Gout

Hippocrates called it “the unwalking disease.” It has also been known as “the affliction of kings.” We call it gout, and by any name it is a vexing complaint, first attacking the big toe in most cases and inflicting pain so acute that even the weight of a bedsheet is unbearable.

A form of arthritis, gout is caused by deposits of needle-sharp uric acid crystals in joints, on tendons and in the kidneys, the latter in the form of stones.

More than 90% of gout sufferers are men, with onset coming most often at age 40-50. The condition also has racial propensities, high among Polynesians but rare in Australian aborigines. American men of African descent are twice as likely to contract the disease as Caucasians.

But cutting across all such distinctions is the long association of gout with excess. Going back to the Egyptian pharaohs and beyond (gout has been found in mummies), it is historically a disease of the super-rich, the price of over-indulgence in high-protein foods such as red meat and shellfish, and too much alcohol, especially beer.

Curiously, although affluent societies are more obese and subject as never before to diabetes, high blood pressure, and heart disease – all predispositions for gout – the disease is less common today than it once was. That’s because medical science has learned a great deal about its causes, cure and prevention.

The first line of defense is pain reduction, and one of the most effective treatments is still colchicine, an extract (now synthesized) of the autumn crocus, used as an anti-inflammatory and pain reliever for at least 2000 years. Extremely poisonous in larger doses, this botanical has for the most part been supplanted by other drugs because of its many dangerous side effects.

Cure and prevention of gout are one and the same thing: adjustments in diet and lifestyle to reduce the synthesis of uric acid in the kidneys and increase its excretion in urine. Alcohol gets the chop, as do organ and red meats, shellfish, herring, sardines, mackerel, anchovies, yeast and fatty dairy products – all reduced to a minimum, if not eliminated. Avoid aspirin, vitamin C and niacin (vitamin B3), as well – they will only make gout worse.

On the plus side, you can gorge on cherries, either canned or fresh, which are highly effective in lowering bodily uric acid levels. Extract of Devil’s Claw, long known as an anti-inflammatory and analgesic for arthritis sufferers, is also useful. Helpful supplements include omega 3s (salmon is a source), vitamin E, folic acid and bromelain, an enzyme found in pineapple. (Do not take the latter with food, or its anti-inflammatory effect is lost.)

Lead is another reason why the ancients suffered more from gout than we do. While we keep the toxic metal out of our food and water, the Romans laced their cooking and wine with a sweetener called sugar of lead, produced by boiling grapes or water in lead containers. The consequence was not only addled brains (which many believe contributed to the decline and fall of the Roman Empire), but also rampant “saturnine gout” caused by a symbiotic relationship between uric acid and lead, and named for the gloomy and pasty appearance it lent to the faces of its victims.

So, when you drink lots of water – essential for flushing uric acid from the kidneys – just make sure it doesn’t come to you through lead pipes, as was the case in Rome.