Gout or the joint evil

The Library has recently catalogued the Heberden collection (Library reference SA/HEB).This is a collection of records acquired by the Heberden Library of the British Society of Rheumatology on the subjects of rheumatology, arthritis and gout.

 

Gout is a form of arthritis that often attacks just one joint and is caused by the build-up of uric acid crystals in the joints. Gout has affected people for centuries and is a condition that is often mentioned in historic records. Dr William Sydney Charles Copeman (1900–1970), a rheumatologist, is credited with having written the first full historical account of this condition (Library reference SA/HEB/E/1/17).

The term ‘gout’ comes from the Latin word ‘gutta’ meaning ‘drop’ and was used in the classical world to explain an excess in the flow of one of the four humours of the body. References have been found in the writings of Hippocrates and Aretaeus the Cappadocian, a physician of the 2nd century, and by the Byzantine physician Paul of Aegina, in the year 600 CE, who believed that mental stress was a contributing factor to the condition.

Copeman’s research found that the first person to use the term ‘gout’ to describe a painful swelling of the big toe was a Dominican monk, Randolfus of Bocking, in the early 13th century. Randolfus describes how he himself was a great sufferer with “Gutta quam podagra vel arteticam vocant” or “the gout which they call podagra or arthritis”. Treatments in this period drew heavily on Christian theories of miracles and holy cures. In the 16th century, the Swiss physician Paracelus (1493-1541) was the first to suggest a chemical rather than humoural explanation for gout. He suggested that some people’s bodies had a tendency to retain acrid substances that became trapped in the joints.

Various treatises and theories were published on gout in the 17th century including the Trattato della Podagra, written by David de Planis Campy in the early 17th century (Library reference SA/HEB/E/2/3). However, it was not until the 18th century that Paracelus’s ideas of a chemical basis for the disease were explored further, along with the theory that a tendency to gout might be hereditary.

William Copeman’s interest in the history of gout led him to collect several original manuscripts relating to gout, which were given to the Heberden Society Library upon his death and which are now held by the Wellcome Library. One interesting document is a recipe for gout (Library reference: SA/HEB/E/2/2); this details a gout cure used by Thomas, Duke of Norfolk, in the 16th century. He tried taking a quantity of black soap and mixing it with half the same quantity of egg yolks until the soap lost its colour. Then he spread the mixture thickly over fine flax and applied it to the inflamed joint. Next he mixed the egg whites with wheat flour and applied this to a linen or lining cloth, which he applied over the flax and left for four to five days.

He declared the recipe as effective for both men and women and that it was more precious than gold. His instructions were that it should not be revealed to anyone other than “family members and dear friends”.