ABSTRACT
The study of gout epidemiology dates to antiquity, to Hippocrates’ first
descriptions of disease risk factors including advancing age, female menopause,
and male sex. Thomas Sydenham, a 17th century English physician and infamous
gout sufferer, made seminal contributions to our understanding of gout as an entity
distinct from other forms of “rheumatism.” In the latter half of the 18th century,
uric acid was isolated from select bladder stones and found to be the primary
constituent of gouty tophi. In the middle part of the 19th century, Sir Alfred Barring
Garrod devised the first qualitative test for serum urate (the so-called “string test”)
and, in the process, defined the association of hyperuricemia with gout. Perhaps in
response to the work of his contemporary (Robert Koch, who published his
postulates in 1884), Freudweiler reproduced acute gout attacks by injecting
monosodium urate crystals into the knee joints of otherwise healthy “volunteers.”
