Notwithstanding this, Charcot, to our mind, unquestionably refers to the category of _chronic articular gout_ certain of these examples of Vidal’s _atrophic_ type of _arthritis deformans_. The reasons he adduces for their _gouty_ nature are, to say the least of it, both conflicting and unconvincing. On the one hand, he admits that they are clinically indistinguishable from Vidal’s type, in respect of their pronounced _atrophic_ changes; on the other, he postulates them as _gouty_ even though the _uratic deposits_ “either do not exist at all, or only mere traces of them, or when only the articular cartilages are invaded by the urate of soda.” It must be conceded that _chronic articular gout_ and _rheumatoid_ or _atrophic arthritis_ are totally distinct affections. Now as to the _hypertrophic_ variety, or osteoarthritis, which, of the twain, more closely resembles gout, and whose confusion therewith is far from infrequent even at the present time. Sir Dyce Duckworth, while he recognises with Charcot a _tophaceous_ form of chronic articular gout, postulates the existence of another type, _arthritis deformans uratica_. Unlike Charcot, however, he seems only to have included under this term instances of the osteoarthritic or _hypertrophic_ variety. But like Charcot, his claim that this particular variety is of _gouty_ nature seems to rest on equally frail foundations, as witness his statement that they “may be complicated with visible or invisible tophaceous deposits!” That osteoarthritis and gout may coexist in the same individual is certain, and equally sure is it that uratic deposits may supervene in joints the seat of osteoarthritis. But it is now, I think, generally conceded that, despite these coincidences, _gouty arthritis_ and _osteoarthritis_ are wholly distinct disorders, of wholly different origin. At this period of our historical _résumé_ we see that by the withdrawal of these three great groups—_rheumatism_, the _nerve arthropathies_ and _arthritis deformans_—the domain of gout has, through these several allotments, undergone substantial shrinkage. ELIMINATION OF THE INFECTIVE ARTHRITIDES Yet again was the territory of gout destined to undergo further restriction, and this largely owing to the rise of the science of _bacteriology_. For in light of recent improvements in _diagnostic_ methods, who can escape the conviction that under the term “gout” had been wrongfully included many forms of arthritis, now known to be due to _specific infections_. What, for example, of Hippocrates’ aphorism that gout was unknown in youths—_ante usum veneris_—who can doubt that some of his reputed cases of gout were examples of _gonococcal_ or _syphilitic_ arthritis?