MODE OF LIFE - GOUT The effects of diet and modes of life are by far more potent than the influences of race and climate in the production of gout and its congeners. It is true that heredity plays a great part in determining the incidence of the disease in certain families. Living for genera tion after generation under the same faulty conditions of hygiene and dietetics, a morbid predisposition becomes more easily established, so that it really appears to the superficial observer as if the disease itself were handed down from parent to child. But, as will be more clearly evident when we pass to the study of the nature of gout, it is not the disease that is transmitted, it is the environment and the conditions of existence that are perpetuated; and they reproduce the malady in those who are subjected to their influence. For this reason it is possible by a change of habits to eradicate gout from a family or a nation. The history of the Roman Empire is exceedingly instructive in this particular. During the period of unbridled luxury that followed the conquest of the world, the Romans suffered severely with gout; but with the ruin of the empire and the disappearance of wealth before the invading Huns and Goths and Arabs, the disease declined, and is now prevalent in Italy and the Orient only among the few opulent citizens who neglect the laws of health and the precepts of the Koran. With the growth of temperance and the diffusion of
hygienic knowledge, gout is in Europe becoming everywhere less common. The great improvement in all the conditions of life that has been effected during the nineteenth century has diminished the amount of suffering from diseases of nutrition, so that everywhere upon the continent there has been less gout than in former days. The wider diffusion of the comforts of life is also attended by less of their abuse on the part of those who formerly monopolized all the good things of the earth. These facts serve to illustrate the superior influence of personal habits over all considerations of race and climate.