摘要:We describe the oldest evidence of gout from skeletal remains found in Asia. A middle-aged male skeleton excavated from the shell mound at Ohta in Onomichi-city, Hiroshima prefecture, Western Japan (the middle Jomon period: 4500-3500 BP), showed erosive arthritis in the forefoot. The characteristic feature of the erosions observed in the present skeleton is a periosteal bone apposition at the outer aspect of the involved cortex and a “punched-out” configuration as seen in radiographs. In addition to thesepaleopathological indings, a pauciarticular nature, involvement of the forefoot, male gender and a lack of perilesional osteopenia provided further support for the diagnosis of tophaceous gout. Because gout is associated with good nutrition, the presence of some well-nourished society in Jomon period should be considered.