Even admitting the ingestion of, _e.g._, hypoxanthin was followed by a gouty outbreak, it must be insisted that mere sequence does not establish causation. Clinically, on the whole, there is little or nothing to support the contention that the _purin bases_ have much to do with the pathogeny of gout. “The proof of the pudding is in the eating,” and contrary to the view, at one time so prevalent, that purin foodstuffs were most deleterious, it has been found that, for the average gouty person, a purin-free dietary is not only not essential, but prejudicial. Those, therefore, who may be inclined to see in the above sequence proof of a _causal_ connection, would do well to recall Bacon’s dictum that “there is in the human mind a peculiar tendency to dwell on affirmative and to overlook negative instances.” In conclusion, we must affirm our belief that _neither uric acid nor its precursors_ is responsible for the fever, local inflammation, and general constitutional disturbance in gout, for uric acid and the urates are themselves practically non-toxic. Albeit, though holding this view, I do not for one moment suggest that _uric acid_ has nothing whatever to do with gout. The fact that _tophi_, its pathognomonic stigmata, are compounded of biurate of soda, would _per se_ stamp such an attitude as untenable. On the other hand, _uric acid_ must be viewed in its proper perspective as a concomitant or sequel of gout, the essential _cause_ of which must be sought elsewhere. CHAPTER XIII THE RISE OF THE INFECTIVE THEORY With the abandonment of the uric acid theory of the causation of gout we see a reversion, curiously enough, to the hypothesis held by the ancient physicians as to its pathogeny. Like Cælius Aurelianus and Paulus Ægineta, we now incline to refer the origin of the disorder to some derangement of the _gastro-intestinal_ tract. This conception indeed endured up to the latter half of the eighteenth century, and was definitely maintained by Van Swieten in his commentary on the aphorisms of his great preceptor, Boerhaave. For him the _fons et origo mali_ in gout was disturbance of the functions of the alimentary tract. “Indigestio viscorum pro origine proxima hujus morbi habitur.” The English Hippocrates, too, Sydenham, in his classic treatise observes: “The more closely I have thought upon gout, the more I have referred it to _indigestion, or to the impaired concoction of matters both in the parts and juices of the body_.” Not only in regard of the initial site are we reverting to the views of old-time physicians, but the tenor of our reflections upon the _nature_ of the disorder exhibits a like trend. Thus the older physiologists, doubtless impressed by its fulminant onset and clinical features, ranked gout amongst the fevers, describing it indeed as a “tertian fever terminating in fourteen days.”