Doctor Roderigo Lopes. Some items of medico-historical interest.

have been the result of tophi-large deposits of chalky concretions composed of needle-shaped crystals of monosodium urate. Unfortunately, if any tophi survived after two millennia in the soil, they were not recognized at the excavation and subsequent cleaning of the skeleton. It will be noted from the above description and from the plates that many of the lesions are not strictly para-articular but occur well away from the joints. Gouty tophi with this distribution are not especially unusual. These clear, punched-out defects and the relatively well-preserved articular surfaces of the ankle joints all agree with this diagnosis. The outstanding example of gout in the history of palaeopathology is an Egyptian mummy of the Coptic period, which was described by Elliot Smith and Warren Dawson (1924). In that case tophi survived and were retained in position by the tendons of the feet and elsewhere. Apart from that solitary specimen there seems to be no other wholly convincing and unambiguous example in early material. The present case, therefore, must rank as being of quite exceptional interest and importance. One further fact may be significant. This skeleton came from a cemetery whose occupants had a low economic standard, as shown by the paucity and poverty of their grave goods and by their inhumantion in cheap wooden coffins or simple shrouds. Of the 268 burials only two were buried in handsome stone sarcophagi-a sign of relative opulence. One of these is the man described here and we may wonder, perhaps, whether his gout was causally related to a well-lined pocket and an over-indulged belly.