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Article
December 11, 1909

FOUR GENERATIONS OF AMERICAN GOUT

JAMA. 1909;LIII(24):2000-2001. doi:10.1001/jama.1909.92550240001001k
Abstract

The following series of four instances of chronic food-poisoning in four successive generations is submitted for its diagnostic interest, as well as because of its value in suggesting for therapeutic and hygienic attention the ground condition underlying similar obscure cases:

Case 1.  —The patient first came under my medical observation in 1901, when in her eighty-eighth year. She had always been a full eater, but did not consider herself unusual in the matter of appetite. The joints of the fingers and toes showed unmistakable, gouty changes, and the history given was that of an increasing disability of these small joints. On Oct. 10, 1901, while stepping from a carriage she felt a severe pain in the right knee, which gave way, letting her down on the ground. She was in great pain ; the knee when seen by me was hot and considerably swollen, and there was some fluctuation evident above

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