ESSENTIAL lipemia is a rare disease. In a recent review, Movitt, Gerstl, Sherwood, and Epstein1were able to find 14 previously reported cases and added 3 of their own. While the occurrence of xanthomas in the skin, lipemia retinalis, hepatomegaly, and splenomegaly was frequent in this series, the occurrence of gout or peripheral neuritis is not mentioned. These authors stated: "In contrast with familial hypercholesteremic xanthomatosis, premature arteriosclerosis and atheromatosis have not been observed in idiopathic hyperlipemia of adults." Wolfson, Cohn, Levine, Rosenberg, and Hunt2mentioned a single case of gout associated with idiopathic lipemia and stated that, with the exception of this case, the presence of hypercholesteremia is not characteristic of gout. Because the case to be reported adds a second instance of gout in relation to essential lipemia, as well as an additional apparently related neurologic and cardiac syndrome not previously described, and because of the