Rheumatology Advance Access originally published online on January 27, 2009
Rheumatology 2009 48(4):375-377; doi:10.1093/rheumatology/ken493
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The ‘gout’ of the Medici, Grand Dukes of Florence: a palaeopathological study
1Department of Oncology, Transplants and Advanced Technologies in Medicine, Division of Paleopathology, University of Pisa, 2Department of Archaeology and History of Arts, Section of Medieval Archaeology, University of Siena and 3Department of Clinical Physiopathology, Section of Clinical Radiology, University of Florence, Italy.
Correspondence to: Gino Fornaciari, Department of Oncology, Transplants and Advanced Technologies in Medicine, Division of Palaeopathology, University of Pisa, Via Roma 57, 56126 Pisa, Italy. E-mail: g.fornaciari{at}med.unipi.it
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Abstract |
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Objective. According to the written sources several members of the famous Medici family of Renaissance Florence suffered from an arthritic disease, called ‘gout’ by contemporary physicians; a palaeopathological study allowed verification of the true nature of the ‘gout of the Medici’ referred by archive document data.
Methods. The skeletal remains of the Grand Dukes and their families, buried in the Basilica of San Lorenzo in Florence, were examined macroscopically and submitted to X-ray investigation.
Results. Out of 15 investigated individuals, two cases of diffuse idiopathic skeletal hyperostosis (DISH), with ossification of the anterior longitudinal ligament and massive hyperostotic changes of the extra-spinal ligaments, were detected in the skeletons of the Grand Dukes Cosimo I (1519–74) and his son Ferdinand I (1549–1609). The left foot of Ferdinand also revealed typical lesions of the uratic gout, confirming the archive data, which describe the disease in detail.
Conclusions. The association between DISH and elite status, highlighted in recent research, receives further confirmation in the present study, furnishing evidence to the significance of this disorder as a lifestyle indicator, linked specifically with a high-caloric diet, consequent obesity and type II diabetes mellitus. Furthermore, the coexistence between DISH and gout observed in Ferdinand represents the first documentation of this association in the palaeopathological literature.
KEY WORDS: Renaissance, Florence, Medici, Cosimo I, Ferdinand I, Diffuse Idiopathic Skeletal Hyperostosis, Gout
Submitted 5 August 2008;
revised version accepted 4 December 2008.
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  G. M. Weisz Comment on: The 'gout' of the Medici, Grand Dukes of Florence: a palaeopathological study Rheumatology, August 1, 2009; 48(8): 1014 - 1015. [Full Text] [PDF]
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