From the age of 35 years, Dr. De Carro was subject to severe attacks of gout, each attack generally lasting ten or fifteen days, followed by much debility, with great tenderness of the feet. The intervals were of various duration—sometimes months—sometimes years. The complaint is hereditary in his family for four generations. About fifteen years ago (1825) one of the paroxysms ceased suddenly on the third day, followed by alarming symptoms—difficulty of breathing—irritation about the throat—total loss of sleep—copious muco-purulent expectoration, of an acrid and acid taste—rapid emaciation—cadaverous expression of countenance—and all the symptoms of approaching laryngeal phthisis. From these, however, he gradually emerged; but a sense of constriction in the trachea remained, occasioning loss of voice and many uncomfortable feelings. In April 1826, many of the symptoms above-mentioned returned, with considerable violence, and the Dr. removed from Vienna to Carlsbad. The waters of this spa are not beneficial in pulmonic complaints generally, but Dr. De C. considered his own malady as misplaced gout, and he commenced the waters on the 17th of May, at the Neubrunn. “During the first three days he felt no effect whatever. He had been unable to get higher than seven goblets daily; but, on the fourth day, he felt as if he were drunk—lost his appetite—staggered on his legs—had indistinct vision—burning cheeks—excited and agitated circulation—overwhelming drowsiness, and total inability to read or write. These violent symptoms continued for three days, and were _much mitigated by copious evacuations_, (tres soulagé par des evacuations copieuses) and, the storm having subsided, he continued the course of waters for six weeks, without further inconvenience. The bowels became regular, and there was a copious but fætid secretion from the kidneys during the whole time. All the symptoms of misplaced gout disappeared.”[75] Dr. De C. observes that, had he not been a physician, he would have looked upon the above symptoms as forerunners of apoplexy. I am quite confident that they were so, and that the apoplexy was warded off by the “copious evacuations” that were procured, whether by nature or art. I have seen several instances of this “BAD-STURM,” and have no doubt of their being owing to some inflammatory action going on in some part of the body (as was clearly the case in the present instance), or to the neglect of aperient medicine taken in conjunction with the waters. The misplaced gout, such as Dr. De C. presented, is readily relieved by saline aperients, with small doses of colchicum and counter-irritation, without the risk of the “BAD-STURM,” which is a violent conflict between the constitution and the remedy. It is when the complaint is quiescent, and all inflammatory symptoms removed, that the Carlsbad and other mineral waters are beneficial.