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. In contrast, European and American diets, which are high in meat and certain seafoods, are associated with hyperuricemia and gout. Traditional Asian diets, based on rice and vegetables, are low in dietary purines, and gout has been relatively rare in these cultures. The role of excess dietary purines (derived from meat, seafood, and beer) in the development of gout is illustrated by the disparity between the incidence of gout in Asia and Europe. In recent decades, however, the diet and lifestyle that predispose individuals to hyperuricemia and gout have become increasingly common. could I cure that gout, should not I have a fever, a palsy, or an apoplexy?" According to the writer Horace Walpole, gout "prevents other illnesses and prolongs life.
In earlier times, attacks of gout were also seen as a prophylactic against more serious diseases. It is ridiculous that a man should be barred from enjoying gout because he went to the wrong school." In his classic monograph on the history of gout, Copeman refers to a comment in the London Times in 1900, "The common cold is well named – but the gout seems instantly to raise the patient's social status", and to another in Punch in 1964, "In keeping with the spirit of more democratic times, gout is becoming less upper-class and is now open to all. In some eras gout was perceived as socially desirable because of its prevalence among the politically and socially powerful. Because it is clearly associated with a lifestyle that, at least in the past, could only be afforded by the affluent, gout has been referred to as the 'disease of kings'.
Throughout history gout has been associated with rich foods and excessive alcohol consumption. so exquisitely painful as not to endure the weight of the clothes nor the shaking of the room from a person walking briskly therein." , grows gradually more violent every hour. and this is immediately succeeded by a chillness, shivering and a slight fever. The pain resembles that of a dislocated bone. "The patient goes to bed and sleeps quietly until about two in the morning when he is awakened by a pain which usually seizes the great toe, but sometimes the heel, the calf of the leg or the ankle. Later, gout was described by Thomas Sydenham, the famous English physician and proponent of hippocratic medicine, who was himself disabled by gout and renal disease : The term is derived from the Latin word gutta (or 'drop'), and referred to the prevailing medieval belief that an excess of one of the four 'humors' – which in equilibrium were thought to maintain health – would, under certain circumstances, 'drop' or flow into a joint, causing pain and inflammation. The first person to use the word 'gout' to describe podagra ( gutta quam podagram vel artiticam vocant – 'the gout that is called podagra or arthritis') was the Dominican monk Randolphus of Bocking, domestic chaplain to the Bishop of Chichester (1197–1258). Perhaps the most important historical advance in the treatment of hyperuricemia was the development of xanthine oxidase inhibitors, which are effective in reducing plasma and urinary urate levels and have been shown to reverse the development of tophaceous deposits. In the modern era, nonsteroidal anti-inflammatory drugs are usually the drugs of choice for treating acute gout. Uricosuric agents were first used at the end of the 19th century. Although there is evidence that colchicine, an alkaloid derived from the autumn crocus ( Colchicum autumnale), was used as a powerful purgative in ancient Greece more than 2000 years ago, its first use as a selective and specific treatment for gout is attributed to the Byzantine Christian physician Alexander of Tralles in the sixth century AD. Throughout history, gout has been associated with rich foods and excessive alcohol consumption. First identified by the Egyptians in 2640 BC, podagra (acute gout occurring in the first metatarsophalangeal joint) was later recognized by Hippocrates in the fifth century BC, who referred to it as 'the unwalkable disease'.
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