generation, and that it has a peculiar tendency to attack the grandchildren rather than the children : this idea I believe to be erroneous, but at the same time acknowledge that there are often apparent grounds for it. Occasionally the child of a very gouty parent, having the fear of suffering before his eyes, will live such a life as to keep the disease at bay; his children, however, may be fully under the hereditary influence of their grandparent, and liable to a development of the malady from the ordinary exciting causes. When true Gout is met with at an early age, the existence of hereditary taint may be suspected, and in the case of children this cause is certain to be powerfully operative. However, it must not be forgotten that Gout may be acquired at a comparatively early age, by the influence of causes other than that of hereditary predisposition. Influence of Sex.—Men are much more frequently the subject of articular gout than women, and the causes of the comparative exemption of females is not difficult to understand, when we are acquainted with the pathology of the disease. As far as hereditary causes are concerned, women are similarly circumstanced with men ; but there are many reasons explaining the immunity enjoyed b}’ women. Some of these are intimately connected with the functional peculiarities of the female sex; others depend upon the habits of life more commonly adopted by women. The occurrence of the catamenia during a long period of female life, is doubtless a great safeguard against the^ disease, and as a rule, whenever Gout does occur in the female, it is only after the cessation of this function There are however striking exceptions now and then met with—instances of the most severe Gout, attended with great crippling and deformity, in 3 II 2 J