The Severe Gout of Holy Roman Emperor Charles V

Abstract

o c c a s i o n a l n o t e sT h e ne w e ngl a nd jou r na l o f m e dic i ne n engl j med 355;5 www.nejm.

High performance liquid chromatography (HPLC) in the investigation of gout in palaeopathology

“…The relative lack of urate crystals in the samples examined in the present study, and the negative murexide test, suggests that neither sodium monourate nor uric acid is present in sufficient quantities to be the predominant constituent of the powder. (This is in contrast to the incontrovertible evidence of large numbers of urate crystals under polarising microscopy in the mummified specimen from Charles V [Ordi, 2006].) The finding of calcium apatite by X-ray diffraction suggests that the powder could be the residuum of a calcified tophus, although the apatite could have been due to bone dust contamination of the specimen.…”

“…Only two cases of tophi have been identified in the archaeological record, both in mummified remains. One is an early Christian mummy in Nubia (Eliot Smith & Dawson, 1924), and one in a finger of the Habsburg Emperor Charles V of Spain (Ordi et al, 2006).…”

Palaeopathology: The Study of Disease in the Past

“…A paradigm of the latter is the case of Ferrante I of Aragon, King of Naples during the XV century who, according to the microscopic and molecular results provided by Marchetti et al [63], most likely died of colorectal cancer, according to our knowledge, the first bona fide molecular demonstration of a malignant neoplasm in a historical subject. Similarly, the reported death of Francesco I of Medici by malaria and the severe gout of Emperor Charles V of Augsburg, most likely influenced some historical events during the XVI century [64,65]. Very recently, the family lineage and the pathologies affecting Tutankhamen and his possible cause of death have been widely covered by the media and have led to a renewed interest in palaeopathology [66].…”

A Case of Gout from Imperial Rome (1st-2nd Century AD)

“…In more recent times, gout has afflicted many historical figures, like Ferdinando I of the Italian Renaissance family of the Medici [24] or the Roman Emperor Charles V of Spain [25]. Descriptions of pathological cases in ancient skeletal remains are useful to understand the origin and history of diseases and their development or changes in the time, and this is useful to better understand current illness and can help to predict future diseases.…”