In some undoubtedly the alcoholic factor plays a _rôle_, but such symptoms may, on the contrary, arise in very abstemious individuals. This notwithstanding, James Taylor holds that the clinical complex differs substantially from that met with in true _alcoholic neuritis_. It is slighter in degree, the paresis usually restricted to lower limbs, while the exquisite tenderness to pressure on nerve trunks so typical of alcoholic neuritis is little or not at all in evidence. Nor is there the same tendency to contractures in muscles as met with in the alcoholic variety, and withal there is an absence usually of the mental changes—loss of memory—associated therewith. Accordingly Taylor holds that we must recognise the existence in the _gouty_ of a true _glycosuric peripheral neuritis_ quite independent of _alcoholic peripheral neuritis_. Other concomitant nerve troubles noted in this association are _severe intercostal neuralgia_ and, even more commonly, _neuralgia_ of the _fifth nerve_, and to this may be added _migraine_ and that other neurosis _asthma_. Intense mental irritability and depression is not an infrequent sequel in gouty glycosuria. According to James Taylor, melancholia even may result, especially if the glycosuria have merged into true diabetes—a sequel, he says, especially prone to occur in Jewish subjects. Having seen and suffered many painful disillusionments through too flippant relegation of neuralgias or neuritides to diatheses “gouty” or “rheumatic,” I would emphasise the necessity for great caution. In other words, before labelling a neuralgia or neuritis as “gouty,” all possible causes, _infective_ or _other_, should be excluded, this always, but pre-eminently so in _brachialgia_, _sciatica_, and _trigeminal neuralgias_. Nor even, should there be a history of classic _outbreaks_ or blatant _tophi_ present, should we be less vigilant. By all means recognise the _gouty diathesis_. It often avails much in treatment, but not if, _e.g._, _dental caries_, _antral disease_, _cervical rib_, or _pelvic growth_ be overlooked, not to speak of recent or concurrent sources of _infection_ or _toxic absorption_. Lastly, we should always recollect that gouty glycosuria, as Gull said, “does not discover itself”; it is not writ large on the subject like true diabetes. But given the incidence of _nerve_ troubles in a _gouty_ person, _i.e._, a paræsthesia, itching, neuralgia, etc., we should always suspect its presence.[39] Incidentally our search may reveal not only sugar, but also _albumen_, and the latter may explain much that appeared inexplicable. GOUT IN RELATION TO PHLEBITIS