When a torpor, or state of exhausted excitability, of the whole system, has been induced in this manner, and symptoms of indigestion produced, any directly debilitating cause applied to the extremities, adding to the indirect debility, causes a total torpor, or inactivity of the minute vessels of the part, and thus totally destroys the balance between the propelling and resisting force; hence the vessels will be morbidly distended with blood, a swelling and redness will take place, and an asthenic inflammation, produced in the way which I fully pointed out in the last lecture, will be established. Hence the pain, and other symptoms, which accompany a fit of the gout. Hence likewise we see, why debilitating powers applied to the part will not reduce the inflammation; and why a warmth, which aggravates every really sthenic inflammatory affection, is so comfortable in this. Almost any debilitating cause, when the system has been brought by intemperance to the torpid state, which I have described, will bring on a fit of the gout, but nothing more certainly than cold or moisture: hence if a person have his feet chilled or wet, he will be almost certain to have an attack. Hence we see that the asthenic inflammation is not the disease, but merely a symptom of it; and like other symptoms, fallacious in its appearance; the disease is a state of indirect debility, to which our attention ought to be directed. When this inflammation is violent, and accompanied with great pain, after several hours continuance, it excites the action of the minute vessels, enables them to propel the blood, by which they are morbidly distended, and restores the balance between the resisting and the propelling force; and thus the inflammatory appearances will for a time subside, but the torpor of the whole system remaining, and the debility of the vessels returning, when their excitement, which was the consequence of their action, has ceased, another asthenic inflammation will take place, which will again cure itself as before; so that during a paroxysm, several remissions will take place, as was mentioned in the description of the disease. As, during the paroxysm, the pain causes a considerable degree of excitement over the whole system, the action of the stomach and other parts is roused by it; during the fit likewise, little nutriment is taken, so that by the action of the stomach and bowels, they get rid of their load; rest likewise assists to accumulate the excitability, so that from all these causes together, the body becomes restored to a state of vigour, which, compared with its former torpidity, makes the patient imagine that this friendly disease has restored him to a state of unusual health, and even renovated the powers of his constitution. Under this mistaken idea, he does not, when the fit leaves him, abandon the mode of life, which brought on the disease; highly seasoned food, and the usual quantity of wine, are again resorted to: