Gout brings down an emperor

By tsmith on August 11, 2006.

Missed this while I was out last weekend, but John Hawks has a link to a story noting that a new analysis shows that Holy Roman Emperor Charles V suffered from gout, thought to play a key role in his abdication of the throne.

(More below...)

A 450-year-old piece of Charles V's pinkie lends support to the theory that it was gout that led one of the most powerful rulers of all time to abdicate, Spanish researchers report.
Holy Roman Emperor Charles V, whose empire stretched across Europe and included Spanish America, was diagnosed with gout by his doctors in early adulthood. By the end of his reign in 1556, he was a crippled man who could barely walk at times or ride a horse, said Dr. Pedro Luis Fernandez, a pathologist at the University of Barcelona.

"His physical suffering influenced decisions that affected the future of many countries," Fernandez and his colleagues reported in Thursday's New England Journal of Medicine.

I've mentioned previously that I'm just fascinated by these modern-day studies of long-ago infectious diseases, whether it be molecular studies of historical epidemics or historical ruminations about fictional characters. For this one, they used simple histology and analysis using X-rays and electron microscopy to identify urate crystals characteristic of gout--confirming the 450-year old diagnosis. As noted in the MSNBC article:

Dr. Howard Markel, director of the University of Michigan's Center for the History of Medicine, said lab tests on preserved body parts are providing valuable information.

"What used to be almost the doctors' equivalent of a parlor game -- Did Lincoln have Marfan's disease? Or did Nero have lead poisoning? -- has actually become a rather unique tool in the exploration of the history of medicine and the history of disease," Markel said. "I think this is a perfect example of that."

Reference

Ordi et al. 2006. The Severe Gout of Holy Roman Emperor Charles V. NEJM. 355:516-520. Link

Image from http://worldroots.com/brigitte/royal/kent/charles5emperor.jpg

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