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 . . .