From poison to drug: new recipes discovered containing colchicine as a remedy for Podagra in Rome and Byzantium.

OBJECTIVES: In Antiquity, colchicine was used as a poison and as a remedy for Podagra. Research so far has revealed that the physician Alexander of Tralles was the first who used it in the 6th century AD. Alexander recommended a plant he called "Hermodaktylon", which takes off the pain in the feet immediately. "Hermodaktylon" is identified with Colchicum autumnale L., which contains colchicine in his bulbs and seeds. We will present new data that varieties of Colchicum were used for medical treatment of Podagra far earlier than hitherto known by research. METHODS: We performed a systematic full text search in Greek and Latin original sources of Antiquity for "Hermodaktylon"/"Hermodactylus" and for the synonyms "Ephemeron"/"Ephemerum", "Kolchikon"/"Colchicum", and "Bolbos (agrios)"/"bulbus (agrestis)". We analysed our findings with philological and historico-critical methods. RESULTS: There are 48 text passages in original sources. Lucian of Samosata (2nd century AD) was the first who mentioned a plant he called "bolbos" as a remedy for Podagra. The Byzantine physician Jacobus Psychrestes (5th century AD) developed two recipes. Aëtius of Amida (6th century AD) transmitted two recipes. One case with an overdose of colchicine was discovered which resulted in the death of a patient in Byzantine times. CONCLUSIONS: New specific recipes containing Colchicum were discovered. Jacobus Psychrestes and Aëtius used Colchicum systematically for the therapy of Podagra earlier than the 6th century AD. However, the therapeutic use of Colchicum was already known in the 2nd century AD.

[Historical Study of the Etymological Form and Translational Process of Gout (Tongfeng,)].

This study aims to address questions regarding the translation of 'gout' into 'tongfeng ()' in East Asia. To this end, the formation process of the origins, 'gout' from Western medicine and 'tongfeng' from Oriental medicine, and the translational process were investigated through the relevant records and literature dating from the 16th century on. Symptoms associated with gout were originally mentioned in ancient Egypt and various terminologies were used to refer to gout, such as podagra, cheiragra and gonogra. The word 'gout', which is derived from Latin, was used for the first time in the 13th century. The reason for this linguistic alteration is thought to be the need for a comprehensive term to cover the various terms for gout in symptomatic body parts, since it can occur concurrently in many joints. However, it took hundreds of years before gout was independently established as a medical term. In oriental medicine, terms describing diseases with features similar to gout include bibing (), lijiefeng (), baihufeng () and tongfeng (). Among them, the concept of 'tongfeng' has been established since the Jin and Yuan dynasties. The cause, prevention and various treatments for tongfeng were proposed throughout the Ming and Qing dynasties. The early translation of gout and tongfeng in East Asia, respectively, is estimated to have occurred in the 18th century. The first literature translating gout in China was 'An English and Chinese Vocabulary in the Court Dialect (yinghua yunfu lijie, )'. From the publication of this book until the late 19th century, gout was translated into an unfamiliar Chinese character 'Jiu feng jiao ()', likely because the translation was done mostly by foreign missionaries at the time, and they created a new word on the basis of Western medicine instead of researching and translating similar diseases in oriental medicine. In Japan, the first book translating gout was 'A Pocket Dictionary of the English and Japanese Language (Eiwa taiyaku shuchin jisho, )', Japan's the first English-Japanese translation dictionary. In this book, gout was translated into tongfeng, a word adopted from oriental medicine. These differences from China are thought to be caused by Rangaku doctors (), who, influenced by oriental medicine in the Jin and Yuan dynasties, played an important role in translating medical terminology at that time.

Historical Study of the Etymological Form and Translational Process of Gout (Tongfeng) / 의사학

This study aims to address questions regarding the translation of 'gout' into 'tongfeng' in East Asia. To this end, the formation process of the origins, 'gout' from Western medicine and 'tongfeng' from Oriental medicine, and the translational process were investigated through the relevant records and literature dating from the 16th century on. Symptoms associated with gout were originally mentioned in ancient Egypt and various terminologies were used to refer to gout, such as podagra, cheiragra and gonogra. The word 'gout', which is derived from Latin, was used for the first time in the 13th century. The reason for this linguistic alteration is thought to be the need for a comprehensive term to cover the various terms for gout in symptomatic body parts, since it can occur concurrently in many joints. However, it took hundreds of years before gout was independently established as a medical term. In oriental medicine, terms describing diseases with features similar to gout include bibing, lijiefeng, baihufeng and tongfeng. Among them, the concept of 'tongfeng' has been established since the Jin and Yuan dynasties. The cause, prevention and various treatments for tongfeng were proposed throughout the Ming and Qing dynasties. The early translation of gout and tongfeng in East Asia, respectively, is estimated to have occurred in the 18th century. The first literature translating gout in China was 'An English and Chinese Vocabulary in the Court Dialect (yinghua yunfu lijie)'. From the publication of this book until the late 19th century, gout was translated into an unfamiliar Chinese character 'Jiu feng jiao', likely because the translation was done mostly by foreign missionaries at the time, and they created a new word on the basis of Western medicine instead of researching and translating similar diseases in oriental medicine. In Japan, the first book translating gout was 'A Pocket Dictionary of the English and Japanese Language (Eiwa taiyaku shuchin jisho)', Japan's the first English-Japanese translation dictionary. In this book, gout was translated into tongfeng, a word adopted from oriental medicine. These differences from China are thought to be caused by Rangaku doctors, who, influenced by oriental medicine in the Jin and Yuan dynasties, played an important role in translating medical terminology at that time.

Treatment of gout in a recently published 9th century manuscript of Rhazes.

Gout is a common lifestyle disease and was identified by Hippocrates in the fifth century BC although the condition was known ancient Egypt some two millennia earlier. The pharmaceutical suggestions described in a recently edited manuscript, the oldest known medical manuscript of the Arab world, is presented, here for the first time. It is entitled Treatise on Gout by Rhazes, the greatest of Arab clinicians, and was written in the late 9th or early 10th century. Rhazes' pharmaceutics are presented in descriptive tables and their components are also compared with other recipes from manuscripts of the Galen and a recently edited medieval Syrian manuscript of Le Livre des simples (Tables 1-2). It is noteworthy that Rhazes insists that the drugs should be taken before sunrise and at down, showing ignorance of current knowledge of circadian rhythms. This is of interest as arthritis chronotherapy is widely discussed in recent literature.

[Therapy or torture: a treatment of gout misunderstood by Gregory of Tours]. / Therapie oder Tortur--Eine missverstandene Behandlung der Gicht bei Gregor von Tours.

Historiarum libri decem, a work written by St. Gregory, the bishop of Tours, is an important contemporary source for the study of the Merovingian times. In Book V 42 Gregory reports the story of Maurilio, the bishop of Cahors in the Southern Gaul, who was strongly suffering from gout. Maurilio treated the illness himself applying a hot iron to his foot and shank. This therapy is already mentioned in the Corpus Hippocraticum. It seems, however, that cauterization was not known to St. Gregory of Tours as a medical treatment of this particular illness. He simply saw in it a sanctifying practice in the sense of penitential mortification. Indeed, for Gregory this interpretation is an important part of his literary aim, as Maurilio is for him a brilliant example of a minister of the Church. Although Maurilio is well-known for his piety, knowledge, and uprightness in diocesan dealings, he voluntarily, as Gregory thinks, submits to ascetic self-castigation.

The tale of a city saved by gout and a letter from Jesus.

In the 6th century a Persian invasion of the eastern provinces of the Roman empire resulted in the devastation of several cities. Edessa alone was spared, and it was widely believed that this city had divine protection because of postal communication over 5 centuries earlier between its gouty ruler and Jesus Christ. These events are reviewed in detail herein. Some appear to have a well-documented historic basis but others, including the letter from Jesus, have been considered highly questionable by various authorities. The story provides an interesting connection between gout and historic events in the ancient world.

[The autumn crocus: two millenniums of actuality]. / Le colchique: deux millénaires d'actualité.

Colchicum holds a singular place in the History of Medicine. Many names were given through the ages: "ephemera", "finger of Hermes", "pater noster", "tue-chiens". Modern phytonyms clearly refer to the land of Colchis, a mythical place close to Armenia. Several centuries were needed to understand that, despite a frightening reputation, colchic was an elective treatment for the gout. In its long story, appears famous personages as Theophraste, Paulus Aeginata, Gilbertus Anglicus, the baron Storck and Benjamin Franklin. In modern times, colchicum has received besides gout, a wide array of new indications, among others: Behcet disease, collagen diseases and malignancies. A scarcely known chapter of genetics is the findings in 1889, by B. Pernice, an obscure physician from Palermo, of the major mitoic changes observed on gastric and intestinal mucosa of two dogs which had received large doses of colchicum. In spite of their scientific value, the works of Pernice remained largely ignored until 1949. Recent advances in colchiocotheraphy have shown fascinating new fields for research: thus in the familial Mediterranean fever, close to periodic disease, genetic disorder elective for subjects originated from all over Mediterranean and around Black Sea... the mythical country of Colchis. No other medicinal plant than colchic, except poppy, can give such records of perennial use in such a wide range of disorders.

[Historical Archives of Italian Nephrology. The gout as a paradigmatic example of the ancient humoral theory of diseases]. / Archivi storici della Nefrologia Italiana. La gotta come paradigma e superamento dell'antica teoria umorale delle malattie.

Gout is one of the oldest known diseases. The term derives from the Latin "gutta", which means "a drop" This word expresses and describes, as no other term can, a method of interpreting the pathologies that have been with us for more than 2000 yrs. The theory of humoral disturbance goes back to the time of Hippocrates. This paper is a historical review of gout, with particular attention given to the interpretation of the origins of clinical, articular and renal involvement allowing us paradigmatically to sum up all the stages in the evolution of the etiopathogenetic and nosographic concepts of medicine through the ages.

["De Arthetica passione" in a XVth century Italian manuscript]. / "L'Arthetica passione" in un manoscritto italiano del Quattrocento.

The author describes a 15th century Italian manuscript by Antonio Cauchoreus based on the translation of the treatise "De Arthetica passione" by Antonio Guainiero di Pauia. This manuscript, that is in the Capitular Archive of Toledo, in keeping with the method of Consilia (analysis of symptoms, definition of the cause and diagnosis), presents some practical rules to treat gout, including particular herbal remedies.

"Like a virgin": Absence of rheumatoid arthritis and treponematosis, good sanitation and only rare gout in Italy prior to the 15th century.

OBJECTIVES: This study was conducted to test several hypotheses: 1. That rheumatoid arthritis and syphilis were New World diseases, only transmitted to the Old World subsequent to the passages of Christopher Columbus; 2. To indirectly test the hypothesis that lead poisoning was prevalent in Roman Italy by looking for its byproduct, gout; 3. To test the hypothesis of compromised sanitation in ancient Italy, on the basis of spondyloarthropathy frequency; and 4. To assess variation of trauma frequencies in ancient Italy, by examining frequency of focal periosteal reaction. METHODS: Skeletons from sites ranging from the Bronze Age to the Black Plague epidemic of 1485-1486 were macroscopically evaluated for focal periosteal reaction and for the cardinal signs of rheumatoid arthritis, treponemal disease, gout and spondyloarthropathy. RESULTS: Examination of 688 individuals revealed low frequency of focally distributed periosteal reaction (bumps) in sites dated from the 3400-700 years before present, sharply increasing in the 15th century. Diffuse periosteal reaction was present only as isolated occurrences secondary to hypertrophic osteoarthropathy and sabre shin reaction was notably absent. Erosive disease was uncommon and always oligoarticular in distribution. No marginal erosions were present, with the exception of an isolated metatarsal with classic overhanging edge sign of gout. Subchondral erosions, peripheral joint fusion and axial skeletal involvement identified spondyloarthropathy frequencies of 1-3%, independent of the antiquity of the site. CONCLUSIONS: Italy, prior to Columbus was like a virgin. Rheumatoid arthritis and treponemal disease (specifically syphilis) were not present, further supporting the contention that they are New World-derived diseases. Periosteal signs of minor trauma were rare prior to fifteenth century plague times. This suggests a potential role of domestic (as opposed to outside environment activities) in is development. The hypothesis for a role of lead poisoning in the demise of the Roman Empire is falsified by the rarity of gout. The frequency of spondyloarthropathy was significantly below that found in sanitarily challenged populations, suggesting high standards of hygiene in ancient Italy.

[Investigation on "gout" and comparison of disorder between Chinese and Western medicine in pre-Song-yuan dynasty].

Before the Song-Yuan dynasties, it was claimed that "gout" is the result of heat in the blood plus invasion of wind, cold, or dampness, leading to coagulation of turbid dampness in the channel-collaterals, characterized by arthralgia, exacerbated in the nighttime. "Gout" was first seen in the Ming yi bie lu (Other Records of Famous Physicians) of the Liang dynasty. Before that, it was categorized under "bi" syndrome. No detailed description was given to "gout" during the period from the first appearance of the title "gout" to the Yuan dynasty. In fact, it was vaguely mentioned in "bi", "li jie", and "bai hu (white tiger)" disorders. The title of "gout" was named by Zhu Danxi, and appeared alternately with gouty arthritis. "li jie" and "bai hu" are titles of two different diseases which were jointly called "lijiebaihu" in the Song dynasty, both similar to gouty arthritis. The TCM title of gout was based on this condition which is specific and very proximate to gouty arthritis.

[Archeology in medicine: digging up into the tophi of Popes, Dukes and Kings]. / Archeologia medica: scavando nei tofi di Papi, di Duchi e di Re.

According to an Anglo-Saxon pun, "gout is the king of diseases and the disease of Kings". In fact, it is well-known that in past times a quantity of famous persons, including Kings and Popes, were affected with this rheumatic disorder. In this paper biographical anecdotes on several Popes (Pius III, Julius II, Julius III, Clement VIII, Innocent XI, Clement XII and Pius VIII), King George IV and Queen Anne of England, as well as on some members of the Lorraine lineage, all suffering from gout, are sketched out. These historical data are briefly discussed in relation to the celebrated Hippocrates's aphorisms on gout.

[Gout and kidney during XVII and XIX centuries]. / Gotta e rene tra XVII e XIX secolo.

The authors briefly describe the history of gout, mainly focusing their attention on the renal involvement. They report some works and theories on gout of great ancient physicians, such as Paracelsus, Sydenham, Boerhaave, Van Swieten and Morgagni.

'Arthritis' in Byzantium (AD 324-1453): unknown information from non-medical literary sources.

OBJECTIVE--To compile and analyse information contained in non-medical texts of the Byzantine historians and chroniclers concerning arthritis, and to clarify the first use of Colchicum autumnale in the treatment of gout by the fifth century physician, Jacob Psychristus. CONCLUSIONS--This material gives an indication of the problem of arthritis and, in particular, a disease resembling gout that tyrannised a great number of the population in the Byzantine Empire (AD 324-1453). Contemporary historians and chroniclers maintain that the main causes of gout ('podagra') were the over-consumption of alcoholic drinks and food. Most relevant texts include anxiety and heredity among the aetiological factors of the disease. The incidence of this group of diseases among the Byzantine Emperors (it is certain that 14 of a total of 86 had a form of arthritis) and other officials of the State indicates that these diseases were a possible factor in certain political and military difficulties of the Empire.

Gout of the rich and famous.

A number of sources on the subject of gout, and particularly its role in history, were consulted. Highlights are presented to illustrate popular conceptions of the social implications of gout. It is indicated that the consequences of this affliction may be disastrous to empires, yet are not always viewed as entirely negative for individual sufferers.