The Middle Ages and Renaissance periods further cemented gout's association with royalty and nobility. Numerous European monarchs and aristocrats were afflicted by the disease, and their struggles with gout were well documented in historical records and portraits.
One of the most famous historical figures with gout was King Henry VIII of England (1491–1547). Henry VIII’s lifestyle—marked by gluttony, heavy drinking, and obesity—contributed to recurrent gout attacks. His painful condition affected his mobility and may have influenced his temperament and decisions during his reign.
Another prominent sufferer was Sir Isaac Newton (1643–1727), the renowned physicist and mathematician. Newton reportedly suffered from gout in his later years, which is believed to have impacted his health and productivity.
Historical Understanding and Theories of Gout
Until the 19th century, the medical understanding of gout was heavily influenced by humoral theories. Physicians believed that an imbalance of humors, especially an excess of yellow bile or corrupted blood, caused the painful joint inflammation. Treatments aimed at restoring humoral balance, including bloodletting, purging, and dietary modifications.
The physical cause of gout remained mysterious until advances in pathology and chemistry shed light on its etiology. The condition is now understood to be caused by the accumulation of uric acid crystals in joints, leading to inflammation. Uric acid is a waste product formed from the breakdown of purines, substances found in certain foods and body tissues.
In the 17th century, the English physician Thomas Sydenham (1624–1689), known as the “English Hippocrates,” provided one of the first clinical descriptions distinguishing gout from other forms of arthritis. He emphasized the episodic nature of gout attacks and the importance of diet and lifestyle in its management. Sydenham’s work laid the foundation for a more systematic clinical approach. shutdown123