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and by the aid of which the physician may ascertain the changes in the composition of the blood in disease,” led me to reconsider the nature of the urinary deposits, in both gout and rheumatism. The remarkable analogy which exists both in the character of the urine and of its deposits in these two diseases, and the striking points of resemblance in some respects between some of the symptoms of the two diseases and the equally remarkable discrepancy which existed between others, led me to infer that the two diseases depended on the formation of the same morbific matter, generated under different circumstances, and acting on opposite conditions of the blood. In order to arrive at any definite conclusion on these points, it became essential to obtain a more accurate knowledge of the laws of lithiasis, or the physiological principles which regulate the formation, retention, and ultimate deposition of lithates or urates in those tissues for which they have the greatest affinity. This necessarily must be to some extent a matter of conjecture, but my observations and the conclusions derived from them are embodied in the following pages; and however imperfectly they may be expressed, and however feebly they may be advocated, I offer them to the profession and the public, not with an assurance of their infallibility, for that would be presumptuous, but with that strong conviction of their general correctness which a careful consideration of the subject entitles one to hold. Many men who form opinions, differing from those generally entertained on any given subject, are frequently deterred by the fear of criticism from giving them publicity; if all were influenced by this morbid sensibility, science would stand still. Criticism promotes discussion, discussion ventilates the facts and elicits truth, and it is by the truths of science that pathology becomes enriched and suffering humanity relieved. I therefore venture to publish this book, because I rely with confidence on the old saw,

Magna est veritas et prevalebit;"

because I am somewhat sceptical of the supposed savage severity of reviewers, and because I believe

in

“ The average justice of the popular din.

If it is bad they will not take it in,
Nor will it take them in.”

If, on the contrary, the principles are sound, they will conduce to the public good, and will not detract from

my

humble reputation. It will be observed that I have avoided appending formulæ of prescriptions in the treatment of these diseases. My reason for doing so is, that every well-informed professional man knows that he never sees two cases of either gout or rheumatism in which the symptoms are precisely alike, and in which the treatment that might be applicable in one case would not require to be very much modified to meet the exigencies of another; and although he might be willing enough to recognise the general correctness of the principles advocated in a treatise of this description, he would never think of adopting prescriptions from this or any other medical work for the treatment of diseases so variable in their character and peculiarities. The public, on the other hand, unacquainted with these circumstances, will use or rather misuse prescriptions in medical books; and they do so, not only to their detriment, but they bring discredit on the science of medicine in general, and the author in particular; and as I despair of attaining the ultima thule of medical bliss, and making “every man his own doctor,” I have thought it better to adopt a conservative practice in this respect, by preventing as far as is in my power any man doing himself harm and laying the blame at my door. If rheumatism has been a constant source of doubt and difficulty to the pathologist, it must be admitted by all that

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