|Punch cures the gout, the colic, and the ‘tisick, 1799
Two great political figures, William Pitt the Elder (later to become Lord Chatham) and William Pitt the Younger, shaped the destinies of Great Britain during the second half of the 18th century. The father was the main architect of England’s victory in the Seven Years War (in America the French-Indian War). The son became the youngest ever prime-minister of England and led his country in the war against Napoleon Bonaparte. They are remembered to this day by many places named after them, notably Pittsburgh after the father, Pitt Street in Sydney and Hong Kong after the son. Of medical interest, both suffered from gout for much of their lives.
During the 18th and 19th centuries gout was highly prevalent in England. Stories are told of medical students visiting from the continent and shown an acutely inflamed joint, being unfamiliar with gout in their own countries, would recommend surgical drainage to the great amusement of their English colleagues. Gout affected especially the upper classes. Possibly occurring on a hereditary basis, it more likely was due to drinking port delivered from Portugal in caskets of lead, which also gave it a pleasant sweet taste. Other sources of lead, such as lead pipes and drinking vessels, may have also played a part, causing not only so-called Saturnine gout but also hypertension and kidney failure.
William Pitt the Elder was the grandson of “Diamond Pitt,” so called from the huge diamond he brought from India hidden in his son’s shoe and later sold to the Duke of Orleans for a profit of 450%. Born in 1715, he inherited one of the family’s rotten boroughs in which only five people could vote, and made his fame in the House of Commons by means of his brilliant oratory and vitriolic attacks against the government. Known as the “Great Commoner,” he became secretary of state in 1756 and single-handedly managed the Seven Years War against France in which England acquired a huge empire, including India and Canada. Relevant to our modern times, he laid it down as early as 1740 that England should never assist its allies with a great number of troops, but support them with its Navy and money, especially as soldiers in Europe cost less to maintain and therefore one could have a greater number of them.
In 1760 William Pitt was dismissed by the new king, George III, and became Lord Chatham. While in opposition he was for a time “totally incapacitated for business.” Prime minister again from 1766 to 1768, he seems to have entered the depressive phase of manic depressive illness, scarcely seeing any of his colleagues even when urgently pressed for interviews, and even declining an offer from the king to visit him. After 1768 he returned to active political life, opposing the Stamp Act and the war against the American colonists. In 1778 he famously collapsed while speaking in the House of Lords and died soon afterwards.
|The Collapse of the Earl of Chatham in the
House of Lords
|William Pitt the Younger in the
House of Commons
The son, William Pitt the Younger, born in 1750, was brought up and educated in his illustrious father’s house. He entered Cambridge University at age 13, and became prime minister at 24 years. For his extraordinary skill and competence, he has been regarded as one of Britain’s greatest prime ministers, a great administrator and inspiring leader. Cool, aloof, and sarcastic, he was not popular but highly effective. Work was his passion. When asked about a possible marriage, he replied that he was married to his country. He was prime minister from 1783 to 1801, and then again from 1804 until his death in 1806.
From childhood he had suffered from poor health and was troubled by recurring attacks of gout from the age of six. In his first year at Cambridge he became so ill that he had to be transported home by carriage and put under the care of his physician, Dr. Addington. At this point he received the famous piece of medical advice that may possibly have contributed to his early death three decades later. In addition to going to bed early, ending his habit of studying classical literature into the night, and taking a special diet and regular exercise on horseback, he was also advised to take a hefty dose of port wine every day, a habit he continued throughout his life.
He died at age 46. He had become increasingly emaciated and feeble, his face yellow, his looks dejected. Troubled by abdominal pain, he was eating but little. To fortify himself, he was drinking at dinner as many as 20 glasses of wine. To no avail, his doctors prescribed asses’ milk, chicken broth, and yolk of egg, later also rhubarb, paregoric elixir, and infusions of cascarilla. He died in January 1806, a few days after hearing of Napoleon’s victory at Austerlitz. Some authors think he died from peptic ulceration and pancreatitis, others from kidney failure due to uric acid crystal precipitation and the effects of lead. He probably also had cirrhosis of the liver.
Lord Rosebery. Lord Chatham. Harper & Brothers Publishers: New York and London, 1910.
Edward Pierce. Pitt the Elder, Man of War. Pimlico: London, 2011.
Sir Charles Petrie. William Pitt. Duckworth: London, 1935.
William Hague. William Pitt the Younger. Harper Perennial: London, 2005.
Robin Reilly. William Pitt the Younger. GP Putnam’ Sons: New York.
George Dunea, MD, Editor-in-Chief (Winter 2012)