Gout is a disease of the joints sometimes known as "the disease of kings and the king of diseases". It was known to Hippocrates, and is still being studied today.

Gout is caused by an excess of uric acid in the body: that is, your body is generating more uric acid than your kidneys can get rid of, and that excess has to go somewhere. Where it goes is into tiny crystals of uric acid, which end up in the fluid of the joints (the synovial fluid). As you might guess, this is a painful event.

One cause of increased uric acid levels is a diet high in purines. These substances, which are metabolized to uric acid, are found in such foods as herring, anchovies, mackeral, liver, kidneys, brains, sweetbreads, gravies, and dried beans and peas. Smaller amounts of purines are found in all meats, fish, and poultry. In an age when kings were more likely than others to have exotic foods on the table, you can see that gout would have been a disease of the upper classes. Alcohol also tends to increase uric acid levels by interfering with kidney function and so precipitate a gout attack.

Gout tends to occur first in the big toe, a condition called podagra. From there is tends to spread to the instep, ankles, heels, knees, wrists, fingers, and elbows. The classic picture of a gout sufferer with well-padded big toe elevated on a footstool is based on the early stage of the disease.

Gout occurs in approximately 275 of every 100,000 people. The most common gout patients are men between the ages of 40 and 50. Women rarely develop gout before menopause.

Fortunately, gout can be effectively treated these days. In the 19th century, colchicine (an alkaloid extracted from the autumn crocus) was discovered to be very effective against the pain of gout. Unfortunately it also causes nausea, vomiting, and diarrhea. These days, the treatment of choice is one of the many non-steroidal anti-inflammatory drugs, commonly known as NSAIDs. Common NSAIDs prescribed for gout include indomethacin and naproxen. There are also drugs that help the kidneys get rid of uric acid, including probenecid, and drugs to block the production of uric acid, including alopurinol. With this arsenal the physician can generally treat both the symptoms and underlying causes of gout.

By the way, there's also a disease called pseudogout. It has pretty much the same effects as regular gout, but it caused by the deposition of calcium pyrophosphate crystals.