For the course of gout, like other arthritides of chronic type, is not one of steady, uninterrupted progress, but one marked rather by _periodic_ or _intermittent_ advances, as if seemingly due to a series of successive _infections_ or _sub-infections_. One is reminded of _gonococcal_ arthritis in its more severe forms, the acute exacerbations which chequer its course being generally referred to intermittent absorption of fresh doses of the toxin from some smouldering infection in the prostatic urethra. Now, if the general course or evolution of _gouty_ arthritis is notably similar to that of the specific infective arthritides, so, also, do the clinical features approximate. Thus its _onset_, more often than not, is _abrupt_ and attended by pyrexia of _irregular_ or _septic_ type, with an occasional _leucocytosis_. Again, that not all cases of gout are of _acute fulminant_ type may be admitted. We know that it may assume the guise of a fleeting _arthralgia_ or “flying gout,” a transient _synovitis_, as well as an acute _arthritis_ of _mono-_, _oligo-_, or _poly-articular_ extent. This same _polymorphism_ in respect of the joint lesions in gout is a replica of that met with in the _specific infective arthritides_. The milder varieties betokened by arthralgia or synovitis tend commonly to disappear, as it were, spontaneously in precisely the same manner as the arthralgias or synovites that follow the exanthemata, and we presume that, comparably with these latter, the source of infection dries up and _restitutio ad integrum_ of more or less completeness follows. But with repeated attacks, as in the specific infective arthritides, progressive infiltration and thickening of ligaments, capsule, and related tendinous and aponeurotic structures ensue. As far as these anatomical changes are concerned, gouty arthritis and the specific arthritides are at one, but with this outstanding difference, the associated _uratic deposition_. Save in respect of this last, the analogy is complete, and herein resides the specificity of gouty arthritis. Chalmers Watson, from his observations of “gouty deposits” in human subjects in their relation to _tendons_, _cartilage_, and _bone_, came to the conclusion that the _tout ensemble_ of the pathological lesions was very reminiscent of that typical of the more chronic types of _infective_ disorders. Thus necrotic areas in gouty tendons stood in such clear relationship to the vascular supply as to suggest some infection _viâ_ the blood-stream. Again, areas of erosion in the cartilage were found to be due, not to uric acid, but to the disintegrating action of small round cells of the nature of granulation tissue. As to uratic deposits located in the _bones_, it was noted that their vicinity was characterised by marked vascularity, the existence of giant cells, and an accumulation of the small round cells so commonly correlated with the action of bacterial toxins.