SEX - GOUT.
are far less liable than men to the incidence of gout. Even among the English, Scudamore could find but 12 females out of 68 cases of the disease. Durand-Fardel and PAtissier, in a total of 580 cases, numbered only 20 women. If, however, the allied diseases, lithiasis and arthritis deformans, were taken into account, the disproportion would not be so glaring, for these are the forms of arthritism that are most frequently experienced by the female sex. A certain connection between the cessation of the menses and the manifestation of gout in the female has been asserted from time immemorial. It is probable that menstrual suppression does operate somewhat unfavorably in this respect. In the majority of cases that are uncomplicated by local disease of the female organs of generation the occurrence of pelvic disturbance is due to gout in its masked va rieties. In many instances the cessation of the menstrual flux seems to close up an outlet for " peccant humors," and gout attacks the joints. It is a notable fact that the age of puberty is for the female another epoch at which arthritic manifestations are not uncommon. The frequent occurrence of gouty headaches at the time of the monthly periods indicates that menstruation must not be considered a shield against gout. In fact, among young women who are predis posed to arthritic disease the occurrence of articular crises seems to be quite independent of menstrual disorder, so that it is very likely that the frequent development of gout that is witnessed after the close of sexual life in the female is fully as much the result of advancing years as of the cessation of the menses.
Gout does not seem to be favored by any particular type of con stitution. It attacks the corpulent and the lean-favored, the sanguine and the bilious. But it is noteworthy that in the majority of cases its victims give evidence of good living, either through a tendency to obesity or through the dyspepsia that results from over-feeding and an inactive life. Scudamore, who is nothing if not statistical, found, among 156 patients, 126 who were more ponderous than the average individual. The type of the gouty manifestation conforms very closely to the general constitution of the patient. Vigorous, florid, and sanguine subjects have acute inflammatory attacks of the disease ; bilious and dyspeptic people suffer with hemorrhoidal and hepatic crises ; while those who possess a weakly and nervous organization exhibit all the phenomena of nervous gout: neuralgia, abdominal pain, muscular cramp, asthma, angina pectoris, headache, etc.