[Gout in the Corpus Hippocraticum].

Abstract

Gout is the oldest recorded form of inflammatory arthritis to affect humankind, with roots stretching back to 2640 BC and known in Greece by 1700 BCE. It is due to deposition of sodium monourate driven by hyperuricemia. The association of humours with causation stems from Hippocrates (460-370 BCE). More specifically, a toxic humour was suspected by Celsus (25 BCE-50 CE) and Rufus of Ephesus (98-138 CE), and confirmed by Alfred Garrod in 1849. Its therapy has been based on colchicine since Severus Iatrosophista, Theodosius the Philosopher, and Jacobus Psychrestos, introducing Colchicum as an innovative treatment for podagra in the early Byzantine period. A breakthrough in treatment was the introduction of allopurinol in 1966. This study aimed to examine gout in the Corpus Hippocraticum. For Hippocrates, gout is a disease caused by bile and phlegm, not by the wrath of a god. Gout is mentioned in the Corpus 20 times, and a total of five Aphorisms are dedicated to podagra. In Affections, "Gout is a disease that induces burning pains in the joints; it comes to paroxysms, now in one limb, now in the other, where it causes ailments of variable severity". In Prorrhetics, it is described as a disease not amenable to cure in the elderly patients with tophi - a goal achievable in the young patient willing to adhere strictly to the therapy suggested by the physician.