Further, Hippocrates was the first to associate the disease with a specific lifestyle (an arthritis of the “rich”), distinguishing it from rheumatism which afflicted the poor and introduced the term “podagra” signifying the involvement of the great toe, differentiating this presentation of the disorder from “chiagra” (involvement of the wrist) and “gonagra” (involvement of the knee). With these maxims, Hippocrates bestows the condition a personality-an affliction of mature, sexually active men. Among his many contributions to clinical medicine, his observations concerning gout ( the unwalkable disease) include his five aphorisms, truths which have held for 2500 years (Table 2). Yet, despite his enduring fame and legacy, little is actually known about his thoughts, writings, and work habits. Often referred to as the father of western medicine, he is widely known for the Hippocratic Oath which is still recited at medical school graduation ceremonies across the globe. Hippocrates of Cos was a Greek physician in the Age of Pericles (Classical Greece), now regarded as perhaps the most outstanding figure in the history of medicine. However, the historical record concerning the clinical features of gout, its presentation, and natural course begins with Hippocrates (460–370 BC) in whose writing is found the first description of the condition. While virtually nothing is known concerning the clinical recognition of the disorder in these early times, together these discoveries establish gout as a disease of antiquity. In addition, Smith and Jones (1910) described uric acid accretions in the great toe of an elderly male buried in an ancient Egyptian cemetery, the oldest known example of tophi. The oldest recorded example of uric acid deposition is the demonstration of a uric acid contacting renal calculus found in an Egyptian mummy dating back 7000 years. Although the first clinical description of this condition is attributed to Hippocrates, important contributions to our knowledge concerning its history have been derived from archeological studies. Īn historical chronology of gout highlighting the important milestones in our understanding of this disorder is shown in Table 1. “is the most violent of all joint affections, it lasts long, and becomes chronic… the pain may remain fixed in the great toes … it is not fatal”. This paper reviews the history of this disease emphasizing how clinical observation lead to mechanistic understanding, upon which rationale therapy was developed. Coupling these sociological phenomena with its remarkable story of scientific discovery, gout fascinates at multiple levels. Accompanying this written outpouring has been an equally vigorous portraiture depicting the experience with the condition. With origins in antiquity, gout has not only seized the interest of physicians, but also provoked a voluminous literature, frequently products of its sufferers. Due to its unique presentation, well-established pathophysiology, and effective therapy, gout as a condition is well known to rheumatologists, indeed physicians of every stripe. Affected joints become markedly inflamed and painful, some patients depositing concretions of uric acid (likened to chalk) into the affected joints, known as tophi. Its course is punctuated by the episodic deposition of urate in the joints of the extremities, particularly the great toe. The NHLBI is leading and supporting research and clinical trials to find a cure for sickle cell disease.Gout is a disorder of uric acid metabolism resulting in excessive concentrations of uric acid in the blood. Your healthcare team will work with you on a treatment plan to reduce your symptoms and manage the condition. Sickle cell disease is a lifelong illness. A blood and bone marrow transplant is currently the only cure for sickle cell disease, but there are effective treatments that can reduce symptoms and prolong life. The blocked blood flow through the body can lead to serious problems, including stroke, eye problems, infections, and episodes of pain called pain crises. These cells do not bend or move easily and can block blood flow to the rest of your body. If you have sickle cell disease, your red blood cells are crescent- or “sickle”-shaped. Normally, red blood cells are disc-shaped and flexible enough to move easily through the blood vessels. The condition affects more than 100,000 people in the United States and 20 million people worldwide. Sickle cell disease is a group of inherited red blood cell disorders that affect hemoglobin, the protein that carries oxygen through the body.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |