Gout is, and was, horrible. It causes sudden, severe and unpredictable pain. It is most famous for attacking the joints- usually the big toe, or fingers, wrists, elbows or knee. But gout is much, much more than that. It was not just an aching big toe, or gouty foot, although Georgian cartoonists used that image as visual shorthand. Other symptoms included;
Chilliness, yawning, stuverings, anxiety, nausea, sickness at stomach, debility, drowsiness, stupor confused head, and these are often followed by full quick hard pulse and burning heat with thirst and aversion to food (1)
Gout could kill, as Lieutenant General Floyd knew; his would have died in agony with his atonic gout affecting the stomach. His last hours would have been acute stomach spasms and uncontrollable diarrhoea. This did not stop the newspaper making a little joke in the announcement above (1818);
One of the many regency poems about gout makes that clear- here, mercifully, is just two lines of forty (1816) ;
Gout was so bad that the Georgians wrote doggerel poetry and sent it to the newspapers, who published it. Here is another poem, advertising, Warren’s Jet Blacking for boots:
It was a favourite of the quack medicine cure-alls, always near the top of a long list of illnesses and conditions that it would cure. It was usually linked with rheumatism, which was correct. Many medicines did not claim to cure it, unlike other conditions; this was because it was clearly a disease that re-occurred. So, whether it was Dr Wilsons’s Gout Tincture, Okey’s Concentrated Essence of Jamaican Ginger or Fenn’s Embrocation, the relief was temporary. One ‘permanent’ cure was -apparently – Bullman’s Imperial Pills, but it would only cure you in Kent where it was sold only in local shops. A cynic would say that it would have gone national if it worked.
Respectable doctors in the Regency knew that lifestyle changes were the key. They had also worked out that it was hereditary, and that could sometimes be initiated by a trauma or break to the limbs. ‘The most undeviating moderation and temperance’ is necessary, according to Dr. Gibbes of Bath in 1812. (2) Yet limiting or avoiding alcohol and rich foods was not a Regency habit .
People moaned about gout, but it was an acceptable ailment in Regency Britain. When the newspapers reported a celebrity absence from an event, they were generically ill or ‘indisposed’, but gout was gout. It was a reason that could be referenced. The best people had it.
The King, through his insanity between 1811-1820, was reported to have gout; when it reappeared it stopped his therapeutic walks at Windsor; the Prince Regent had gout often, firstly in 1811 after an accident to his leg, and later in Brighton in 1816, which kept him indoors, and his friends had to come to him at the Pavilion to grovel and toady. They would have remembered not to notice that his knees were swelled and huge. William Pitt, another six bottle a day man- had the same problem, as did the Prince Regent’s brother and future king, William IV. The Lord Chancellor, Lord Eldon had gout which kept him away from his duties in the 1810s. The King of France had it- ‘Louis the Gouty’, as Byron called him.
Notice the gouty knees.
Why was gout acceptable? It was regarded as the ailment of the well healed – especially those who had had easy, comfortable lives with lots of expensive spirits and wines, and who did not exercise like younger people would. This was not a new idea. Over two thousand years early, the Greek doctor Hippocrates. He called gout “the unwalkable disease” and “the arthritis of the rich”, and blamed it on too much food, wine and sex, showing that the 18th century stereotype had ancient origins. Poor people could get gout if they could steal high quality alcohol. Medical experts suggested that gout in the poor was restricted to brewer’s assistants, cellermen and bottlers who had access to drink that they could not afford to buy.
For the rich, a little gout was expected in later life. These are from the Annals of Bath (1830) describing the situation a few decades earlier:
A bon vivant of about half a century old who has never yet experienced a determined fit of the gout fancies he has a little of what he calls the flying gout about him and takes it into his head to visit Bath with a full intention to eat his three meals a day and drink his bottle of port in the evening
He then reports top his friends that he does have a touch of ‘flying gout’, in the same way that the 80s executive had to have ‘stress’ to be doing his job. He seems to have taken the waters to cure it and drink a bottle of port to encourage it in order to prove that, by having gout, he had reached a high social level.
(1)The Gout Alleviated: Proved by Cases of the Most Painful Fits Being Removed By William Rowley
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Passengers- a history social history of Britain 1780 to 1840 through a focus on transport and hospitality. More details here