I must make one partial exception to this statement. In his _Diseases of the Nose, Throat, and Ear_, Philadelphia, 1906, Professor Grayson says that, in hay fever, there is "some diathetic state that is rooted in defective nutrition. Whether we term this lithæmia or gout or uric acid diathesis is immaterial, the central fact being that through intestinal toxæmia or some disturbance of normal metabolism we have resulting a persistent poisoning of the blood-current." Now this is simply substituting one theory for another without proof of either; for the origin of hay fever in auto-intoxication is as little proved as its origin in gout or uric acid. Auto-intoxication has simply replaced uric acid in the Doctor's mental picture gallery; for, like uric acid, auto-intoxication often exists in the imagination of the physician and not in the patient. For further discussion of this point, the reader is referred to the next chapter, on the Uric Acid Theory. A novel and interesting article in Grayson is the description of angioneurotic oedema as affecting the nose and throat, page 182. He writes: "I have no doubt that in this disease, as in hay fever, the gastro-intestinal tract is the birthplace of the toxic material. Although the disease may occur in gouty or rheumatic individuals, there is scarcely sufficient reason for ascribing any pathological connection between it and these other affections." The comment on this is that, until we know what gout is, which we do not at present, we cannot argue satisfactorily either way. Some day I shall tell a listening world what I know about gout. I shall elaborate my favorite theory that the American neurasthenia, now rapidly increasing in other countries, is a form of gout, a gout of the nervous system. And here, too, I find that Frenchman, de Mussy, anticipating me in his remark that "_Behind a vast number of nervous troubles, behind a vast number of functional anomalies stamped with a nervous imprint, we find arthritism._" The name _neurasthenia_ was not known in de Mussy's day, but he hit off the condition neatly as "functional anomalies stamped with a nervous imprint."