The Gout
This tragedy, in poetic form, was composed towards the close of the sixteenth century by J. D. L. Blambeausaut. It has only three scenes, and depicts the triumph of the gout. The poet describes an old man overcome by the multiple pains of podagra, praying to obtain some slight respite from the atrocious and agonizing pain he endures. The Gout, an ever malevolent deity, rejects the old man’s prayer for help, but carries him into a gathering of doctors who are vaunting, in mutual admiration society fashion, their power in jugulating all forms of disease and exalting their specifics for every known affection. In order to punish these arrogant disciples of Æsculapius for their presumption, the Gout gives them all the disease that bears his name, and afterwards jeers at their impotent efforts to cure themselves of aching joints.
This tragedy, name given by the author of the poem, is a very curious treatise on the gout in rhyme, in which we find all the pathogenetic theories given credence before the time that medical chemistry revealed the action of an excess of uric acid in the organism. The blood, bile, peccant humors settling in the parts affected were, as we all know, causes attributed to diathesis by the majority of medical authors of the Middle Ages. Thus the gout-afflicted man, in his imprecations against what he calls “the torturer of humanity,” comes to say:
“From the top of my head to the end of my toes
I am cruelly tortured by agony’s woes,
Filled up with black blood and billious humor,
My flesh seems to pulsate like a sore tumor.
The eating and gnawing I can’t describe well;
My tendons all ache with the twinges of Hell,
While through my fingers pains cut like a knife
And add to my torment! I’m weary of life.”
Meantime our patient does not appear to have a robust faith in the humoral theories of his physician, for he adds, in accursing the malady that has ruined his health, that it permits him no repose:
“Mal que jamais l’homme n’a pu comprendre
Qui le plus sage induirait a se pendre.”
That is to say, that the doctors do not understand how to manage the disease, a common idea among patients who are not cured of their malady as speedily as they desire.
In one of the scenes the gout addresses a pompous eulogy on its power over humanity, and inveighs against those physicians who discover a new specific against gout every day. This list of remedies for the disease is appalling; we cull but a few to satisfy the reader’s curiosity:
“One advises flea wort and a parsley pill,
One eats fruit at morning, when with gout he’s ill,
One chews leaves of lettuce, one takes wild purslain;
Another smells pond lilies, when he doth complain.
Some remedies most curious are for gout deemed good,
Such are herbs and simples to purify the blood;
Angelica and gentian, the iris and green thyme,
Along with fresh culled myrtle will cure it all the time;
Hyssop and lavender, cherry and water cress,
Basil, hops and anise, all make the pain grow less.
Lentills, sage and savory, when the bowels they unbind,
And the marvelous merchoracan that comes from far off Ind.
There’s the beauteous laurel leaf that crowneth bard and king,
Privet and cardamoms, whose praise we often sing.
And there’s the sleeping poppy, what peace within it resides,
Culled by the Turkish houris in the garden Hesperides;
There’s the soothing comfrey and the glorious hoarhound,
And the magic betal nut, in tropic isles that’s found;
There’s the fragrant fleur de lis, when with pain you cry,
There’s the odorous sheep dung, given always on the sly.
Some dote on peach blossoms; some on saffron red,
Some like hyoscyamus mixed with piss-a-bed;
There’s bread crumbs and fennel mixed with young carrots
Pounded in a mortar along with eschalots.
There are some who use an ointment this disease to heal,
Made of rinds of citron and golden orange peel,
With frankencense and veratria root, to ease gouty pain,
Applied to the great toes on the leaves of green plantain.
There’s saltpeter ointment too, when to the foot applied
It makes the patient furious wroth, or else he’s terrified,
Giving the gout new twinges, and the sufferer spasms
Only eased by eggs and flour in a soft cataplasm.
Some patients take a razor and their own flesh deeply cut;
The wound then duly poulticed is with meal and Cyprus nut.
Some take red cabbage when other methods fail
And eat it with vinegar mixed with the slime of snail;
Some use biting dressings made from ugly lizards,
Pounded up with doe’s hoof and weasel gizzards.
Many think a certain and most efficacious cure
Is a little blue stone ointment mixed with man’s ordure,
And a celebrated surgeon, a knight of great renown,
Used virgin urine as a cure for all the men in town.
Some wear charms like foxes’ tails, or a beaver tooth;
Others boil a new born caul and chew it up, forsooth,” etc., etc., ad nauseam.
Such are a few of the drugs employed against the gout, and certainly we cannot enumerate all the remedies spoken of by this malevolent demon. The treatment of Alexander Trallian, for example, is no less odd than many of the recipes given in this poetic formulary; it was composed of myrrh, coral, cloves, rue, peony and birthwort pounded together and mixed in certain proportions, and prescribed as an antidote to the gout for the space of 365 days, in the following manner: To be taken for 100 consecutive days, and then omitted for thirty days; then taken for another 100 days, with fifteen days omission afterwards; finally, every other day for 360 days. Circumcision was also a remedy, only applicable to Christians for obvious reasons.98
This treatment is an example of the methodical system, and “rests upon superstitious gifts,” says Sprengel. But there are some merits discoverable even in this apparent superstition, i.e., the great truth that the gout is a constitutional disease produced by luxury, and consequently incurable by medicines; a severe regimen being imposed, at the same time foolish prescriptions were given; it was the dieting and not the formula that made Alexander Trallian’s treatment so successful. However, it must not be forgotten that some medicines had a powerful effect in attenuating the violence of the gouty attack; it was for this reason that Cœlius Aurelianus resorted to purgatives and mineral waters; and among the drugs used by chance in the Middle Ages were found the flowers and bulbs of colchicum; the haughty Demon of Gout dared not treat this remedy with disdain.
Meantime the Gout addressed the following lines to the physicians and mires of the age.
“Gardez vous, Siriens;
Menteurs magiciens,
Vendeurs de theriaque,
Qu’elle ne vous attaque.”
To call the doctor of ancient times a “vender of Theriacum” was an insult to professional pride. This absurd remedy was invented by one of Nero’s slaves, and held a high place in public estimation. “It was laid down in the pharmacopœias, ad ostentationem artis,” says Pliny, “and enjoyed a reputation that was never justified by its thirty-six ingredients and the varied assortment of inert gums entering into its composition.”
In the third scene of the tragedy, the Demon Gout, recalls to the memory of the doctors of the Middle Ages, its illustrious victims of antiquity.
“Priam, disposed to run, had gout;
Achilles was too lame to get about;
Bellerophon’s saddle toes complained;
Ædipus had big joints that pained;
Plisthenes on his feet, all swollen stood,
Cursing the gout that coursed with his blood.”
How many other of the great have wept with the gout?
Then calling his faithful servitors, Pain, Insomnia, and Indigestion, the Demon Gout bids them plunge his fiery darts into his enemies, to burn them with an unquenchable flame:
“Toy, brule ici par des douleurs nouvelles
Le chef premier, les cuisses et tendons,
Toy, convertis leur nerfs en noir charbons,
Et vous aussi, d’une fureur soudaine,
Froissez leurs mains, rendez leur drogue vaine.”
With this superb peroration, he afflicts all good doctors with the gout and rheumatism. Since that day physicians the world over, says our talented author, J. D. L. Blambeausaut, have been the victims of this horrible malady. Let us now turn to the consideration of a curious hygienic play, no less interesting than that of the Gout,