How mismanagement of gout could have impacted the American Revolution
Penn biology professor Philip A. Rea has written a provocative piece examining how gout sidelined two influential 18th-century British leaders and why England eschewed an effective gout treatment.
2 min. read
Did gout—and rejection of a flower-derived chemical called colchicine as a means of treatment—alter the course of the American Revolution?
“The piece is deliberately tongue-in-cheek—I am not suggesting that colchicine ‘caused’ the Revolution,” Rea says. “But it speaks to how history is shaped by both grand forces and trivial, domestic contingencies. In that sense, it offers a quiet reminder that empires, like bodies, may be undone from within as much as they are conquered from without.”
Rea cites two examples of gout—a painful inflammatory arthritis that can lead to excruciating pain and swelling—sidelining influential 18th-century British leaders.
Admiral George Brydges Rodney “was widely regarded as Britain’s most formidable seaman” for his tactical innovations, Rea writes, but in 1781, he was incapacitated by gout. The “hesitant and indecisive maneuvers” of his replacement at the Battle of the Chesapeake led to British withdrawal and the subsequent American victory at the Battle of Yorktown. Six months later, in the Battle of the Saintes, Rodney led the same British ships from the Battle of Chesapeake to victory against the same French admiral.
The decade prior, an eloquent British parliamentarian who advocated for colonial rights, William Pitt the Elder, was absent due to gout when Parliament enacted the Stamp Act of 1765 and the Townshend Revenue Act of 1767, which imposed new import duties on paper, glass, tea, and more. Pitt had moved for the repeal of the Stamp Act in the interim. The “escalating provocations” of these acts might not have occurred if Pitt’s gout had not “removed his formidable voice of restraint at two crucial moments,” Rea writes.
Physicians in mainland Europe at the time were successful in treating gout with a tincture made from the autumn crocus (Colchicum autumnale). Butcolchicum was largely excluded from medical practice in England, as the influential English physician Thomas Sydenham eschewed the treatment of gout, believing that people died from mismanagement rather than from the disease. It would take decades—and advocacy from a prince regent—for colchicum to return to British medicine.
Rea says his article “advocates for humility regarding medical orthodoxy: Treatments come and go, and history can often teach us more than we expect.”
This piece grew out of an article he has been working on about colchicine. Rea explains that colchicine is attracting renewed attention because of its potential to dampen the inflammation that contributes to atherosclerotic cardiovascular disease, a major component of the world’s leading cause of death.
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