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GOUTY PERICEMENTITIS. 527
ents having been victims of the same disease. Magitot was impressed
with the significance of this fact years ago, and stated that pyorrhea
extended through two and three generations and made its appearance
at corresponding periods of life and in similar types of constitution.
2. Sex.—As far as the writer's observations extend, sex does not
appear to have much influence in the production of pyorrhea, women
seeming to be equally affected with men ; eliminate the masculine
dietary habit and there would certainly be little diiference in the pre-
disposition to the disease.
3. Age.—The age at which pyorrhea most frequently presents itself
is the period of middle life—that is, between the ages of thirty and
fifty. It may be, though it is very rarely seen before the age of
thirty, and still less frequently does it make its appearance after the
age of sixty. These observations are corroborated by the writings of
Magitot and others. It is very evident that pyorrhea is a disease
belonging largely to a period of life when growth has ceased and food
is required only for tissue repair and the production of heat.
4. Diet.—A careful investigation into the dietary of pyorrhea
patients will disclose the fact that there is usually a consumption of
excessive quantity of both albuminous and starchy foods, much more
than is necessary for the maintenance of the nutrition, and more than
can be completely oxidized under the customary or existing modes of
the individual's daily life. Coincidently there is also a diminished
consumption of water, leading to an imperfect elimination and a reten-
tion of the products of this incomplete oxidation. In connection with
excessive consumption of food must be also mentioned as co-operative
factors the use of fermented malt liquors, the richer claret wines, cham-
pagnes, etc. While perhaps no one class of foods can be said to be
especially active in the causation of pyorrhea it is evident that exces-
sive quantity and variety, by impairing the activity of the digestive appa-
ratus and giving rise to a large quantity of nitrogenized waste products
through imperfect oxidation, would materially impair and lower the func-
tional activity of the system generally and individual tissues in particular.
5. Sedentari/ Oceiqxdlons.—Occupation is also an inq)ortant factor
in the production of pyorrhea. In the majority of instances the disease
makes its appearance in those who are obliged to lead lives of enforced
inactivity— school teachers, accountants, etc. All sedentary occupations
which necessitate insufficient personal exercise Avill favor the imperfect
oxidation of food and at the same time retard the elimination of waste
products.
Exciting Causes.—The immediate agency in the development of
pvorrhea is undoubtedly the deposition in the pericemental mem-
brane of waste products of nitrogenous metabolism in c()m})ination