6. The remote causes of the gout which induce this debility, are, indolence, great bodily labour, long protracted bodily exercise, intemperance in eating, and in venery, acid aliments and drinks, strong tea and coffee, public and domestic vexation, the violent, or long continued exercise of the understanding, imagination, and passions in study, business, or pleasure, and, lastly, the use of ardent, and fermented liquors. The last are absolutely necessary to produce that form of gout which appears in the ligaments and muscles. I assert this, not only from my own observations, but from those of Dr. Cadogan, and Dr. Darwin, who say they never saw a case of gout in the limbs in any person who had not used spirits or wine in a greater or less quantity. Perhaps this may be another reason why women, who drink less of those liquors than men, are so rarely affected with this disease in the extreme parts of their bodies. Wines of all kinds are more disposed to produce this form of gout than spirits. The reason of this must be resolved into the less stimulus in the former, than in the latter liquors. Wine appears to resemble, in its action upon the body, the moderate stimulus of miasmata which produce a common remitting fever, or intermitting fever, while spirits resemble that violent action induced by miasmata which passes by the blood-vessels, ligaments, and muscles, and invades at once the liver, bowels, and brain. There is one symptom of the gout in the extremities which seems to be produced exclusively by ardent spirits, and that is a burning in the palms of the hands, and soles of the feet. This is so uniform, that I have sometimes been able to convict my patients of intemperance in the use of spirits, when no other mark of their having taken them in _excess_, appeared in the system. I have enumerated among the remote causes of the gout, the use of strong tea. I infer its predisposing quality to that disease, from its frequency at Japan, where tea is used in large quantities, and from the gout being more common among that sex in our country who drink the most, and the strongest tea.