This usage of the term “tophaceous” is unjustifiable and misleading. The significance of tophi is _qualitative_ not _quantitative_. One tophus bespeaks the “gouty diathesis” as surely as a myriad concretions. Solitary though it be, the same, given elimination of all other sources of arthritis, will suffice to establish the “gouty” nature of an associated joint disorder. It is in this more catholic sense that I would translate the term “_tophaceous_ gout.” The conclusion, then, to my mind, is obvious—there is but one form of articular gout, and one only, viz., an arthritis, the victim of which exhibits _uratic deposits in situ or elsewhere in his body_. On this and on no other grounds can a chronic arthritis, with any show of certitude, be certified as truly “uratic” or “gouty.” This rigid attitude may not commend itself to some, but I feel convinced that, only by holding on grimly to the tophus, shall we steer a safe course through all the pitfalls that beset the diagnosis of the chronic arthritides. Only in this way, too, can we preserve for ourselves a clear conception of _gouty arthritis_ as a specific disorder, the which otherwise loses its identity, submerged in a medley of joint diseases. Prior to the differentiation of gout, on the one hand, from _rheumatism_ and _arthritis deformans_, and on the other from the _nerve arthropathies_ and the _infective arthritides_, such laxity might be condonable, but not, we think, in the present stage of our knowledge. In drawing to a close my remarks on the classifications of articular gout, it will be noted that I have made no reference to that variety known as _retrocedent_ gout, but to this I shall allude at a more favourable juncture, viz., in the chapter devoted to the clinical account of articular gout. Conformably, too, it will, I think, be more convenient, to defer any criticisms of the term “irregular gout” to the chapter I purpose devoting to consideration of the varied clinical content of the same. ETIOLOGY AND MORBID ANATOMY To the antiquity of gout and no less its distinctive clinical _facies_, when of classic type, we owe not a little. Its salient phenomena have endured unchanged from the time of Hippocrates onward through the ages. So it is that, even allowing for the enhanced powers of discrimination of latter days, we are in no doubt that the gout of the ancients is the gout of to-day. How signal the advantage thus accruing, when we come to consider the conditions which engender or tend to engender the disease! For, _quâ_ its broad etiological factors, we find ourselves in accord with the physicians of old, our experience a confirmation of their old-time findings.