(1) Acute articular gout is not infrequently complicated by fibrositis. (2) The same infection that determines the articular outbreak is responsible for the concomitant muscular and nerve phenomena. (3) Persons of gouty heritage are especially liable to fibrositis, notably _lumbago_ and _sciatica_. (4) Gout predisposes to fibrositis in that the inherent pathological attributes of gouty tissues favour the incidence of _infection_. In regard of this last postulate, it is well known that _gouty_ persons who contract _gonorrhœa_ are more prone than the _non-gouty_ to develop _gonorrhœal rheumatism_, in other words, to sustain a widespread infection involving the fibrous tissues, not only of the joints, but of the muscles and even of the nerve sheaths. With this concrete example to hand, is it not reasonable to suppose that such a constitutional taint will favour the incidence also of other infections or sub-infections, and that this may explain the relative frequency of fibrositis, not only in the actually gouty, but in those of gouty heritage, this the more cogently having regard to the fact that so much exact evidence is forthcoming in favour of local infection as the cause of all types of fibrositis? CHAPTER XVIII CLINICAL ACCOUNT (_continued_) CHRONIC ARTICULAR GOUT In delineating the features of the _acute polyarticular_ variety, we have to a certain extent trenched on the clinical territory of the _chronic_ form; this is scarcely avoidable, inasmuch as the line drawn between acute and chronic gout is purely arbitrary. Thus one authority remarks of acute gout: “If the disease continue beyond three or four weeks, it is to be considered as persistent or chronic” (Flint). Trousseau, again, discussing the acute variety, more particularly the acute polyarticular type, states that it “may last for some weeks, or even for three months,” adding: “Should it extend beyond that period, it is no longer acute gout; it is chronic gout.” The truth is that articular gout in this respect is very prone to vagaries. Thus, in rare instances an attack of _acute_ or _sub-acute_ gout, more particularly the latter, may merge without break into the _chronic_ form of the disease.[35] Far more commonly the tragedy is more slowly played out. The unfortunate victim, after passing through several more or less classical attacks, finds that the intervals become shorter and shorter until they merge, as it were, one into the other. Fortunately its course is not one of continuous uniform severity. _Remissions_, but not complete _intermissions_, occur, and every now and again intercurrent acute attacks take place.