[Rheumatism and art : Max Slevogt. The bon viveur and artist plagued by gout]. / Rheuma und Kunst : Max Slevogt. Von Gicht geplagter Genussmensch und Künstler.

The painter Max Slevogt (1868-1932), together with Lovis Corinth and Max Liebermann, was one of the most important representatives of German impressionism. Slevogt, a gourmet who appreciated fine food and good wines, suffered from acute recurrent gouty arthritis starting at the age of 27 years. His medical history is reconstructed for the first time from the published and previously unpublished letters of his doctor János Plesch. After gout attacks at longer intervals in the first years of the disease, the attacks increased and from 1917 onwards were manifested in 1-2-year intervals with no evidence of a chronic gouty arthritis. Many of his attacks of gouty arthritis are illustrated by drawings that document the involvement of the feet and knees. Slevogt usually treated the gout attacks with bed rest, which prevented him from painting. He used a drug treatment with Colchicum only rarely. Dietary measures, a health cure for weight loss and multiple spa treatments in the last years of life at annual intervals, were among the other treatment modalities. The gout and heavy smoking resulted in coronary heart disease from which he died shortly before his 65th birthday.

Ribera's depiction of the sense of taste: A case of 'gouty arthritis' resulting from overindulgence?

Jusepe de Ribera's seventeenth-century painting devoted to the sense of taste, part of a series on the five senses, depicts a man from one of 'the humbler walks of life' enjoying his meal. The redness of the man's cheeks and nose, and the swollen index finger on his left hand, are discussed in relation to the food and drink shown in the painting. It is suggested that the man's high purine intake combined with a substantial quantity of alcohol supports the hypothesis that the swollen finger is affected by gout, which was traditionally considered a 'patrician disease'. Ribera's portrayal of a well-fed but non-patrician figure with gouty arthritis of the finger may have been intended as a warning against overindulgence and gluttony at all levels of society.

Some historical remarks on microcrystalline arthritis (gout and chondrocalcinosis).

The history of microcrystalline arthritis only began in 1961 when Daniel McCarty and Joseph Lee Hollander demonstrated the presence of sodium monourate crystals in the synovial fluid of gouty patients. However, gout is a historical disease, thanks to the descriptions of Hippocrates, Caelius Aurelianus, Soranus of Ephesus and Araeteus of Cappadocia. The relationship between hyperuricemia and gout was first documented in the nineteenth century by Alfred Baring Garrod, who demonstrated deposits of uric acid crystals on a linen thread held dipped in acidified blood (the so-called "thread method"). Gout has always been considered a prerogative of the moneyed classes (arthritis divitum), and history is full of famous gouty personalities, including kings, emperors, popes, commanders, politicians, artists, writers, philosophers and scientists. Another form of microcrystalline arthritis, chondrocalcinosis, was identified as being a rheumatic disorder different from gout in the 1960s. As a specific clinical entity, it was first identified in 1958 by Dusan Zitnˇan and Stefan Sit'aj in a few Slovak families.

[Uric arthritis--a historical view]. / Uricni artritis--pogled u proslost.

This paper gives a historical review of uric arthritis in the world and in Croatia.

Inflammatory gout: observations over a half-century.

This is a discussion of acute gouty arthritis, seen for over 50 years of engagement. It addresses the evolution of our current understanding of the interaction between urate crystals and key cellular components of the gouty inflammatory paroxysm, with new material on pathogenesis.

[Rheumatic diseases at the court of the Medici of Florence: the so-called "gout" of the Medici]. / Le malattie reumatiche alla corte medicea di Firenze: la cosiddetta "gotta" dei Medici.

According to the archive documents several members of the Medici family of Florence suffered from gout. The word "gout", with which the Renaissance physicians indicated pain episodes localised to hands, feet, spine and shoulders, was in general improperly used, and hint other nosological entities. A paleopathological investigation carried out on the skeletal remains of the Grand Dukes of Florence and their relatives, revealed the true nature of the diseases they suffered from, allowing to diagnose two cases of diffuse idiopathic skeletal hyperostosis (DISH), a case of rheumatoid arthritis in an advanced stage, and a case of gout.

A concise history of gout and hyperuricemia and their treatment.

First identified by the Egyptians in 2640 BC, podagra (acute gout occurring in the first metatarsophalangeal joint) was later recognized by Hippocrates in the fifth century BC, who referred to it as 'the unwalkable disease'. The term is derived from the Latin word gutta (or 'drop'), and referred to the prevailing medieval belief that an excess of one of the four 'humors'--which in equilibrium were thought to maintain health--would, under certain circumstances, 'drop' or flow into a joint, causing pain and inflammation. Throughout history, gout has been associated with rich foods and excessive alcohol consumption. Because it is clearly associated with a lifestyle that, at least in the past, could only be afforded by the affluent, gout has been referred to as the 'disease of kings'. Although there is evidence that colchicine, an alkaloid derived from the autumn crocus (Colchicum autumnale), was used as a powerful purgative in ancient Greece more than 2000 years ago, its first use as a selective and specific treatment for gout is attributed to the Byzantine Christian physician Alexander of Tralles in the sixth century AD. Uricosuric agents were first used at the end of the 19th century. In the modern era, nonsteroidal anti-inflammatory drugs are usually the drugs of choice for treating acute gout. Perhaps the most important historical advance in the treatment of hyperuricemia was the development of xanthine oxidase inhibitors, which are effective in reducing plasma and urinary urate levels and have been shown to reverse the development of tophaceous deposits.

[Theories and cures of the rheumatic diseases during the byzantine period (330-1453 a.D.)]. / Teorie e trattamento delle malattie reumatiche nel periodo bizantino (330-1453 d.C.).

Most Byzantine medical texts described the rheumatic diseases. The Byzantine physicians, based on the ancient Greek texts, explained the causes of rheumatic diseases, described their symptoms and proposed certain treatments. The Byzantine medical sources described various types of rheumatic diseases, as inflammatory arthritis, chronic deformans polyarthritis, and gout. As it can be concluded by the available medical sources, during the Byzantine period rheumatic diseases constituted a serious medical and social problem, representing a remarkable cause of disability, and this complaint was part of the epidemiological interest of the Byzantine physicians.

[Gout in the past and uric arthritis today in Croatia] ]. / Podagra nekoc i uricni artritis danas u Hrvatskoj.

In the past, gout was well known in these places, from Istria to Dubrovnik. Our very first dictionaries also witness about gout. Old doctors from Krapinske Toplice had also written about gout. Dr Edmund Mai, in his article published in "Lijecnicki vjesnik" in 1904 mentions "171 cases of uric arthritis". But, after that, for long 60 years there wasn't even a word about our patients, except surprise on very high incidence of the disease in the past. Even our handbooks had claimed that uric arthritis is not common in our country. In 1964 after 60 years of silence, the first article about our patients with uric arthritis, was published in "Lijecnicki vjesnik". These patients were medically treated for average of 13 years, and still were misdiagnosed. After that article, the numbers of patients with gout and articles on uric arthritis permanently rise. Today, the incidence of gout in Croatia is similar to that in other European countries.

[Music for rheumatism--a historical overview]. / Musik gegen Rheuma--Ein historischer Uberblick.

The history of the use of music to lessen the pain of rheumatism is seen in the use of musical therapy in medicine as a whole. Sources citing the use of music specifically in rheumatism are rare; often, rather than rheumatism, terms like "gout (podagra)" or "joint-pain" are mentioned. This is connected with the obscure and pathognomic perceptions of rheumatism. In the archeo-medicine and for primitive cultures the considered potency of music was primarily dominated by animistic thinking. In antiquity humoral pathology developed a philosophy that tried to explain the benefits of music, even for rheumatism, but found little acceptance. In the Middle Ages and in the Baroque period iatromechanistic conceptions determined music as useful in fight against pain. In the Romantic period there was speculation about music as a causal therapy, but it was shortlived. In the 20th century music is applied as an active therapy in the care of persons suffering from rheumatism; its empiric success as a remedy in rehabilitative and palliative therapy is recognized.