he other end may become inflamed by sensitive association.

15. _Podagra._ The gout, except when it affects the liver or stomach, seems
always to be a secondary disease, and, like the rheumatism and erysipelas
mentioned below, begins with the torpor of some distant part of the system.

The most frequent primary seat of the gout I suppose to be the liver, which
is probably affected with torpor not only previous to the annual paroxysms
of the gout, but to every change of its situation from one limb to another.
The reasons, which induce me to suspect the liver to be first affected, are
not only because the jaundice sometimes attends the commencement of gout,
as described in Sect. XXIV. 2. 8. but a pain also over the pit of the
stomach, which I suppose to be of the termination of the bile-duct in the
duodenum, and which is erroneously supposed to be the gout of the stomach,
with indigestion and flatulency, generally attends the commencement of the
inflammation of each limb. See Arthritis ventriculi, Class I. 2. 4. 6. In
the two cases, which I saw, of the gout in the limbs being preceded by
jaundice, there was a cold shivering fit attended the inflammation of the
foot, and a pain at the pit of the stomach; which ceased along with the
jaundice, as soon as the foot became inflamed. This led me to suspect, that
there was a torpor of the liver, and perhaps of the foot also, but
nevertheless the liver might also in this case be previously inflamed, as
observed in Sect. XXIV. 2. 8.

Now as the membranes of the joints of the feet suffer greater variations of
heat and cold than the membranes of the liver, and are more habituated to
extension and contraction than other parts of the skin in their vicinity; I
suppose them to be more mobile, that is, more liable to run into extremes
of exertion or quiescence; and are thence more susceptible of inflammation,
than such parts as are less exposed to great variations of heat and cold,
or of extension and contraction.

When a stone presses into the sphincter of the bladder, the glans penis is
affected with greater pain by sympathy, owing to its greater sensibility,
than the sphincter of the bladder; and when this pain commences, that of
the sphincter ceases, when the stone is not too large, or pushed too far
into the urethra. Thus when the membrane, which covers the ball of the
great toe, sympathizes with some membranous part of a torpid or inflamed
liver; this membrane of the toe falls into