When Rheumatic Disease May Have Affected the Course of Western Civilization

Figure 1A PT2. (Click to enlarge.)

Herod the Great’s son, Herod Antipas (21 BCE–39 CE), was tetrarch of Judea and Perea, and the subject of artistic depictions, among which is Salome, the opera by Richard Strauss (Note: derived from an Oscar Wilde play that was inspired by a Gustave Moreau painting), in which the tetrarch ordered the murder of every male under age 2, killed his own sons and executed John the Baptist at the whim of his teenage daughter.^7,8

This Herod clearly experienced dementia, hallucinations, paranoia, heavy use of alcohol and drinking the emperor’s wine—a habit perhaps influenced or encouraged by his father’s behaviors—violence, twitches and sterility; different interpretations also show him with falls, chills, shaking, thirst, forgetfulness and sleepiness. We favor the diagnosis of chronic lead intoxication. He had compatible symptoms (e.g., encephalopathy and neuromuscular abnormalities) and consumed excessive quantities of imperial wine, known to be highly contaminated with lead and likely associated with similar symptoms among Roman aristocracy.^7,8

What if … King Herod the Great and/or Herod Antipas had not been such prolific consumers of Roman wine? Might the beginnings of early Christianity and the destruction of the Second Temple have been different?

Saturnine Gout, Sir William Pitt & the American Revolution

The gouty attacks of Sir William Pitt the Elder, the British prime minister, have been speculated to be one contributing factor to the American Revolution.^18,19 Pitt grew up in a wealthy family that delighted in a diet rich in protein and port; this contributed to numerous episodes of gout in both father and son.

Port wines from lead-lined vats in Portugal have previously been shown to contain toxic amounts of lead, explaining the epidemic of saturnine gout among British aristocracy of that era.^17,24 Pitt became a powerful political force and, ultimately, prime minister. He was an outspoken champion of the colonies, believing the American colonies deserved representation with their taxation. Pitt developed an acute episode of gout the night before the vote for the Stamp Act of 1765, stayed home and missed the parliamentary debate; Pitt opposed the act, and historians opine that his influence would have prevailed. The Stamp Act passed and, together with the Tea Act, helped precipitate the American Revolution.¹⁹

What if … Pitt, who was influential and sympathetic to the colonies, had not had an acute episode of (saturnine) gout on the eve of that fateful parliamentary debate that led to the passing of the Stamp Act? How different might American and British history have been?