Discoveries of early Māori skeletal remains showing tell-tale signs of gout have been corroborated by new evidence that dispels the myth that the disease was largely an upper class European affliction that did not affect any indigenous populations.
Researching historic newspapers and records of missionaries, early physicians and accounts by Captain James Cook and his crew, University of Otago PhD student Anna Gosling has found suggestions that Māori suffered from gout around the time of European settlement.
However, European observers did not recognise the disease among Māori as being gout, often referring to it in early reports of health as rheumatism, a term to describe general inflammatory joint diseases.
"Most of the papers discussing gout in Māori talk about gout as if it is a disease primarily related to transitions to modern lifestyles and the adoption of a westernised diet such as soft drinks, alcohol and highly processed foods," she says.
"However, the archaeological evidence for gout found earlier at Wairau Bar, and then at another prehistoric site from Mangere, Auckland, contradicts this. And in this review of early literature, not only were we able to find suggestion of gout among Māori during the 19th century in historic newspapers and other sources, but we have also put forward some ideas as to why this idea of a lack of gout among Māori during this time has been perpetuated."
The paper, recently published in the journal Rheumatology, builds on the work of Otago biological anthropologist Hallie Buckley and others, who reported skeletal evidence of gout in the koiwi from Wairau Bar and examined prior to repatriation in 2009.
Ms Gosling says gout had long been perceived as a disease of the aristocracy – a disease of affluence and sumptuous lifestyles.
"The Europeans who were reporting on the presence of certain diseases among the Māori may not have recognised the disease which the Māori were suffering as being gout because Māori were not living lifestyles of luxury and excess as seen in the upper echelons of European society at the time. This may be the basis for the high rate of 'rheumatism' being reported by such observers," she says.
This study and the skeletal evidence shows that genetic factors play a significant role and are likely to have meant that Māori had suffered from gout well before first European contact.
She believes there needs to be more awareness that gout is a disease which has affected Māori and Pacific peoples since very early on – probably since before they first arrived on the shores of New Zealand.
"While lifestyle, particularly diet, can contribute to the likelihood of developing gout, there is also a genetic component, which seems particularly strong among Māori and Pacific Islanders.
"This is something which both the clinicians, who treat gout, and the sufferers of gout, should be aware of. There is a precedent which dates back hundreds, possibly thousands of years (across the Pacific), for Māori and other Pacific peoples suffering gout. Given the importance of ancestry among Māori and Pacific communities, the link with tupuna means that gout is not just a result of how the patient is living, and an awareness of this may hopefully help promote the message that effective modern drugs are available to prevent gout," says Ms Gosling.
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