This is no theoretical quibble. In the Royal Mineral Water Hospital, Bath, one constantly meets with cases in which the very elect would be puzzled as to whether they should be placed in the category of _gouty_ or in that of _infective_ arthritis. I have at present in my wards a middle-aged man, stout of body, rubicund of face, with well-marked auricular tophi and widespread arthritis. There are no tophi round his joints. On X-ray examination his phalanges show Bruce’s nodes, and his phalangeal joints show changes indistinguishable from those constantly met with in infective arthritides occurring in _non-gouty_ subjects. Indeed, this overlapping may proceed still further, the gouty and the infective characters neighbouring in such proximity as to suggest actual fusion, a community of origin. What else in truth can be the inference, when one meets with examples in which the _peri-articular_ tissues are the seat of demonstrable _uratic deposits_, while the X-ray changes within the joint proper, the bone and cartilage, are typically those met with in _infective_ arthritis? Now, who will deny that if tophi were absent in such a case we should without hesitation hold the case to be one of infective arthritis? My own contention is that even in the presence of tophi the same appellation is indicated. In other words, I submit that _acute gouty polyarthritis_ is itself but a form of _infective arthritis_ which derives its _specific_ character from the associated _uratic deposits_. As to differentiation of the latter from these cryptic infective arthritides, this will rest mainly on— (1) The presence of tophi; (2) A history of previous attacks in the great toe; (3) A swift response to colchicum. In addition, acute gouty polyarthritis is confined to _middle-aged males_, while no period of life is immune from infective arthritis, and both sexes are equally liable. Again, acute gouty polyarthritis may be _afebrile_. Pyrexia when present is moderate in grade, its curve undulating as the paroxysms rise and wane. In infective arthritis the temperature curve is irregular and erratic. Lastly, the _uric acid output_ in acute gouty polyarthritis drops a day or two before the paroxysm, rises markedly after its inception, then sinks again. Also we may add that occasionally glycosuria or albuminuria is present. In conclusion, I would allow myself a brief digression regarding these infective arthritides of undifferentiated type. They constitute the bulk of the cases of arthritis that find their way to the Royal Mineral Water Hospital, Bath, under one or other of the appellations “gout,” “rheumatism,” and “rheumatic gout.” It is within this category that most of the cripples met with at spas fall, and their obduracy to “drug” treatment accounts for their belated despatch thereto.