would desire no more pleasure than to walk about my gardens and parks; but, alas! that is
not permitted; for I am generally wrapped up in flannel, and wheeled up and down my
rooms in a chair. I cannot be very solicitous for life upon such terms, when I can only live
to have more fits of the gout.’
Nevertheless, on some occasions gout was actively desired, as the belief was that it was
incompatible with and would therefore drive out other illnesses. Horace Walpole called it
‘a remedy and not a disease’. Betsy Sheridan, sister of the playwright Richard Brinsley
Sheridan, wrote to her sister Alicia LeFanu: ‘My Father is at last thank God fairly in the
Gout – And has received the congratulations of Dr Millman on the occasion. The fact is
that all his Phisicians have wish’d for this event but seem’d fearfull that he had not
strength enough to throw off his disorders in that way.’
Gout had many disguises. Roy Porter and G.S. Rousseau identified over 60 different types
in one 18th-century treatise, including ‘galloping gouts’ and ‘flying gouts’. Other
conditions were falsely labelled gout, including headaches and stomach complaints; the
belief was that it came about as the result of an excess of one of the four humours flowing
(or ‘dropping’, since the name is derived from the Latin gutta, a drop) to a weakened area
of the body. Consequently gout was considered to be caused by ‘a sedentary life, drinking
too freely of tartarous wines; irregular living, excess in venery; and obstructed perspiration
and a supression of the natural evacuations’. Now we know that gout results from too
much uric acid in the blood, either because an excess is produced or the kidneys are not
filtering it efficiently. It can be worsened by the consumption of foods rich in purines,
including anchovies, venison and goose – all of which featured strongly in the 18th-
century diet of the better off. Then, as now, obesity and a high alcohol intake are
contributory factors.
William Rowley’s provocative treatise The Gout Alleviated (1770) compares ‘a gentleman
of fortune’ – who feasts on ‘wild fowl, made dishes, rich sauces, puddings, tarts, &c. with
glasses of various liquors’ – with ‘a poor man’, who during a hard day’s work contents
himself with ‘meat, if it be attainable ... a little strong or small beer’ and bread and cheese
for supper. It is thus almost natural, in Rowley’s view, that: ‘The generality of men of
fashion have the gout before they are 50 ... The gout is scarce ever seen amongst the lower
order of people.’ Today the greatest number of gout cases are found in the north-east of
England, an area with the highest level of unemployment and of alcohol-related illness.