The College of Physicians of Philadelphia Digital Library

Hands with Gout

About This Item


Hands with Gout




These preserved human hands from the 19th century show the physical signs of a painful condition called gout. The swollen masses visible on the knuckles are called tophi.

Gout is a form of arthritis that can affect any joint in the body, commonly beginning with the great toe. In gout, high levels of uric acid in the blood lead to the formation of urate crystals around joints. This causes swelling, pain, and redness. Causes of gout include certain types of medication, inactivity, and a diet rich in meat, seafood, and alcohol. From 2007 to 2008, 8.3 million people reported suffering from gout in the United States. It is more common among men than women.

Gout was not uncommon in the 19th century, especially among wealthy men, who were likely to consume a diet rich in animal protein and alcohol. However, there may have been a more insidious cause of the condition. Lead, a toxic heavy metal, was in widespread use at the time. Everyday items such utensils, bottle lids, and paint often contained lead. In 2012, researchers found that long-term exposure to low levels of lead was associated with gout.

In the past, physicians would treat gout episodes by elevating and bandaging the joint, and using bloodletting to reduce the swelling and inflammation. Today, physicians treat gout with medications and recommend physical exercise and diet changes to prevent recurrence.


Digitized by the Mütter Museum of The College of Physicians of Philadelphia






19th Century

Original Format

Human hands, preserving fluid, glass


“Hands with Gout,” The College of Physicians of Philadelphia Digital Library, accessed May 18, 2021,