Fortunately such examples are relatively rare, and a study of the condition in its earlier stages reveals some interesting features. The uratic deposits, it is important to note, _are not located exactly at the level of the articulation_. Unattached as they are to the _articular ends_, they are not compelled to, nor do they in any way, adapt themselves, as it were, to the contour or shape thereof. In short, the tophaceous formations are _erratic_, are not like _osteo-arthritic_ nodules, erupted from and continuous with the articular bone ends. Again, relatively independent of the contiguous tissues, they, unlike osseous outgrowths, are slightly _movable_ in lateral directions. When of _recent_ incidence, their consistence is _soft_, and, be they never so ancient, they do not attain the _density_ and _hardness_ of _bony outgrowths_. The overlying skin, to which they are sometimes adherent, takes on a peculiar glossy and satin-like texture, its dusky pink blotched with spots of dead white colour, _i.e._, subjacent uratic deposits. In other particulars also they differ from bony outgrowths. The tophaceous masses may _soften_ and _disappear_ after exacerbations of _arthritis_, and others may form at different sites. Following such absorption or difference in their location, some increase in joint _mobility_ may happily ensue. This same fortunate occurrence may follow discharge of the uratic masses through _ulceration_ and _perforation_ of the skin. TOPHI: THEIR EVOLUTION AND DISTRIBUTION In our chapter on _Uratosis_ we dealt with the chemical nature and mode of formation of tophi. Also we affirmed our belief that tophi, whether _articular_ or _ab-articular_ in site, were always _preceded by local inflammatory reaction_, and to the clinical tokens of their impending eruption we need not recur. Albeit this point, _i.e._, _antecedent_ inflammation, is of such prime importance that we have not hesitated to append to our text a lengthy footnote,[37] this because, as Garrod, who quotes the same _in extenso_, rightly claims, the genesis and evolution of tophi has never been so graphically depicted as in Moore’s description.