A concise history of gout and hyperuricemia and their treatment — Arthritis Research & Therapy

Claims

1. allopurinol-history
   Allopurinol, the first xanthine oxidase inhibitor, was developed by George Hitchings and Gertrude Elion, who shared the 1988 Nobel Prize in medicine partly for it; it became the most frequently used urate-lowering drug.

   "Perhaps the most important historical advance in the treatment of hyperuricemia was the development of allopurinol, the first xanthine oxidase inhibitor. George Hitchings and Gertrude Elion were awarded the 1988 Nobel prize in medicine for their work in developing allopurinol, azathioprine, and five other drugs. Allopurinol has since become the most frequently used uric acid lowering drug in clinical practice."

   Locator: section: Treatments for gout through the ages · Quote language: en
2. ancient-recognition
   Podagra (acute gout of the big-toe joint) was first identified by the Egyptians in 2640 BC and later described by Hippocrates in the fifth century BC as 'the unwalkable disease'.

   "First identified by the Egyptians in 2640 BC, podagra (acute gout occurring in the first metatarsophalangeal joint) was later recognized by Hippocrates in the fifth century BC, who referred to it as 'the unwalkable disease'."

   Locator: section: Introduction · Quote language: en
3. colchicine-history
   Colchicine, from the autumn crocus, was first used specifically for gout by Alexander of Tralles in the sixth century AD; it fell out of use under Sydenham's influence and was rediscovered in 1763 by Baron Von Stoerk.

   "its first use as a selective and specific treatment for gout is attributed to the Byzantine Christian physician Alexander of Tralles in the sixth century AD ... colchicine was not used for the treatment of gout for about 150 years until its rediscovery in 1763 by Professor Baron Von Stoerk in Vienna"

   Locator: section: Treatments for gout through the ages · Quote language: en
4. disease-of-kings
   Because gout was associated with rich food and alcohol that only the affluent could afford, it was called the 'disease of kings'; Hippocrates called it an 'arthritis of the rich'.

   "Because it is clearly associated with a lifestyle that, at least in the past, could only be afforded by the affluent, gout has been referred to as the 'disease of kings'."

   Locator: section: Introduction · Quote language: en
5. etymology
   The word 'gout' was first used for podagra by the Dominican monk Randolphus of Bocking; it derives from Latin gutta ('drop'), reflecting the medieval belief that an excess humor dropped into the joint.

   "The first person to use the word 'gout' to describe podagra ... was the Dominican monk Randolphus of Bocking, domestic chaplain to the Bishop of Chichester (1197–1258). The term is derived from the Latin word gutta (or 'drop'), and referred to the prevailing medieval belief that an excess of one of the four 'humors' ... would, under certain circumstances, 'drop' or flow into a joint, causing pain and inflammation."

   Locator: section: Introduction · Quote language: en
6. mccarty-hollander
   McCarty and Hollander showed that crystals in gouty joint fluid were monosodium urate and introduced compensated polarized light microscopy to identify them.

   "a seminal paper by McCarty and Hollander, which showed that crystals from the synovial fluid of patients with gout were composed of monosodium urate. Their classic report described the use of compensated polarized light microscopy to examine joint fluid for crystals"

   Locator: section: Uric acid as a factor in the causation of gout · Quote language: en
7. sydenham
   Thomas Sydenham, himself disabled by gout, described a flare that wakes the patient around two in the morning with pain in the big toe that becomes so severe the patient cannot bear the weight of bedclothes.

   "The patient goes to bed and sleeps quietly until about two in the morning when he is awakened by a pain which usually seizes the great toe ... so exquisitely painful as not to endure the weight of the clothes nor the shaking of the room from a person walking briskly therein."

   Locator: section: Introduction · Quote language: en
8. uric-acid-discovery
   Van Leeuwenhoek described tophus crystals in 1679; Scheele identified uric acid in a kidney stone in 1776; Wollaston found urate in a tophus in 1797; and Alfred Baring Garrod's 'thread test' measured uric acid in blood, leading him in 1859 to call deposited urate the cause of gouty inflammation.

   "In 1776 the chemical identity of uric acid was first established as a constituent of a renal calculus by the Swedish chemist Scheele, and the English chemist Woolaston demonstrated urate in a tophus from his own ear in 1797. Fifty years later, Sir Alfred Baring Garrod described his famous 'thread test' ... Garrod stated that, "the deposited urate of soda may be looked upon as the cause, and not the effect, of the gouty inflammation"."

   Locator: section: Uric acid as a factor in the causation of gout · Quote language: en
9. uricosurics
   Uricosuric drugs, which increase the kidneys' excretion of urate, were first used in the late 19th century; high-dose salicylates were later replaced by probenecid, sulfinpyrazone and benzbromarone.

   "Uricosuric agents, which enhance the renal clearance of urate, were first used at the end of the 19th century. ... they were supplanted as uricosuric agents by probenecid, sulfinpyrazone, and benzbromarone."

   Locator: section: Treatments for gout through the ages · Quote language: en