4 Facts You Don't Know About Gout

Did you know that gout has been recognized as a disease since 2640 BC?

Despite its longevity, there are still a few things pharmacists probably don’t know about what Hippocrates called the “unwalkable disease.”

Gout recently made headlines when Democratic presidential candidate and US Senator Bernie Sanders shared a letter from his congressional physician who said that he had suffered from gout over the years, though it wasn’t disclosed when or how often. Other politicians who have had bouts of gout include Thomas Jefferson, Ben Franklin, Grover Cleveland, William Howard Taft, and Dick Cheney.

Here are 4 additional facts you may not have known about gout, courtesy of a review on the history of gout and hyperuricemia that was published in Arthritis Research & Therapy in 2006.

1. Gout was once known as the “disease of kings.”

In the past, gout was a disease that only the rich seemed to develop, given that it was linked to rich foods and alcohol. (Beer and port are both high in purines.) Only those who could afford diets with lots of meat and seafood—which are also rich in purines—tended to have gout.

Some even considered gout to be “socially desirable” because only those in power politically or socially tended to develop the condition.

“The common cold is well named, but the gout seems instantly to raise the patient’s social status,” the London Times reported back in 1900.

Now, experts know that gout is more of a metabolic disease.

2. Hippocrates wrote 5 aphorisms about gout.

The study authors described Hippocrates’ clinical statements on gout as “remarkable” and “as true today as they were 2500 years ago.”

Those sayings were:

• “Eunuchs do not take the gout, nor become bald.”
• “A woman does not take the gout unless her menses be stopped.”
• “A youth does not get gout before sexual intercourse.”
• “In gouty affections, inflammation subsides within 40 days.”
• “Gouty affections become active in spring and in autumn.”

3. Gout has traditionally been more prevalent among men than women.

Gout was more often seen in men, but during the reign of Nero, Seneca recognized that women developed it, as well. Today, gout is still more common among middle-aged men, but it increasingly affects women, particularly those who are postmenopausal.

In addition, gout is more common in Europe and America because of their higher incidence of foods rich in purines. In contrast, Asian diets tend to include more rice and vegetables, which are low in purines, so gout is less common in Asia, though this may be changing.

“Increasing affluence has also led to an expansion in the number of people following a westernized diet and lifestyle, and this has been paralleled by an increase in the incidence and prevalence of gout worldwide,” the study authors wrote.

4. Colchicine was recognized as a gout treatment in 6th century AD.

Colchicine was first used as a purgative in Greece more than 2000 years ago and then later became recognized as a gout treatment by physician Alexander of Tralles in 6th century AD. Because of colchicine’s gastrointestinal adverse effects, however, it was rejected as a gout treatment by Thomas Sydenham, who was known as the English Hippocrates.

Colchicine was later rediscovered as a gout treatment in 1763 by a Vienna professor. Today, nonsteroidal anti-inflammatory drugs are typically the first-line treatment for gout.

The study authors complimented George Hitchings and Gertrude Elion for “perhaps the most important historical advancement in the treatment of hyperuricemia,” which was allopurional, the first xanthine oxidase inhibitor. Elion and Hitchings won the Nobel Prize for their development of allopurional, azathioprine, and 5 other drugs in 1988.