Prime Minister's Gout

A still-smarting convalescent from the occupational disease of British Prime Ministers was Britain's Prime Minister last week. Hobbling gingerly after his first bout of gout (podagra) in 18 months, Neville Chamberlain presided over a Cabinet meeting, his left foot swathed in an enormous flannel boot. Outside, London was whistling the newest hit tune: God Bless You, Mr. Chamberlain. What consolation he could the Prime Minister took from echoes of this ditty and from the list of his distinguished gouty predecessors: Derby, Disraeli, Palmerston, Melbourne, Canning, the Pitts.-Several of these statesmen courted gout by stuffing themselves with mutton chops and port. But hard-working Neville Chamberlain is no high liver. Said his sympathetic friends: his trouble was "poor man's gout," a hereditary chronic disease (his father, Joseph Chamberlain, had it) which may torment even teetotalers.

Chief cause of gout is imperfect elimination of uric acid, and attacks may be caused by heavy consumption of rich food, malt liquors, or by mental shock. Although 50% of gout is hereditary, overindulgence usually aggravates the underlying weakness. Rare in the whiskey-drinking U. S., gout is most common in aley Britain and beery Germany.

Uric acid retained in the bloodstream is likely to form chalky, stony deposits in the joints and in the cartilage of the ears. Frequently first to suffer is the joint of the big toe, then ankles, knees, hands and wrists. Common symptoms: cramps, inflammation, fever, headache, neuralgia, together with hot, itching feet (known to ancients as "the lisping of the gout").

"Once gouty always gouty" is an old medical maxim, yet doctors believe that clean living and plenty of outdoor exercise can reduce attacks to mere demonstrations in force. Standard treatment, besides wrapping the throbbing foot in cotton wool, is a diet with plenty of water, and strangely enough, fat, especially fresh butter. Many doctors also rely on injections of colchicine (from the root of the autumn crocus) to relieve the agonizing pain, and cinchophen (a complicated synthetic acid) to promote uric acid elimination.

Even doctors, some of whom have been "terrible sufferers," find it hard to speak of gout with a straight face. Some, like their patients, pride themselves on their virile infirmity. Osier quotes approvingly Germany's Willibald Pirkheimer (translated into English in 1617) : "I take no pleasure," he wrote, "in those hard, rough, rusticke, agresticke kind of people who are never at rest, but ... are moyling and toyling, do seldom or never give themselves to pleasure, do endure hunger, which are content with a slender diet."

* "[The elder Pitt's] attacks of gout," said the Italian paper Telegrafo last week, "were the most splendid and memorable in British history. They are definitely linked with the conquest of Canada and India. In British statesmen [gout] acts as an imperialist stimulant. Beware if Mr.Chamberlain returns to the House of Commons . . . hobbling on crutches."

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