that it
is a disease which returns at intervals, after being cured; yet, it
will return as infallibly as the gout, if a person take the same kind
of leap, or expose himself to the same accidents as those which
brought it on. Let those, therefore, who wish to avoid a return of
the gout, totally change their mode of living: otherwise, if the
attacks return, let them blame themselves, and not the nature of the
complaint.

These observations were thought necessary, with a view to do away
some prejudices, which very much retarded our inquiries into the
nature and cure of this disease. I shall now proceed to give an
account of the symptoms by which it is usually attended.

The gout generally attacks the male sex; but it sometimes, though
more rarely, attacks also the female, particularly those of robust
and full habits. It does not generally make its appearance, till the
period of greatest strength and vigour is past; for instance, about
the fortieth year; but, in some cases, where the exciting causes have
been powerfully applied, or where the hereditary predisposition is
very strong, it attacks much earlier; such cases are, however,
comparatively rare, and can, in general, be easily accounted for.

This disease is seldom known to attack persons employed in constant
bodily labour, and who live temperately; and is totally unknown to
those who use no wine or other fermented liquors.

If then a person of a full strong habit have for several years
accustomed himself to full diet of animal food, and a regular use of
wine, and malt liquor, though he may for a long time find that he can
perform all the functions with vigour, his strength will at last
fail: the mind and body become affected with a degree of torpor and
languor for which he cannot account, and the functions of the stomach
become more or less disturbed. The appetite becomes diminished, and
flatulency, and other symptoms of indigestion are felt. These
symptoms take place for several days, and sometimes for several weeks
before the fit comes on; but often, on the day immediately preceding
it, the appetite becomes greater than usual.

In this state, if the person have fatigued himself by violent
exercise, or if he have exposed the extremities to cold, or if his
mind have been particularly affected by any anxiety, or distressing
event; or in short, if any directly debilitating cause have been
applied, the fit will often follow. It sometimes comes on in the
evening,