Gout refers to a certain form of inflammation of the joints and swellings of a recurrent type. Although chronic in character, it breaks in acute attacks. It is a disease of the wealthy and chiefly affects the middle-aged men. Women, after menopause, are also sometimes affected by this disease.
Gout was known to the physicians of ancient Greece and Rome. The classical description was written in 1663 by Sydenham, himself a life-long sufferer, who clearly differentiated it from other joint disorders. It was recognised in the 18th century that large enjoyable meals and the consumption of alcoholic drinks were often the prelude to an attack of gout.
This disease affected many famous men in history, including Alexander the Great, Luther, Newton, Milton, Dr. Johnson, Franklin and Louis XIV.
Symptoms
An attack of gout is usually accompanied by acute pain in the big toe, which becomes tender, hot and swollen in a few hours. Usually it is almost impossible to put any weight on the affected foot in the acute stage. It may also affect other joints such as the knees and wrists in a similar manner. Sometimes more than one joint may be affected at a time.
The attack usually occurs at mid- night or in the early hours of the morning, when the patient is suddenly awakened. The acute attack generally lasts for a week or so. During this period the patient may run a slight fever, and feel disinclined to eat. His general health usually remains unaffected.
The attack may occur again after several weeks or months. The interval becomes shorter if the disease is not treated properly. The joint gradually becomes damaged by arthritis. This is chronic gout, in which chalky lumps of uric acid crystals remain the joint and also form under the skin.
Another serious complication of gout is kidney stones containing uric acid, causing severe colic pains in the stomach. In some cases the kidneys become damaged and do not function properly. This is a serious condition as the poisonous waste products which are normally removed by the kidneys accumulate in the blood.
Causes
The chief cause of gout is the formation of uric acid crystals in the joints, skin and kidneys. Uric acid is an end product of the body’s chemical processes. Those affected by gout have a higher level of uric acid than the normal, due to either the formation of increased amounts of acid or to the reduced amounts of acid being passed out by kidneys in the urine.
This uric acid usually remains dissolved in the blood. But when the blood becomes too full of it, the uric acid forms needle-shaped crystals in the joints which bring about attacks of gout.
Heredity is an important factor in causing this disease and certain races are prone to gout. Other causes include excessive intake of alcoholic drinks, regular eating of foods rich in protein and carbohydrate and lack of proper exercise. Stress is also regarded as an important cause of gout. During the alarm reaction, millions of body cells are destroyed and large quantities of uric acid freed from these cells enter the tissues after being neutralised by sodium.