The interesting article by Hirschmann et al, titled “Death of an Arabian Jew,”1 brought back fond memories of a sabbatical spent in Israel in 1974. While working as a volunteer at several archeological digs, I had the opportunity to read Josephus, and came upon the description of Herod’s life and death. As a nephrologist, I found it easy to be persuaded at that time that he died of chronic renal failure and was surprised to find that no book in the medical library indicated this. Given the fact that Herod was a very wealthy man and a leader in the Roman Empire, I came up with a possible cause that was not mentioned in the article by Hirschmann et al.1 There had been substantial speculation over the years that exposure to lead contributed to the downfall of the Roman Empire.2-7 Apparently, only the wealthy could afford the wines that contained lead as a preservative, and the exposure to lead could be substantial.1-6 The problem of environmental lead exposure and progression of chronic renal disease exists to this day.8 Not only could lead exposure account for the chronic renal failure, it could also have contributed to the central nervous system and gastrointestinal expression of Herod’s illness. Modern methods for detecting lead in bone will make it possible to close this fascinating story when and if Herod’s remains can be found. As pointed out by Hirschmann et al,1 we know where to look. Correspondence: Dr Hollenberg, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115 (firstname.lastname@example.org). References 1. Hirschmann JVRichardson PKramer RSMackowiak PA Death of an Arabian Jew. Arch Intern Med 2004;164833- 839PubMedGoogle ScholarCrossref 2. Singhal RLThomas JA Lead Toxicity. Baltimore, Md Urban & Schwarzenberg Inc1980; 3. Nriagu JO Lead & Lead Poisoning in Antiquity. New York, NY John Wiley & Sons Inc1983; 4. Wedeen RP Poison in the Pot: The Legacy of Lead. Carbondale Southern Illinois University Press1984; 5. Lansdown RYule W Lead Toxicity: History and Environmental Impact. Baltimore, Md Johns Hopkins University Press1986; 6. Lynam DRPiantanida LGCole JF Environmental Lead. London, England Academic Press Inc1981; 7. Nriagu JO A history of global metal pollution. Science 1996;272223- 224Google ScholarCrossref 8. Marsden PA Increased body lead burden—cause or consequence of chronic renal insufficiency? N Engl J Med 2003;348345- 347PubMedGoogle ScholarCrossref
Archives of Internal Medicine – American Medical Association
Published: Dec 13, 2004
Keywords: kidney failure, chronic,lead poisoning
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