Gold drugs are still amongst the most efficacious for the treatment of rheumatoid arthritis. Their mechanism of action, as well as the molecular basis of their side-effects, remain poorly understood. Current theories are reviewed, including recent potential breakthroughs. The interaction of gold(III) with peptides and proteins and its immunochemical implications are discussed.Ninety elements occur naturally on earth of which 9 are radioactive. Eighty-one elements are therefore potentially available to support life, of which 61 are metals. It is believed that about 25 are essential for human life but our knowledge of the biochemistry of several of these (e.g.V; Ni, Sn) is poor. In general, therefore, there is enormous scope for the use of inorganic compounds in medicine, and a need for research in this area. Metals currently used in medicine include gold in antiarthritic agents, platinum in anticancer drugs, lithium for manic depression, bismuth in anti-ulcer drugs, and silver and mercury in antimicrobial agents (1). The effectiveness of ruthenium complexes as anti-metastatic agents with potential use in cancer therapy is currently receiving much attention (2). However, the potential of inorganic metal compounds as drugs has yet to be fully explored. With the exception of platinum, which has attracted the most research efforts because of its importance in the therapy of some types of cancer, and which is now generally thought to be effective by interaction with DNA, the mechanism of action of other inorganic drugs is mostly unknown.One of the problems of inorganic drugs is their side-effects. For gold drugs used in the therapy of * Hypersensitivity is an adaptive immune response occurring in an exaggerated or inappropriate form causing tissue damage. It is a characteristic of the individual and is manifested on second contact with the particular antigen (in this case gold drugs). Delayed-type hypersensitivity takes more than 12 hours to develop and is mediated primarily by T cell and macrophages.