One of the more interesting theories which seeks to explain at least some part of The Fall of the Roman Empire is the lead poisoning theory. Lead poisoning, or Saturnine Gout.

In the 18th and 19th centuries, gout was considered to be symbolic of a wealthy, aristocratic lifestyle - a fact which is attested to by the literature of the time. Roman literature reflects a similar view. First mentioned by Hippocrates as a disease which appeared to be caused by rich foods and wines, Seneca viewed gout as an example of the depravity of the age in which he lived in. Other authors such as Virgil, Ovid, Martial and Athenaeus used gout as a target of their satire. Galen is said to have coined the aphorism

"Gout is the daughter of Bacchus and Venus"
In Roman literature a strong link is therefore made between gout and rich foods and alcohol. Roman wines were enhanced by a grape syrup which improved the color, sweetness and preservation of the wine, often called sapa or defratum. Sapa, by tradition of the time, was to be simmered slowly in a lead lined pot or kettle. The sapa was then mixed in to the wine at the concentration of between 250 and 1000 Milligram per liter - an enormous amount considering only one teaspoon of sapa would have been enough to cause chronic lead poisoning. The average consumption of wine in ancient Rome was between 1 to 5 liters per day. This, in combination of the effects of the lead water pipes, and the use of sapa in other recipes to replace sugar, results in a conservative estimate of about lead consumption, per day, of at least 250µg, in comparision of with the World Health Organization's maximum recommendation of 45µg per day.

The psychological profiles that we have of the emperors, hyperbole aside, anecodotally describe a great deal of potential lead poisoning. Claudius is the most likely candidate for lead-poisoning. He suffered disturbed speech, weak limbs, fits of excessive inappropriate laughter and he often slobbered. He suffered recurring attacks of stomachache which reportedly could drive him to the brink of suicide. Not only this, but Claudius was a known alcoholic, even by Roman standards.

Tiberius, Caligula, Galba, Nero, Nerva and almost all of the late-Empire emperors were known to be both heavy drinkers and suffer gout-like symptoms. Elagabalus in particular was a huge pleasure seeking emperor, with enormous banquets, exotic dishes and blended wines. His alcohol consumption was so legendary that he was his contemporaries thought he have been drinking from a swimming pool. He was also, no doubt due to lead poisoning, mentally impaired.

It is therefore clear that a great deal of lead-poisoning and ensuing lack of mental health that was common in the Roman Empire. Gout would not have affected only the Emperors, but any wealthy Romans, including those in important decision making areas, including those who would serve in the military. While a direct causal link is not available between lead-poisoning and the inability to make good decisions regarding the fate of the Empire due to the lack of hard evidence, it is clear that lead-poisoning was certainly a factor in at least its moral decline, if not leaving it more internally vulnerable.

- Jerome O. Nriagu. "Saturnine Gout amoung Roman Aristocrats" New England Journal of Medicine. March (1985): 660-3