Lead and wine. Eberhard Gockel and the colica Pictonum

Thecolica Pictonum or colic of Poitou, under these and many other names, was a frequent, widespread, and deadly disease from Roman times until the eighteenth century. Its unique pathognomonic, notably a severe colic succeeded by paralysis and other central nervous system dysfunction, makes it possible to identify the disease with certainty as chronic lead disease, usually caused by the ingestion of lead-adulterated wines. The custom of sweetening and preserving sour wines with lead-containing additives is traced to the Romans. They had made the empirical discovery that sapa, a syrup prepared by concentrating must in a lead vessel, kept wine from spoiling and that it had, moreover, an agreeable flavour.Reports of outbreaks of the colica Pictonum appear in the medical literature from Roman times, but the correct aetiology of the disease was not discovered until the seventeenth century following a series of outbreaks in Southern Germany which were related to unfavourable climatic and political conditions. The connexion between the disease and prevailing methods for "correcting" wines was drawn in 1696 by Eberhard Gockel, then the city physician of Ulm. This achievement can be traced to his familiarity with Samuel Stockhausen's work on plumbism among miners and potters, as well as to the favourable epidemiological situation presented by Gockel's monastic patients. From the literary evidence assembled here and from experimental determinations of the lead content of sapa and similar concentrates, it is possible to estimate the lead levels and toxicity of wines from various eras. The levels range up to 80 mg/l and make it apparent that many wines were sufficiently toxic to account for the incidence and severity of the colica Pictonum. Explanations for the disastrous persistence of the colic of Poitou are discussed, as are the similarities between Gockel's approach and the methods of modern environmental medicine.