The  diagnosis  of  irregular  gout  is  based  upon  the  family  and
personal  history  of  the  patient,  and  the  general  experience  of  clinicians
that  gouty  individuals  more  frequently  manifest  these  particular  derange-
ments of  health  than  others.  The  diagnosis  of  visceral  gout  depends,
likewise,  upon  the  anamnesis  and  the  fact  that  the  onset  of  the  symptoms,
indicating  disease  of  a  particular  organ,  corresponds  in  time  to  the  sub-
sidence or  disappearance  of  the  familiar  symptoms  of  the  acute  attack  of
gout.  The  diagnosis  of  irregular,  retrocedent,  and  visceral  gout  should  be
made  with  some  reserve  and  only  in  the  case  of  a  distinct  hereditary
predisposition,  or  of  an  individual  who  has  had  acute  attacks,  or  who  shows
tophi  or  characteristic  deformities,  and  in  whom,  in  the  absence  of  such
fiigns,  other  etiological  factors  can  be  excluded.
008  MEDICAL  DIAGNOSIS.
n.  ARTHRITIS  DEFORMANS.
Definition. — A  chronic  disease  of  the  joints,  of  undetermined  causa-
tion, characterized  anatomically  by  lesions  of  the  synovial  membrane
with  hypertrophy  of  its  fringes,  atrophic  changes  in  the  cartUages  and
bones,  irregular  hypertrophy  of  the  bones,  and  wasting  in  the  periarticular
structures;  and  clinically  by  characteristic  deformities.
