Page:A treatise on gout (IA treatiseongout00duck).pdf/27



NOTHING is more difficult than the task of forming an exact definition of a morbid state. It is notoriously easier to criticize than to propound one. The besetting danger, or fallacy, that must always underlie attempts in this direction consists in the tendency to take typical or exquisite examples, and to formulate from them theories which are insufficiently comprehensive.

"Definitions, if they are to be more than convenient helps to arrangements, belong only to sciences more exact than pathology can be. It is better at present to think of diseases as in groups with borders that are not clearly marked; or as of nations with ill-defined frontiers, and with inhabitants intermingling, and even intermarrying. We may find typical examples, as of peoples, . and may call them by distinct namies, ... but we must use them very cautiously in the real study of pathology."1

In attempting to define what, in the existing state of our knowledge, constitutes gout, I shall take heed to the caution thus expressed. In my study of this disease, I have for long been trying to discover how, and on what lines, the changes proper to it work themselves ont, and thus to be able to say in any given case, this is, and this is not, a manifestation or product of gout. It is of the last importance to seek to be thus exact in the case of a disorder such as this, beenuse other pathological conditions certainly run on lines alımost parallel with it; and what is of more consequence, as will be shown, is that some of these conditions are occasionally mixed up with those proper to gont, thus pro- ducing hybrid states very difficult to unravel. Throughout this

Sir J. Paget, Morton Lecture, Roy. Coll, of Surgeons, 1887. 106 al