31 March 2008

The lame companion of geniuses: five questions about gout

1. Why was gout called either a "royal disease" or an "aristocratic disease"?

Both in ancient times and in our time, gout chooses victims among people with a high standard of living and especially with good nutrition. The development of the disease provokes an excess of meat dishes, smoked meats, various delicacies, alcohol (especially red wine and beer), as well as frequent stress. Before, of course, they were wealthy and noble people. The portrait of a typical modern "gouty" is associated not so much with "nobility" as with a way of life. This is, as a rule, an active, pleasure-loving middle-aged man with high income, often occupying a managerial position, temperamental. The frequency of the disease is 3-5 cases per thousand people. Women get gout about 10 times less often than men.

2. How and why does gout occur?

The mechanism of the disease is as follows: an excess of animal proteins and alcohol on the background of stress increases the level of uric acid and its salts – urates in the blood. Normally, uric acid, which is the end product of cell activity, should be excreted by the kidneys. But if its concentration is too high, the kidneys can not cope.

Excess urates can crystallize and be deposited in the joints, which causes inflammation and severe pain in the fingers of the hands and feet, elbow, knee. But most often the attack begins with the first joint of the big toe. The pain is so intense that even the touch of the sheet seems unbearable. Sometimes an abscess appears on the affected joint, and when it is opened, small crystals can be seen in it.

If gout is not treated and the diet recommended by the doctor is neglected, the attacks become more frequent and more intense. The disease affects increasingly large joints, kidneys and urinary tract.

3. How is gout treated?

The first thing a rheumatologist or arthrologist will recommend is a strict diet. Meat dishes, liver, fatty fish, smoked meats, caviar, beans, peas, sweets, alcohol are excluded from the diet. They recommend copious drinking. Medications are prescribed that affect the metabolism, reducing the concentration of uric acid, as well as diuretics, anti-inflammatory and painkillers. During the attack, complete immobilization (immobilization) of the affected joint is recommended.

4. Why do patients with gout recommend a hemocorrection procedure?

In recent years, methods of hemocorrection have been widely used, that is, "correcting" the composition of blood outside the patient's body. One of the forms of hemocorrection – cryoprecipitation – allows you to remove excess uric acid and other harmful substances from the blood. It looks like this: the patient is seated in a chair, a catheter is inserted into a vein and connected to an apparatus through which his blood is "driven". During the procedure, which can last from 1.5 to 3 hours, the patient is allowed to read, watch TV, conduct telephone conversations, talk with medical staff or just sleep. After such a "cleaning" of the blood, the healing of the inflamed joint proceeds faster, the likelihood of a relapse of the disease decreases.

5. Is it true that animals do not have gout?

Truth. In most mammals, a special uricase enzyme is produced in the body, which is able to decompose uric acid into simpler compounds. Unfortunately, humans do not have this enzyme, so uric acid seems to accumulate in the body. However, normally it is filtered out by the kidneys and up to 85% (about 1-2 g daily) is removed with urine. Approximately the same amount re-enters the bloodstream as a result of the breakdown of dietary proteins. As a result, the concentration of uric acid in the human body remains approximately constant. But sometimes, due to errors in nutrition and lifestyle, its concentration jumps 10-20, or even 30 times.

The Lame companion of geniuses

Since ancient times, it has been noticed that not only kings and emperors, but also famous generals, admirals and philosophers often suffered from gout. In the Middle Ages, historians noticed a connection between the degree of development and prosperity of cities and states and the spread of gout among the population.

For the first time, the possible direct connection of gout with increased mental activity was pointed out by the English researcher E. Orvan in his article "The Origin of Man", published in the journal Nature in 1955. He drew attention to the fact that uric acid is similar in structure to caffeine and theobromine – substances contained in coffee and tea and capable of stimulating mental activity.

Among Russian researchers, the outstanding contribution to the development of the "gouty" theory of genius was made by the Soviet geneticist Vladimir Efroimson. At the end of his eventful life, he wrote the book "Biosocial factors of increasing mental activity." At that time – the 80s of the last century – the book was not published. It was published only in 1997 under the title "Prerequisites of genius".

Efroimson did not limit himself to listing examples, but took up statistics. And he proved that among talents, the prevalence of gout is 5-10%, which is 10 times higher than the average, and among geniuses it soars to 30-50%. In other words, every second genius was gouty! And for the rest, genius turned out to be linked with other rare genetic abnormalities – Marfan and Morris syndromes, as well as a mental illness – manic-depressive psychosis. 

How to get rid of the trap?

During an attack of gout, doctors advise:

1. Observe complete rest. The diseased joint should be kept in an elevated state, putting a pillow under the foot.

2. Drink plenty of water. 5-6 glasses of liquid a day will accelerate the removal of uric acid from the body. It is best to make herbal tea, a decoction of rosehip or lingonberry juice. Do not add sugar.

3. Avoid aspirin. Aspirin and other nonsteroidal anti-inflammatory drugs (voltaren, diclofenac, etc.) can aggravate the condition by slowing the excretion of uric acid.

4. Use cold. If the affected joint allows you to touch it, you can attach a bag of crushed ice to it for ten minutes. The cold will have an analgesic effect.

5. Avoid animal food. High–protein animal products – meat, fish, liver, smoked meats, etc. - are harmful to gout. During the period of exacerbation, you can arrange fasting days every other day (vegetable, fruit, juice, dairy). Alcohol is completely excluded.

6. Remove excess uric acid from the body as soon as possible. Acid and its salts (urates) damage not only joints, but also kidneys, blood vessels, and other organs. To quickly remove them from the body, urgently consult a rheumatologist or arthrologist.

Great Sufferers

Famous gouty people were:

– Alexander the Great, Julius Caesar, Charlemagne, Charles XII, Louis XI, Frederick III, Henry VII and Henry VIII, Elizabeth I, Frederick II, Louis XIV, John the Terrible, Boris Godunov, Peter I, Oliver Cromwell, Admiral Nelson;

– Michelangelo, Dante, Beethoven, Rubens, Auguste Renoir, Guy de Maupassant, Charles Dickens, Ivan Turgenev;

– Martin Luther, Jean Calvin;

– Carl Linnaeus, Charles Darwin, Galileo Galilei;

– Thomas More, Erasmus of Rotterdam, Montaigne, Voltaire, Christopher Columbus, Chaplin, Churchill.

Not to be confused with "bone"

Quite often, gout is called another, even more common disease – a "bone" or "bump" on the first joint of the big toe caused by transverse flat feet. Scientifically, it is called "hallux valgus" (the finger is curved) and occurs among women 4 times more often than among men.

The cause of joint deformation is the weakness of the musculoskeletal system, but uncomfortable, narrow shoes, wearing high heels, standing work also provoke the development of "bones". At first, the cartilage tissue simply increases at the first joint of the thumb, but then the cartilage ossifies, the finger deviates more and more from a straight line, the foot deforms, the joint becomes inflamed and mercilessly hurts, and in severe cases does not allow walking at all.

In the early stages, special gymnastics for the feet, wearing orthopedic insoles and special orthoses help. In late and severe cases, doctors recommend surgical reconstruction of the entire foot. More than 300 types of various operations have been developed for such indications, which in itself indicates the complexity of the task. Unfortunately, the results of the operation are not always satisfactory. But there is no other option to fix the foot.

Portal "Eternal youth" www.vechnayamolodost.ru

Found a typo? Select it and press ctrl + enter Print version