_Sex._—In the matter of liability to gout the sexes stand in marked contrast, the disorder being infinitely more common in males. Out of eighty cases submitted to the French Academy, seventy-eight were men and only two women; but according to other authorities, this is an under-estimate. Thus in James Lindsay’s series of cases of gout, 84·7 per cent. were males, 15·3 per cent. females, percentages which he notes “are in accordance with the observations of other writers.” J. Lambert, out of 125 examples of gout, noted that 102 were men, _i.e._, 81·6 per cent., twenty-three women, _i.e._, 18·4 per cent. From my own experience, the figures submitted to the French Academy probably represent the ratio of incidence in males as opposed to females. This certainly, if _regular_, in opposition to “irregular,” types of gout be the criterion; for it must be admitted that regular gout does occur in women, though exceptionally rare either prior or subsequent to the climacteric. As to the current opinion that the _regular_ manifestations of gout in women are of _asthenic_ as opposed to sthenic character, this has, I think, often proved a source of fallacy. At any rate, in many of these cases the assumed _gouty_ inflammation resolves itself into one of inflamed _bunion_. Again, in but too many instances, women, showing _Heberden’s nodes_, are held to have gout or “rheumatic gout.” The latter term, as Pye-Smith observed, “is a bad name for _osteoarthritis_,” to which category Heberden’s nodes belong. Judged by the one unequivocal diagnostic criterion, _i.e._, _tophi_, gout in women is extremely rare. If to this be added the further fact, viz., the rarity in their sex of classical attacks in the _great toe_, we see clearly that the diagnosis of gout in women is often a matter of _assumption_ rather than of certitude. Moreover, having regard to the fact that the diagnosis of gout in women is frequently based on so-called “masked and irregular manifestations,” I must admit that, to my mind, statistics, purporting to indicate the percentage incidence of gout in women and men, are not very convincing. As to the why and wherefore of the relative immunity of _women_ it may be due to the fact that their habits and mode of life are less calculated to evoke the disorder. There is also the further possibility that the _catamenial_ discharges to a certain extent are protective against gout, for most authorities support Hippocrates’ aphorism, “Mulier podagra non laborat nisi ipsi menstrua defecerint.” _Heredity._—By the ancient physicians gout was held to be hereditary, and even to-day most will agree that “From father to son its seeds are transmitted, and bear fruit in exact proportion to the degree in which circumstances prove favourable to their growth.” Cullen, indeed, went further and held it _purely hereditary_; but, on the other hand, the belief, that it is often _acquired_ is widely countenanced.