Note 1 — Chapter I · HISTORICAL AND INTRODUCTORY

Ewart, discussing the antiquity of gout, observes that it is “certainly as ancient as civilisation,” and as far as we can identify them in the accounts handed down from remote ages, the etiology, the leading symptoms, the outward characters of the articular gout of the ancients were practically the same as belong to gout in our own times! But of its relative prevalence in antiquity we have no means of judging. Continuing, he holds that “the ultimate lesions of gouty arthritis and its pathology are presumably as immutable as those of osteoarthritis.” This may be so, but such objective evidence as we possess certainly points to the greater antiquity of osteoarthritis as the following quotation from our work, “Arthritis Deformans,” testifies:—

“During the course of some excavations undertaken by the Survey Department of the Egyptian Government in that tract of Nubia lying immediately south of the First Cataract, over 6,000 bodies were brought to light, comprising among them representatives of all periods from early pre-dynastic times down to the fifth century after Christ. As the result of their examination of this vast accumulation of human débris, Professor Elliot Smith, in the Nubian Survey Bulletin, states that “The disease which shows itself with by far the greatest frequency in the bodies of all periods is rheumatoid arthritis” (Osteoarthritis).