James Gillray (1799)
Descriptions of gout date back almost 5,000 years to ancient Egypt and are included in the Smith and Ebers Papyri. The most prominent symptoms of gout—a type of arthritis—are swelling, redness, and intense joint pain that most commonly affects the big toe and that may persist for days to weeks. In this condition, crystals of uric acid—the normal end-product of purine metabolism—deposit in the joints.
In his classic work De Materia Medica (Regarding Medical Matters), written in approximately the year 70, Dioscorides describes the use of Colchicum (meadow saffron) seeds to treat gout. Extracts of the seeds were used well into the nineteenth century. Colchicine, an alkaloid and the active constituent in Colchicum, was extracted and isolated from the seeds in 1820 by the French chemists Pierre-Joseph Pelletier and Joseph Bienaimé Caventou.
Colchicine is very selective and effective in its ability to relieve the pain and swelling seen with acute attacks of gout but not with other types of arthritis. It is also used to prevent attacks in individuals afflicted with frequent and recurrent episodes of gout. Colchicine use has declined and has been replaced by less toxic drugs, such as Benemid, which increases the elimination of uric acid in the urine, and Zyloprim, which reduces uric acid synthesis in the body.
Combating the “Disease of Kings.” Gout has long been considered a “disease of kings,” or at least of the very wealthy, because of their overindulgence in rich foods and alcohol. (It has now been downgraded to a middle-class disease.) Among the many famous gout sufferers were King Henry VIII, Thomas Jefferson, Martin Luther, Charles Darwin, and Benjamin Franklin. Franklin used Colchicum extract while serving as the Ambassador to France (1776–1785) and introduced the drug to his fellow Americans. He also offered the following sage advice: “Be temperate in wine, in eating, girls, and cloth, or the Gout will seize you and plague you both.”