urates, perhaps also with some organic body.  It has been shown that the blood of the gouty is not saturated with uric acid, but can take up more, and that the alkalinity of the blood is not diminished.  The excess over the normal is in many cases small; it is said to be absent in some persons, and rarely, if ever reaches the quantity found in leukaemia.  Leukaemia is a disease marked by an excessive and permanent increase in the white blood corpuscles and consequent progressive anaemia.  Neither does the uric acid of gout reach the quantity produced in persons whilst being fed with thymus gland (sweetbread), for medical purposes.  In neither of these cases are any of the symptoms of gout present.  In the urine of children, it is not unusual to find a copious precipitate of urates, yet without any observed effect on them.

The symptoms of gout point to the presence of a toxin in the blood, and it is this which produces the lesions; the deposition of urates in the joints being secondary.  This poison is probably of bacterial origin, derived from decomposing faecal matter in the large intestine.  This is due to faulty digestion and insufficient or defective intestinal secretions and constipation.  This explains why excessive feeding, especially of proteid food, is so bad.  The imperfectly digested residue of such food, when left to stagnate and become a mass of bacteria and putrefaction, gives off poisons which are absorbed in part, into the system.  This bacterial poison produces headache, migraine, gouty or other symptoms.  Because of the general failure of gouty persons to absorb the proper amount of nutriment from their food, they require to eat a larger quantity; this gives a further increase of faecal decomposition and thus aggravates matters.  The voluminous bowel or colon of man is a legacy from remote pre-human ancestors, whose food consisted of bulky, fibrous and slowly digested vegetable matters.  It was more useful then, than now that most of our food is highly cooked.  About a third part of the faecal matter consists of bacteria of numerous species, though chiefly of the species known as the bacillus coli communis, one of the less harmful kind which is a constant inhabitant of the intestinal tract in man and animals.  This species is even thought to be useful in breaking down the cellulose, which forms a part of the food of the herbivora.  Flesh meat leaves a residue in which the bacteria of putrefaction find a congenial home.  Poisons such as ptomaines, fatty acids and even true toxins are produced.  It is believed that there exists in the colons of gouty persons, either conditions more favourable to the growth of the bacteria of putrefaction, or that they are less able to resist the effect of the poisons produced.  It has generally been found that milk is a very good food for gouty patients.  This seems due to its being little liable to putrefaction, the bacterial fermentation to which it is liable producing lactic acid—­the souring of milk.  The growth of most bacteria, particularly the putrefactive kinds are hindered or entirely stopped by acids slightly alkaline media are most favourable.  This explains how it is that milk will often stop diarrhoea.