How did they treat gout in the 1800s?
Gout is a form of inflammatory arthritis that is caused by elevated uric acid levels in the blood, leading to the formation of crystals that cause swelling, pain, and inflammation in the joints, particularly in the big toe. In the 1800s, understanding and treatment approaches for gout were influenced by the prevailing medical knowledge and practices of the time.
Bloodletting and Purging: During this period, bloodletting was commonly practiced to remove "impurities" from the body. For gout, it was believed that removing some blood would help reduce the concentration of uric acid. Patients might undergo periodic bloodletting to relieve symptoms. Additionally, purging or laxative use aimed to eliminate uric acid through bowel movements.
Colchicum: Colchicum, a plant extract, was widely used for gout relief. It was typically administered orally or as a tincture. Colchicum is known to have anti-inflammatory properties, and it can provide temporary relief from gout symptoms; however, it also has a narrow therapeutic window, meaning that toxic doses are close to the effective range, requiring caution in dosing.
Alkaline Diets and Mineral Waters: It was believed that maintaining an alkaline environment in the body could dissolve uric acid crystals. Physicians often recommended diets rich in alkaline foods, such as fruits and vegetables, and consumption of alkaline mineral waters or medications to change urine pH.
Limiting Meat and Alcohol: Consuming certain foods, particularly meat and alcohol, was thought to contribute to gout. Thus, limiting these items was often advised to reduce the frequency and severity of gout attacks.
Cupping and Blistering: These practices involved creating suction cups on the skin or intentionally causing blisters to draw out excess fluids and "toxins." They were sometimes employed to relieve gout pain and inflammation.
Joint Immobilization: In severe cases, the affected joint might be immobilized using splints or casts to minimize movement and pain.
Surgical Intervention: In extreme situations where the joint was severely damaged, surgical amputation of the affected toe or joint might be considered as a last resort.
It's worth mentioning that medical knowledge and practices have advanced significantly since the 1800s, leading to more effective and safer treatment approaches for gout, such as medications, dietary modifications, and lifestyle changes.