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Age - Gout

experienced, life and children


Gout is almost always a disease of adult age. But it has been occasionally experienced by children. Boethaave observed such cases, and others have been reported by Schenck, Debout, and Reudu, occurring in children between the ages of seven and seventeen years. In the majority of cases, however, it is in the fourth decade of life that the first attack is experienced. In this particular the following statistics, borrowed from Scudamore, are very instructive: From this table it appears that considerably more than half the cases were first attacked between the ages of twenty-five and thirty five years; while the largest number in any period of five years oc curred during the first half of the fourth decade of life. l'iltissier has reached the same statistical result, and has also noted the interesting fact that among the victims of hereditary gout the first attack is most frequently experienced at the age of thirty-four, while in eases of the acquired disease the favorite age is thirty-eight, showing that it takes four years longer to subdue a virgin soil than to overcome a constitution that has been enfeebled in advance by ancestral excesses.

Among the very aged articular gout is almost as infrequent as among small children. Yet Sir A. Garrod has seen the disease in a number of instances after seventy, and Blackmore relates the history of a patient who at seventy-eight suffered for the first time with gout. In the majority of such cases, there are special reasons that deter mine the tardy onset of the malady. They are usually cases in which the effects of luxury have been held in check by the exercises of an active life in the open air, until at last, during the concluding years of a long existence, the individual retires from business, but continues to indulge without stint in the pleasures of the table. Under such circumstances disorder soon arises ; and, if articular manifestations be not developed, the minor evidences of uric-acid accumulations are sure to appear with all that tendency to subacute intensity and sluggish progress which is characteristic of gout in old people.