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Gout can be caused by large amounts of red meat and alcohol, a common diet of historical kings        Source: diter / Adobe Stock

Why Was Gout The Kingliest of Ailments?

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When we think of historically significant diseases we tend to think of diseases like the bubonic plague, cholera, tuberculosis, or more recently, COVID-19. These are all diseases that have had almost unimaginable death tolls. However, sometimes it isn’t how many a disease kills but who it kills that makes it a concern. Gout, an incredibly painful form of inflammatory arthritis, is not deadly. However, gout’s reputation as ‘the disease of kings’ meant there were times when it helped shape world history.

Famous People with Gout and the Consequences

Of course, gout’s reputation wouldn’t be what it is today if it hadn’t affected some big names throughout history. After all, you can’t call it ‘the disease of kings’ unless kings actually developed it. Gout is most commonly associated with a rich, meat and alcohol-heavy diet – exactly the kind of diet rulers throughout history have tended to enjoy. There is a long list of high-profile historical people who reportedly suffered from gout. Below are a few famous men who suffered from gout, and the historic consequences of the disease.

Gathering around the castle table for a meal rich in meat and alcohol, common factors in gout ( Nejron Photo / Adobe Stock)

Henry VIII

Given King Henry VIII ’s depiction throughout history, it is perhaps not surprising that he suffered from gout. In fact, he’s practically the poster boy for the gluttonous disease! King Henry VIII doesn’t have the best of reputations; beheading your wives and forcing your nation to change religions so you can get a divorce will do that.

Some historians believe part of Henry’s troublesome disposition could be ascribed to his ill health. Once a young, fit man, at some point, Henry suffered an injury (perhaps a jousting accident ) that left him unable to exercise. This disability led to massive weight gain, with his waist growing past 52 inches (132 centimeters!)

Henry VIII’s ill health and constant pain probably led him to find solace in rich food and too much wine, which led to his gout. Eventually, the king’s gout condition became so painful that he was left unable to walk, having to be carried around in a chair and leaving him in a perpetually bad mood.

Waxwork of an obese Henry VIII from Madam Tussaud’s Wax Museum ( MurdocksImages / Adobe Stock)

Piero di Cosimo de’ Medici (Piero the Gouty)

Another famous leader who has helped contribute to gout’s reputation is Piero di Cosimo de Medici . He was so famous for his awful gout that he earned the nickname Piero the Gouty, which seems particularly cruel.

Piero’s life was marked by ill health. After his father’s death, he became head of the Medici bank and would eventually go on to lead Florence.  However, his gout kept him bedridden, and his bedroom acted as his office.

He was seen as weak by many, which led to a coup, including some of his own family members. Ultimately, the coup failed, but it did not help his image. He died of a combination of gout and lung disease in 1469 at the age of 53.

Painting of Piero de’ Medicici by Bronzino, circa 1550 ( Public Domain )

Charles V

When gout can take down an emperor, you know it's not to be taken lightly. Case in point: Emperor Charles V of the Holy Roman Empire .

Charles V ruled from 1519 until 1556. Throughout his reign, Charles had a reputation for overeating meat and drinking as much wine and beer as he could get his hands on. It is doubtful that his gout diagnosis came as a shock to anyone.  Charles’s gout started off painful and ended up crippling him.

Charles’s gout made it practically impossible for him to lead during his empire’s battles with the French. When the French took Metz in 1552, Charles was left unable to respond. He delayed his counterattack due to a bout of gout, handing his enemy a major victory and destroying his own army's morale.

Charles abdicated soon after. During his abdication speech, he was forced to lean on his advisor William the Silent for support. He cried throughout his speech and ultimately blamed gout for his failings as a leader. A somewhat pathetic figure, Charles spent the rest of his days being carried around a monastery, unable to walk due to his gout.

Oil painting of Emperor Charles V by Christoph Amberger, circa 1532 ( Public Domain )

William Pitt

Anyone familiar with the history of the American Revolution and the Boston Tea Party will know that one major factor was the heavy taxes England placed on the American colonies. But what many people don’t know is that gout played a role in those taxes.

William Pitt the Elder was a British statesman who was largely sympathetic toward the American colonists. Unfortunately, he also suffered from horrendous gout. When the British Parliament passed the 1765 Stamp Act, forcing the unhappy colonists to pay a heavy tax, Pitt was at home sick with gout.

When Pitt got back to work, he quickly had the act repealed, stating "The Americans are the sons, not the bastards, of England. As subjects, they are entitled to the right of common representation and cannot be bound to pay taxes without their consent.”

Yet, his victory was short-lived. The next time Pitt’s gout flared up and caused his absence, Lord Townshend persuaded Parliament to pass a heavy duty on colonial tea imports to replace the revenue lost thanks to Pitt.

This all led to the Boston Tea Party in 1773. Who knows what would have happened if Pitt had been a healthier man?

A portrait of British statesman William Pitt the Elder, who was crippled by gout ( Public Domain )

Gout and the American Revolution: Franklin, Jefferson, the Comte de Vergennes, and Hancock

Gout’s role in the American Revolution was not finished. Benjamin Franklin , Thomas Jefferson , and the Comte de Vergennes were all key players in the American Revolution who also suffered from gout.

Some historians have speculated that the three men had such a strong personal connection because they all commiserated with each other over their gout. Perhaps Comte de Vergennes would have been less willing to help finance the American Revolution if he had not had so much in common with Franklin and Jefferson.

In January 1788, prospects for the revolution were looking good, but there was a problem. Only 5 of 9 required states had ratified the new constitution.  The revolutionary leader and governor of Massachusetts, John Hancock, was one of these holdouts. Hancock had been struck by indecision and couldn’t make his mind up on whether to sign or not. So he claimed a lousy bout of gout and took to his bed.

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Later, when Federalists offered him the vice-presidency, his gout miraculously cleared up, and soon thereafter Hancock delivered his block of votes. Massachusetts soon went on to ratify the Constitution, and the rest is history.

Several men involved with drafting the US Declaration of Independence and Constitution suffered from gout. Pictured above: Benjamin Franklin, John Adams, and Thomas Jefferson pictured above ( Public Domain )

Conclusion

In modern times, gout has managed to keep its reputation as a rich man's disease, despite the fact that science has contradicted this. Thanks to increasingly unhealthy lifestyles and diets, gout is on the rise across the developed world.

Gout can be a crippling disease, making sufferers unable to use their hands or walk ( Chatuphot / Adobe Stock)

Gout is a horrible, often debilitating disease, but there is a tendency to poke fun at those who suffer from it. Just remember that without gout, world history and American history may have turned out differently.

Top Image: Gout can be caused by large amounts of red meat and alcohol, a common diet of historical kings        Source: diter / Adobe Stock

By Robbie Mitchell

References

Nuki, G. and Simkin, P. 2006. A Concise History of Gout and Hyperuricemia and their Treatment. Arthritis Research and Therapy 8. Available at: https://arthritis-research.biomedcentral.com/articles/10.1186/ar1906#Sec3

Schwartz, S. Disease of Distinction . Available at: http://www.stephanaschwartz.com/PDF/disease_of_distinction.pdf

The Disease of Kings . April 1, 2003. Forbes. Available at: https://www.forbes.com/2003/04/01/cx_cd_0401feat.html

Comments

Gout was considered a rich man’s disease and the disease of kings and queens, because it meant they had access to the fattiest meats and foods: the foods with the highest purine content.  Common people didn’t have access to these foods.  Therefore, there was a far lower incidence of this painful disease.

Today, almost anyone can have gout.  Take a trip to the supermarket and notice how prominent salty, sugary, fatty foods are displayed.  Walk down the frozen food isles and pay attention to what’s for sale and what you might be ingesting in the name of speed and convenience.

Within the last few weeks there was a report that during the pandemic, the incidence of gout skyrocketed.  I can believe this.  All of us wanted comfort foods and now we’re paying the price for indulging ourselves.

We have a direct link to the rich people and kings and queens of history.  It’s unfortunate it has to be through so painful a disease.

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