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JCR: Journal of Clinical Rheumatology:
Rheumatology Retrospective

Thomas Sydenham (1624-1689), on Gout: 1717

Dorwart, Bonnie Brice MD, FACP

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From the Lankenau Hospital, Wynnewood, Pennsylvania.

Reprints: Bonnie Brice Dorwart, MD, FACP, 124 Maple Avenue, Bala Cynwyd, PA 19004-3031. E-mail:

“He goes to bed and sleeps well, but about 2 a [sic] clock in the morning, is waked by the pain, seizing either his great toe, the heel, the calf of the leg or the ancle [sic]; this pain is like that of dislocated bones, with the sense … of water almost cold, poured upon the membranes of the parts affected … [;] presently shivering and shaking follow with a feverish disposition; the pain is first gentle, but increases by degrees … and that hourly, till towards night it comes to its height … [B]ones of the tarsus and metatarsus … it seizes, … sometimes [like] the gnawing of a dog, and sometimes a weight; moreover, the part affected has such a quick and exquisite pain, that it is not able to bear the weight of the cloaths [sic] upon it nor hard walking in the [bed] chamber; and the night is … passed over in pain … also by … the restless turning of the part hither and thither, and the continual change of its place. Nor is the tossing of the whole body, which always accompanies the fit … , less than the continual agitation and pain of the tormented member: there are a thousand fruitless endeavors used to ease the pain, … yet there is no ease to be had, till 2 or 3 a-clock [sic] in the morning, viz., (a night and a day being spent in the first approach of the fit) at which time the sick has suddenly ease [sic], by reason there is a little digestion of the peccant matter. … And now being in a breathing sweat, he falls asleep … [;] when he wakes he finds the pain much abated, and the part affected swell’d [sic] afresh; for before there was only … visible a swelling of the veins intermixed with the affected members. The next day, and perhaps 2 or 3 after, if the matter apt to generate the gout is copious, the part affected will be in pain, which will be violent too towards evening, but it will be eased about the time of the cocks-crowing;” once it has left off aching, “the weakness which rendered it infirm will presently vanish, strength and perfect health being so perfectly restored, as if it had never been out of order. ...” In those “whom the gout has rarely visited,” a return to their former health “comes to pass often in fourteen days, and in those that have been often affected by it in 2 months.”

Sydenham, Thomas. In: Pechey, John, The Whole Works of that excellent Physician, Dr. Thomas Sydenham, 7th ed., London: Printed for M. Wellington; 1717: 341–353.

From the Historical Medical Library, College of Physicians of Philadelphia, Philadelphia, PA 19103–3097. Web Site: Click on Library & Wood Institute, and then on Historical Library.


gout; crystal-induced synovitis

© 2004 Lippincott Williams & Wilkins, Inc.

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