Alcohol in Gout
Said Sir Thomas Watson: “I am sure it is worth any young man’s while who has had the gout to become a teetotaler.” Few will gainsay the wisdom of this advice. But I would fain go further and impress on gouty parents the incumbent duty of bringing up their children as total abstainers. For gout, once avowed, has a vicious tendency to recurrence. The illustrious Sydenham, I think, would have approved of such advice: “Water alone is bad and dangerous, as I know from personal experience. When taken as the regular drink from youth upwards it is beneficial.”
When, however, gout attacks a man for the first time in middle or late life, most authorities agree that an abrupt change of habit in respect of stimulants is of questionable wisdom. In saying this, I do not for one moment mean that excess should be approved, but that I do not believe that the enforcement of total abstinence is prudent. In such cases restriction, not total elimination, is the better course. One must recollect, too, that total abstainers are by no means exempt from gout, while, on the other hand, many, if not the majority, of drunkards are. The latter have their penalties, cirrhosis, etc., but not inevitably gout.
I agree that gout is infinitely more common in those who take alcohol than in those who abstain therefrom. But nowadays, at any rate, the “gouty” as a class cannot with fairness be ranked as among the confessedly intemperate. With relatively few exceptions, they belong rather to those given to what may be termed the legitimate use of alcoholic beverages. My conclusions then are that:—
(1) The children of “gouty” parents should be brought up as total abstainers.
(2) The incidence of a first attack in a young man should be the signal for abstinence from alcohol in all forms.
(3) Given its occurrence in an older subject who has used alcohol but sparingly and stands in no need of it as a stimulant, the same total abstinence should be inculcated.
(4) In middle-aged or old subjects habituated to the use or abuse of alcohol abstemiousness, not abstinence, is the safer course.