While these reflections are in the main, we think, justifiable, we must recollect that in gout, as in other maladies, the elements of _prognosis_ reside in the _individual_, not the disease. Does he come of a long-lived stock?—not uncommonly a feature of gouty families. If so, the outlook is favourable. If he come of a short-lived breed, then in all probability, no matter how carefully he lives, he will not likely make “old bones,” this, certainly, if the gout makes its appearance early in life, say under thirty. As to the axiom, generally accepted, that the earlier in life gout makes its _début_, the more unfavourable the outlook, there are exceptions. Where _longevity_ marks the stock, they usually are true to type. Thus, even if the first outbreak occurs in the twenties, I have known them reach the allotted span and over. Nor if their urine show traces of _albumen_ is this necessarily of grave import, for these gouty veterans may for many years, even to old age, exhibit traces of albumen without apparently developing genuine Bright’s disease. “There dies not above one of a thousand of the gout, although I believe that more die _gouty_,” wrote Graunt long years since; and this contains a kernel of truth, for the _prognosis of gout_ rests in the main not on the _gout_, but the _conditions correlated therewith_—the absence or not of _complications_. For, be it always remembered, gout, though it may appear in youth, is chiefly an appanage of the middle and later decades, in short of the _regressive_ period of life. This last is, I think, apt to be forgotten, and gout vicariously saddled with all the infirmities of age. Thus, out of 2,680 examples of _arterio-sclerosis_ Huchard held _gout_ and lithiasis responsible for no less than 693. An appalling indictment, but what of the long arm of _coincidence_? For _age_ unquestionably is the chief factor in the production of arterio-sclerosis, though many allot gout a dominant _rôle_ in its genesis. This certainly is by no means proven. Still, whatever be the relationship, _gout_ and _arterio-sclerosis_ are very often found _in association_. If so, the prognosis will obviously rest, not on the gout, but on the _vascular_ disease—the pulse tension. If therewith be correlated _albuminuria_ and a displaced apex beat, the outlook is unfavourable. Again, is the subject lean or obese? If the former, so much the better, for _corpulency_ and _gout_ are a sinister combination. Gout in itself, as previously observed, favours microbic invasion, and obesity accentuates the liability. Moreover, the gouty obese are prone to _arterio-sclerosis_ and _granular kidneys_, with sometimes a superadded _glycosuria_, or even true diabetes. In such subjects also the presence or absence of signs of cardiac mural degeneration must enter into our forecast, which at best is but gloomy.