"See what an excess of lime salts there must have been in the blood." He is thinking of laboratory glassware and the ground around a mineral spring that becomes encrusted with salts as the solutions evaporate. But, in animal pathology, this is a false conclusion. The animal body is not a test-tube and, in it, the laws of physics are modified by those of physiology. Lime salts are deposited in the caseous gland or tubercle not because they are in excess in the blood but because lime salts are attracted to all caseous material from normal blood. Whether or not this calcification is an intentional provision of nature to protect the body, to petrify the necrotic material and make it harmless, is not the question here, though the calcification has this effect. The point here is that calcification of caseous glands or necrotic areas does not presuppose an excess of lime salts in the blood. The first step is not an excess of lime in the blood but a necrosis, after which the lime salts will be deposited from normal blood. So, it has seemed to me that the deposit of urates in and around a joint is no proof of their excess in the blood. Just as in calcification, so in gout, the first step may be a minute area of necrosis or other local degeneration that attracts the urates that are always present in normal blood; or the secret of the gouty inflammation, like that of urticaria and hay fever, may at last be found in Anaphylaxis, as described in the next chapter. FOOTNOTES: [1] Wenn mehr als 60 Atome Kohlenstoff im Molekül sind, dann ueberlasse ich das Object zu andern. Bunge, page 262, quoting "einen hervorragenden Forscher auf dem Gebiete der organischen Chemie." See Bunge for authority of these statements. CHAPTER X _HAY FEVER AS ANAPHYLAXIS THE GOUTY DIATHESIS REAPPEARS_ Fifty years ago de Mussy pointed to the resemblance between hay fever and gout and claimed hay fever as a manifestation of the gouty diathesis. As related in Chapter VII, he based his theory on the resemblance between the history and symptoms of hay fever patients with those of gouty patients. In his day he found both hay fever and gout confined to the Anglo-Saxon race, both hereditary and familial, both exhibiting urticaria, eczema, and asthma, and he recognized that the lesion in the eyes and nose of the hay fever patient was not a true catarrh but an urticaria. On the other hand, Wolff-Eisner declared that hay fever is an anaphylaxis and this idea has been developed and confirmed by Koessler and others so fully that we must accept it as proven. Let us examine this matter of anaphylaxis to determine whether after all there is any essential difference between the two views of hay fever.