Laycock also subscribed to Charcot’s view, and Sir Dyce Duckworth confesses that the conception of “a basic diathetic habit of body called _arthritic_ has well commended itself to my mind,” while as to the clinical commingling of the two disorders Sir Charles Scudamore spoke with no uncertain voice. That an individual may in youth suffer from _acute articular rheumatism_, and later in life develop _gout_, is undeniable, as also the reverse, that a gouty subject may be harassed by manifestations of chronic rheumatism or _fibrositis_. But this mutual trenching of the one upon the clinical territory of the other must not be allowed to impair our views as to the essential distinctness of _gout_ and _rheumatism_. It is undeniable that the difficulty of differentiating between the _chronic_ forms of these two disorders is great, for not even the revelations of _skiagraphy_, in the absence of a clinical history, will suffice to effect a discrimination. But to a further consideration of this vexed matter we refer the reader to the coming chapters on Diagnosis. IDENTIFICATION OF MUSCULAR RHEUMATISM But to resume our thread, one great step forward we owe to Cullen, who not only differentiated _acute_ from _chronic_ articular rheumatism, but also clearly portrayed the clinical distinctness from both of _muscular_ rheumatism. In so doing, he materially assisted in the differentiation of these same disorders from _gout_. But at the same time, owing to his immoderate advocacy of “chill” as the one great cause of _rheumatism_ in all its forms, he undoubtedly retarded progress. For immediately there arose a cloud of witnesses who claimed a “rheumatic kinship” for a myriad _visceral_ disorders, the victims of which had suffered exposure. Thus throughout the seventeenth and eighteenth centuries many of the conditions now assigned to _irregular gout_ were affiliated instead to _rheumatism_. DIFFERENTIATION OF CHRONIC GOUT FROM ARTHRITIS DEFORMANS Apart from Cullen’s contribution the eighteenth century was unmarked by any further advance in differentiating the mass of heterogenous joint affections, indifferently classed as gout and rheumatism. The physicians of this period, indeed, appear not only to have done little themselves, but had omitted to utilise the useful indications furnished by their predecessors.