_Etiology._—History or presence of urethral discharge and isolation of the gonococcus. _Onset._—Insidious, seldom acute. _General Symptoms._—Absent or slight relatively to extent and severity of joint mischief. Pyrexia, low grade or absent. _Distribution of Lesions._—Preference for large joints. Special liability of sacro-iliac, chondro-costal synchondroses, sterno-clavicular, tibio-fibular, and temporo-maxillary joints. _Local Characters._—Persistent passive effusion or peri-articular boggy swelling, with redness and local heat. No tendency to migrancy. Joint swelling very persistent. _Associated Phenomena._—Involvement of fasciæ, especially plantar, and of tendon sheaths, very distinctive, while coincident iritis or conjunctivitis is almost diagnostic. SECONDARY SYPHILITIC ARTHRITIS The ease with which a subacute arthritis of this nature may be confounded with “gout” or “rheumatism” calls for comment. We have met with cases despatched to spas under this impression. The customary _intermittent fever_ of _secondary syphilis_ is usually present. The detection of periosteal nodes in addition to the joint swellings should arouse suspicion, while the presence of _secondary syphilides_ and the rapid response to _specific_ treatment will be confirmatory. I well recollect some years ago a young farmer being sent to me by a medical man as suffering from _gouty arthritis with gouty eczema_. The eruption was a typical _roseola_, and the condition promptly cleared up under _anti-syphilitic_ treatment. ACUTE RHEUMATOID OR ATROPHIC ARTHRITIS While the old term “rheumatic gout” still clings to this affection, it has now achieved its isolation from gout on the one hand and rheumatism on the other. The fact that it occurs in young women in whom gout never occurs, and has a very marked clinical _facies_ of its own, should almost preclude the possibility of its being a source of confusion. Still, for the sake of completeness, we append its chief characteristics. _Age and Sex._—Most common in young women. _Onset._—More or less acute. _General Symptoms._—Continuous low grade pyrexia, quick pulse, and rapid emaciation, and commonly concomitant gastro-intestinal derangements. _Distribution of Lesions._—Polyarticular. Beginning in the small joints, it spreads centripetally, with a tendency to symmetry. No migrant trend, but a steady, progressive involvement of joint after joint, including temporo-maxillary and cervical articulations. _Local Characters._—Overlying skin of affected joint white or semi-asphyxial in tint. Contour spindle-shaped, but in terminal stages shrinkage from atrophy of articular structures sets in. Muscular wasting and contracture conspicuous features. _Associated Phenomena._—Trophic and vasomotor changes prominent, but _no tendency to cardiac lesions_. INFECTIVE ARTHRITIS OF UNDIFFERENTIATED TYPE