Occasional Notes
Saturnine Gout among Roman Aristocrats — Did Lead Poisoning Contribute to the Fall of the Empire?
N Engl J Med 1983; 308:660-663March 17, 1983DOI: 10.1056/NEJM198303173081123
This article has no abstract; the first 100 words appear below.
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 . . .
Jerome O. Nriagu, Ph.D.
National Water Research Institute Burlington, ON L7R 4A6, Canada







