Not everyone agreed that gout was a malady, or a bad thing. Some saw it as Nature’s warning, or as a deliverance from worse afflictions (it was better than haemorrhoids, for instance), and had no desire to be cured of it. As this book says, it was often regarded as a life assurance, not a death sentence. Gilbert Sheldon, Archbishop of Canterbury under Charles II, ‘supposedly offered £1000 to any person who would “help him to the gout”, looking upon it as the only remedy for the distemper in his head, which he feared might in time prove an apoplexy; as in fine it did and killed him’. William Cowper congratulated a friend on contracting the disorder, ‘because it seems to promise us that we shall keep you long’. Hester Piozzi’s husband grew worried and alarmed if his gout did not return regularly.Besides, gout was very much a mark of status. Lord Chesterfield said it was ‘the distemper of a gentleman, whereas the rheumatism is the distemper of a hackney coachman’. It attacked not only the wealthy but the creative, which meant that no man of letters could afford to be without it. Some thought it was the hallmark of genius, a view obstinately perpetuated by Havelock Ellis. In short, it was an honour to have gout and the phrase ‘the honour of the gout’ was in free use. The authors quote Earl Nugent’s apology to the Duke of Newcastle for failing to wait on him: ‘He received the Honor of His Grace’s card here, where he has been detained by the Honor of the Gout.’ For a person of the lower orders to aspire to the honour of the gout was unthinkable. Artisans and crofters did not know their luck; hard work every day kept uric acid at bay. ‘Live upon sixpence a day – and earn it’ was the cure for gout advocated by the surgeon John Abernethy.