Gout, with a section on ocular disease in the goutyLlewellyn, Llewellyn J. (Llewellyn Jones)
Science
Gout, with a section on ocular disease in the gouty
Llewellyn, Llewellyn J. (Llewellyn Jones)
Eye -- Diseases; Gout
Reverting to our own country, what evidences as to its antiquity are
forthcoming? This much may at any rate be affirmed, that according to
Mason Good “Gout is one of the maladies which seem to have been common in
England in its earliest ages of barbarism. It is frequently noticed by
the Anglo-Saxon historian, and the name assigned to it is Fot-adl.”
Cockayne, in his “Leechdoms Wortcumming and Starcraft,” of early England,
has it that the word “addle” appears to have been a synonym for ailment,
thus “Shingles was hight circle addle.” That gout should have flourished
so among our Anglo-Saxon forbears is perhaps a matter for regret but not
for astonishment, when we recall their coarse Gargantuan feasts, washed
down with doughty draughts of ale, “sack and the well spic’d hippocras.”
Gout, we see then, even in our own land, is full ancient, and the word,
as Bradley as shown, may be traced in the English tongue right through
the literature of the various periods.[2] This not only in the brochures
of physicians, but also as in the days of Lucian in the works of
historians, and the satires of poets, which indeed abound with allusions
to the disease.
VIEWS OF THE HUMORALISTS
The Greek physicians, quite familiar as they were with the overt
manifestations of gout, did not, as far as its nosology was concerned,
commit themselves to any appellation that might imply their adherence
to any theory as to its causation. They contented themselves with a
mere _topographical_ designation, terming the affection, _podagra_,
_chirargra_, etc., according as foot or hand was the seat of the
disorder, while for polyarticular types the generic term _arthritis_ was
invoked.
Nevertheless the old Greek physicians had their views as to its
pathology. Thus the source of the peccant humours resided for them in the
_brain_, which they had invested with all the functions of an absorbent
and secreting gland. This hypothesis in time was displaced by the true
humoral theory, according to which the bodily fluids, those found in the
alimentary canal, the blood stream, and the glandular organs, were the
primordial agents of disease. No need, albeit, for gibes on our part, for
how true much of their conception of the genesis of disease even to-day.
Indeed, what else than a fusion of the foregoing views? the modern theory
of Sir Dyce Duckworth, who would ascribe gout to the combined influence
of _neural_ and _humoral_ factors. And now to consider briefly the
individual views of the fathers of medicine.
THE APHORISMS OF HIPPOCRATES
In the eyes of the pioneer priest-physician, the disorder was
attributable to a retention of humours, and many of his dicta have stood
the corroding test of time. He noted, like Sydenham, its tendency to
periodicity, its liability to recur at spring and fall. Also that eunuchs
are immune and youths also, _ante usum veneris_, while in females its
incidence is usually delayed until after the menopause.
Public-domain text, read in full here on John Shaqi.
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