Saturnine Gout among Roman Aristocrats

Abstract

Although Musgrave is generally credited with the first report of coexistent gout and plumbism,1 it was Sir Alfred Garrod who clearly demonstrated the high incidence of plumbism in subjects with gout and adduced a causal relation between the two disorders.2 The effect of lead on renal tubular function is well known; damaged tubules apparently cause retention of uric acid, which many clinicians believe is responsible for gout.3 Saturnine gout can also be attributed to the accretions of guanine (a highly insoluble purine) resulting from the inhibition by lead of guanase (guanine aminohydrolase) activity.4 Indeed, gout is now widely regarded as . . .