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But disease and metaphor inevitably go hand in hand. This was especially true in the days when gout was mysterious, before Queen Victoria's future physician showed it was caused by uric-acid crystals producing excruciating pain in the extremities. Milton told a friend that if he were only free of gout pain, blindness would be tolerable. The pain felt "as if I was walking on my eyeballs," writes one sufferer. Since one had to be rich to live long enough to get gout, and most victims were males (many of whom drank port laced with gout-intensifying lead), it won a reputation as just punishment for high living, and even a kind of badge of meritocratic honor. It was God's gift to caricaturists like Hogarth, Cruikshank, and Gillray. George Eliot used gout as a symbol for a sick society in Middlemarch. The data fascinates, but the professors don't wear their learning lightly. Still, they do score some good phrases. Explaining that there aren't many portraits of gout sufferers because few victims would pose, they write, "Who wants to be remembered as a septuagenarian freak of Falstaffian glob?" --Tim Appelo
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