History of gout - the great and their gout. Sketches of famous gout sufferers
BENJAMIN FRANKLIN
Giclee Print In the history of gout, Benjamin Franklin is one of its most famous sufferers. For non U.S. readers, we should say that Franklin was one of the leaders of the American revolution. His is the face on the US$100 banknote (bill).
The portly, reluctant revolutionary penned a humorous essay where he imagined a conversation with Madam Gout, his tormentor. You can download a freeMP3 audio book of this essay here, courtesy of Project Gutenberg. It's just an essay, not an ebook. You will be listening for 3 - 4 minutes. Or you can read it at this URL. In this essay - A Dialogue between Franklin and The Gout - Franklin disclosed that he understood his diet and sedentary lifestyle could be the causes of his gout. But it seems he never bothered to diet and exercise or give up any of his favourite foods, and especially wine. Neither did he say in this essay that he knew about uric acid. In the last 15 years of his life up to his death in 1790, his gout attacks had become longer and fiercer. They usually do. Ironically, during these years, something of uric acid's role was learnt. The MSU crystals had long been discovered by this time. The discovery of uric acid, a significant development in the history of gout, happened in 1776. The Swedish-German scientist Carl Wilhelm Scheele found it in kidney stones and urine. If Franklin had learnt about uric acid from Scheele's discovery, he would probably have mentioned uric acid in his dialogue with gout essay. He wrote this essay four years after Scheele's discovery, so there had been plenty of time to learn about uric acid. So it's not likely that Franklin knew about uric acid, which means he didn't know about purines, nor which foods are high in them. He knew his gout was something to do with his diet, but not exactly what. Franklin seems to have done little about his gout. He drank copious amounts of wine (at least two bottles a day, perhaps per meal, according to one biography) during the many years he lived in London, and later in Paris. His gout may have developed into the kidney stones which also caused him pain. About 20% of gout sufferers, who do nothing about their gout, will develop kidney stones made from uric acid. The main cause of kidney stones is calcium oxalate but in some cases they are made from uric acid, especially in gout sufferers.
What caused Franklin's gout? He was certainly overweight, sedentary and drinking too much alcohol. It seems like the classic case of excess purines causing gout. Franklin was a printer for many years and would have handled lead type daily. Lead and gout have been linked - there has long been a suspicion that lead exposure can cause gout by inhibiting uric acid excretion. But there is as yet no study proof that there is a causal connection, although lead exposure may lead to something else, which leads to gout. Laudanum and gout These days
laudanum
means tincture of opium i.e. alcohol mixed with a form of opium. In Franklin's time it may have been this, but it could have been opium plus another substance as mixed by the prescribing physician. In the 18th and 19th centuries laudanum was widely used for pain relief and a variety of ailments. Franklin's decision to use it would not have been considered unusual.
KING HENRY VIII
In the history of gout, England's King Henry VIII is another famous sufferer. He was very fond of a type of eel that's thought to be high purine. He was also fond of at least two other high purine foods. Read more about Henry VIII and gout in the October 2008 edition of The Gout Dugout newsletter and find out what these favourite foods were.
Giclee Print
Giclee Print "Who's your fat friend?" flippantly asked the early 19th century British "dandy" George (Beau) Brummell. A dandy was a highly fashionable male. Brummell, for example, recommended polishing boots with the froth of champagne. The fat friend was Britain's Prince Regent, later to be crowned King George IV. He overheard the remark, and never spoke to Brummell again. Brummell, who invented the stiff cravat and who was once rich and feted, died in poverty. George died with gout. George IV may have been "The First Gentleman of Europe" (as he was sometimes known) and highly artistic, but he was also an epicure, a lover of fine foods and wines, to the point of gluttony. He hired the famous French chef Marie-Antoine Careme who cooked in the Great Kitchen at the Royal Pavilion, the palace George built at Brighton on England's south coast. By the age of 52, he had a waist of 50"(127 cms). Almost an inch for every year of life. And when he died he weighed 22 stones (308 lbs). So if you know anything about gout you won't be surprised to hear that George IV suffered it - from the age of 54 (and maybe younger) until his death at 68 in 1830. What did he do for his gout? Did George assiduously study the large literature of the history of gout? Probably not. Take colchicine? Maybe. Colchicine went into a well known gout remedy at the time called L'eau Minerale. Laudanum for gout again But one substance we do know he used to deal with the pain of his gout was laudanum. George either mixed it with cherry brandy or took both together. The result was of course that he was frequently too dopey to conduct government business - he couldn't see his Ministers. And it definitely wasn't the best way to take cherries, which might have helped his gout.
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