Gout is a painful disease of the joints, often associated with high-achieving intellectuals, and high fat diets, Benjamin Franklin, Isaac Newton, Charles Darwin, Henry the VIII, and Imanuel Kant had gout, to mention a few. Franklin wrote a dialogue with Madam Gout, at midnight, October 22, 1780, very funny. And six months ago it struck me too – less funny. I developed the classic symptoms: swelling, redness, and pain in my big, left toe.

I followed the classic cure: I drank lots of water, took aspirin (a mistake, apparently) and wrapped my toe using hockey tape. It helped slightly. A neighbor assured me it was gout, suggesting ibuprofen and a change of diet: Water, avoid meat, sugar, and alcohol. For a week, I did this and kept my toe wrapped, but it didn’t get better. So, I went to a foot specialist who removed the bandage, and pronounced it as gout, a disease caused by uric acid crystals in the joints. He took x-rays that showed nothing, prescribed a slightly different diet and a week of colchicine pills. He also suggested cortisone shots mixed with Novocain, I said no to the shots, but took the colchicine and followed the new diet for two weeks. But they did no good.

Then, one day, I wandered into a New Balance store. The lady asked if I wanted my foot measured, something that I’d not done in 35 years. I said “yes,” and discovered that my feet had expanded about a size and a half, from 9 wide to somewhere between 10 1/2 and 11. I bought comfortable jogging shoes in size 10 1/2, and found that the pain started going away almost immediately. Two months later, the pain is still gone, except for a few days after I tried wearing an old pair as an experiment. I’ve come to think that many, or most gout cases are not gout at all, but caused by walking in too-tight shoes. Surely there are some real gout cases, but it can’t hurt to try new shoes. They may cure you, and even if you have real gout, you might want shoes that really fit.

Take a look at some paintings from the 18th century that depicting people with gout. Generally, like in the painting above they show fat, old men with one foot wrapped, and typically another, unwrapped foot in small, tight ?, shoes. It seems possible that much of their gout in these pictures was the result of too-tight shoes.

Robert Buxbaum, November 10, 2026.