Looking Back

Views from the gallery

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7021.1712 (Published 23 December 1995) Cite this as: BMJ 1995;311:1712
  1. Fiona Haslam, retired medical practitionera
  1. aBolton BL1 5EB


    Thomas Sydenham wrote in 1705

    The gout most commonly seizes such Old men, as have liv'd the most part of their Lives tenderly and delicately, allowing themselves freely Banquets, Wine, and other Spirituous Liquors, and at length by reason of the Sloth that always attends Old-Age, have quite omitted such Exercise as young Men are wont to Use. Moreover they who are Subject to this Disease have large Skulls, and most commonly are of gross Habit of Body, moist and lax, and of strong and lusty Constitution, the best and richest Foundation for Life.

    William Hogarth may never have read any of Sydenham's works, but he did portray a typical gout sufferer—in line with the physician's prescription—in the first scene of his series Marriage a la Mode (1745). Here is a middle aged, well endowed figure, his Constitution stretching back to William the Conqueror, complete with the stereotypical bandaged foot, footstool, and crutches. This man's character, presented with a few brush strokes, is flawed: the gout represents physical, moral, and social defects.

    Fig 1

    The Marriage Contract. …

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