Note 28 — Chapter XVI · CLINICAL ACCOUNT

“While, however, tophaceous concretions generally show themselves after attacks of articular gout, cases occur, as I have already told you, in which the secretion of calcareous matter takes place irrespective of any arthritic attack. This sort of cutaneous gravel, if I may employ a comparison based on the great analogy between the composition of urinary gravel and tophaceous concretions, gravel of the skin, constitutes the sole manifestation of the diathesis, and is accompanied merely by a slight feeling of pain, of pricking unattended by any disturbance of the general health.”—Trousseau’s “Clinical Medicine.”