The Severe Gout of Holy Roman Emperor Charles V

Holy Roman Emperor Charles V was known to have had attacks of gout from early adulthood. This study provides objective confirmation of the clinical diagnosis on the basis of an examination of the mummified terminal phalanx of one of his fingers. The analysis demonstrated typical gouty tophi, eroding bone and extending into the soft tissues. Holy Roman Emperor Charles V was known to have had attacks of gout from early adulthood. This study provides objective confirmation of the clinical diagnosis on the basis of an examination of the mummified terminal phalanx of one of his fingers. Holy Roman Emperor Charles V (who was also King Charles I of Spain) was one of the most powerful rulers of all time (Figure 1A). His 40-year reign (1516–1556) occurred during the transition from the Middle Ages to modern times. He was a global leader, governing territories in Europe, Africa, and Asia as well as the conquered territories of the Aztec Empire of Mexico and the Inca Kingdom of Peru. Given this reach, he was described as ruling an empire “in which the sun does not set.” Despite this power, Charles V had to live within the limitations of very . . .