who, as a Hospital Teacher, has to study and treat all forms of disease, and deduce from them such lessons as may be illustrated by them. My point of view is, therefore, very different from that of a so-called specialist, whose thoughts and practice must necessarily be narrowed and warped by devotion to any one subject.
While the experience of a disease like Gout attained in twenty years of service in London in a great general Hospital, like St. Bartholomew's, is necessarily very large, it is one of the privi- leges attaching to the office of a Physician in such an Institu- tion, that it absolutely prevents the holder of it from becoming a specialist.
Inasmuch as London practice affords probably the largest field of observation in the world for the study of Gout and gonty ailments, it is only right that such opportunities should be utilized for the benefit of the Profession everywhere. Hospitals in London also present fuller opportunities for the study of the morbid anatomy of Gout than are elsewhere available, and in this volume will be found some results of this particular inquiry, for many of which I have to thank my friend and colleague, Dr. Norman Moore, who has paid much attention to the matter.
The classical and epoch-making work of Sir Alfred Garrod on Gout still holds, and will long continue to hold, the foremost place in the English language on the whole subject of Gout, and I must hore express my indebtedness to that work, and, no less, to many suggestions kindly afforded me by my friend, its distinguished author, while writing this volume.
I may state that while a large part of my experience has come from many years' observation of Gont amongst the patients, both at the Royal General Dispensary and St. Bartholomew's Hospital, yet a more complete knowledge of the disease, as a whole. is due to an experience of it gained in another line of prac- tice, and amongst such classes as do not frequent hospitals. With many of the phases of Gout and gonty disease, no sort and no amount of hospital practice avail to render the Physician familiar.
I am of opinion that many of our modern text-books occa-
