Lastly, I cannot confirm out of my own experience Duckworth’s statement that “herpetic attacks in all varieties of ‘gout’ are common.” Nor have I seen shingles co-exist with acute gout, neither have I come across any examples of so-called gouty spinal meningitis!
In conclusion, I would submit that:—
(1) Acute articular gout is not infrequently complicated by fibrositis.
(2) The same infection that determines the articular outbreak is responsible for the concomitant muscular and nerve phenomena.
(3) Persons of gouty heritage are especially liable to fibrositis, notably lumbago and sciatica.
(4) Gout predisposes to fibrositis in that the inherent pathological attributes of gouty tissues favour the incidence of infection.
In regard of this last postulate, it is well known that gouty persons who contract gonorrhœa are more prone than the non-gouty to develop gonorrhœal rheumatism, in other words, to sustain a widespread infection involving the fibrous tissues, not only of the joints, but of the muscles and even of the nerve sheaths. With this concrete example to hand, is it not reasonable to suppose that such a constitutional taint will favour the incidence also of other infections or sub-infections, and that this may explain the relative frequency of fibrositis, not only in the actually gouty, but in those of gouty heritage, this the more cogently having regard to the fact that so much exact evidence is forthcoming in favour of local infection as the cause of all types of fibrositis?