Literary satire and pictorial caricature have been adding for centuries insult to the injury caused by gout. A butt of ridicule, the gouty patient has been depicted as a gluttonous drunk paying for his indiscretions. As a "rich man's disease," gout has been linked with overindulgences that only the affluent could afford.
Belying the popular image is the impressive list of prominent men who had gout. Alexander the Great, Charlemagne, Bacon, Milton, Newton, Darwin, Harvey, and Hunter were victims of the disease. Sydenham—himself a sufferer from gout— noted that the disease tends to afflict the upper social strata. In his Study of British Genius, Havelock Ellis submitted that the association of gout with so many famous men could not be ascribed to chance. More recently Popert and Hewitt1 have noted uncommon frequency of high social class among gout patients attending their clinic.
The observed association—whether apparent or real—between gout