“He was England's greatest enemy, and mine too; but I forgive him everything.
On the death of a Great Man Like him, we should only feel deep concern and regret.”
Sir Hudson Lowe, May 6, 1821
Depending upon which “camp” you follow, you either believe that Napoleon was poisoned with arsenic, probably by Count Montholon, or you accept the autopsy findings, signed off by no fewer than seven doctors in attendance, that indicate Napoleon expired ultimately from stomach cancer. For the record, Napoleon's grandfather, father, his brother Lucien, and three of his sisters also died from stomach cancer. The autopsy reported that Napoleon died from a perforation of the stomach caused by cancer. Which is true – are either correct, or perhaps neither?
Since Napoleon's death on May 5, 1821, hundreds of books, papers, lectures, reports, and prognostications have been written on the subject, most of which extremely partisan and vehemently emotional. To support the arsenic poisoning theory no fewer than seven strands of what is alleged to be Napoleon's hair have been examined by reputable forensic scientists and laboratories, including the FBI in the US, Harwell Nuclear Lab in the UK, and the “Slowpoke” reactor facility in Toronto. In fact, in each case the hairs examined were found to contain levels of arsenic ranging everywhere from 1.93 to 16.8 parts per million (“ppm”). The average of natural arsenic in human hair is about 10/ppm. In fact, after the FBI ran their tests on hair samples submitted by M. Jean Fichou in 1994, they reported that:
“The amount of arsenic is greater than normal background levels found in the hair of most people living today. However, the FBI laboratory has no hair for comparison purposes for the time period of Napoleon. The significance of the previously reported findings is that this hair did not come from a person who died from arsenic in the time period reported by the hairgrowth.”
Furthermore, the hairs submitted by the various “collectors” could not be positively authenticated as coming from Napoleon. Only written provenance can give any assurance. It also appears that no DNA tests were performed which would have indicated that the tested hairs were all from the same person, particularly important given that the levels of arsenic in the hair (all supposedly taken from Napoleon's head right after death) varied in each sample. Indeed, it would be necessary to exhume relatives of Napoleon to compare the DNA strands. And without exhuming Napoleon, there is no way to assure that the hairs submitted are really from the same person, or actually from Napoleon. Therefore, from a scientific standpoint, there is no legitimate way to determine empirically that Napoleon was poisoned by arsenic and that this was the proximate cause of his death.
In recent years the arsenic debate resurfaced when Ben Weider and Dr John Fournier proved conclusively that some of the hairs previously tested, with additional samples obtained by Dr Fournier allegedly from hair given to the Abbe Vignali right after Napoleon's death, contained “commercial” inorganic arsenic that was specifically compounded as rat poison, not the type normally found in nature. However, this too is problematic.
It is a known fact that St. Helena suffered from rat infestation, much like most populated areas at that time. While arsenic was compounded in high doses to kill rats, it was also used in small doses since the time of Henry VIII to treat syphilis and other illnesses. However, rat poison was used in abundance at St. Helena, especially where Napoleon lived at Longwood since the house was infested with them. So there was rat poison everywhere around the imperial residence. There is even an anecdote about how Napoleon reached for his hat one day and a rat jumped out! There even was a British cartoon to that effect at the time.
Let us review the symptoms of arsenic poisoning from various scientific reports.
“There is no one set of symptoms. Different people respond differently, depending on how much exposure they get, and by what means. Arsenic can be inhaled, ingested or absorbed through contact. Arsenic poisoning is difficult to pin down because most of the arsenic leaves the body within three days of exposure. The arsenic which remains is stored in the brain, bones, and tissue and continues to do serious damage. Some people have no immediate symptoms, but the exposure can cause many types of cancer or diabetes later on. There is new evidence that arsenic may also lead to heart disease or strokes. It may cause long term liver, kidney, and central nervous system damage.”
“Arsenic exposure, even at low levels, can result in a range of symptoms. Swallowing or inhaling low levels of inorganic arsenic can result in stomach ache, nausea, vomiting and diarrhea. It can also result in decreased production of red and white blood cells which may cause fatigue, abnormal heart rhythm, blood-vessel damage resulting in bruising, and impaired nerve function. One of the early warning signs of arsenic poisoning is a 'pins and needles' sensation in hands and feet. Long-term oral exposure to inorganic arsenic can result in skin changes including a darkening of the skin and the appearance of small 'corns' or 'warts' on the palms, soles, and torso.”
“Other signs and symptoms include skin thickening, fluid accumulation (resulting in puffiness) especially around the lower eyelids, face and ankles, diarrhea, garlic breath, perspiration, excessive salivation, generalized itching, oral inflammation, sore throat, runny nose, excessive tearing, numbness, skin inflammation, hair loss, weakness, and loss of appetite. Arsenic can also cause a range of neurological effects, including headaches and vision problems. It can cause noticeable behavioral changes, most commonly aggression or depression.”
“Because most arsenic leaves your body within a few days, analysis of urine cannot detect if a person was exposed to arsenic in the past. Tests of hair or fingernails can determine exposure to high levels of arsenic over the past 6-12 months, but these tests are not very useful in detecting low-level exposures.”
“Early treatment of arsenic poisoning is critical. The longer arsenic remains in the body, the more damage is done. If arsenic poisoning is determined, saunas and other methods used for detoxification of heavy metals is the usual treatment.”
“The presence of arsenic in food items is also found. For instance, apples have arsenic in their seeds. Therefore, those who consume even the seeds of an apple are doing nothing but depositing arsenic in their body parts. The other food items that have arsenic in small amounts are seafood, water, bone meal, dolomite, kelp, table salt, and beer.”
“The result can range form damage to the lungs, skin, kidneys and liver to the development of certain types of cancer. People who work in factory that produces pesticides are at greater risk of developing the problem. Other jobs that can cause arsenic poisoning are copper smelting, mining, sheep dipping and metallurgical industries.”
The signs and symptoms of chronic arsenic poisoning are therefore:
• Change in fingernails pigmentation
• Cognitive impairment
• Constant Headache
• Psychological disturbances
• Thickened skin on palms
“Long term exposure to inorganic arsenic may lead to a darkening of the skin and the appearance of small 'corns' or 'warts' on the palms, soles, and torso. Direct skin contact may cause redness and swelling. Breathing inorganic arsenic increases the risk of lung cancer. Ingesting inorganic arsenic increases the risk of skin cancer and tumors of the bladder, kidney, liver, and lung.”
The samples of Napoleon's hair tested previously, especially the “Abbe Vignali” hair obtained by Ben Weider and Dr John Fournier, tested positive for inorganic arsenic (“rat poison”) in the medulla. The claim resulting from this test was “qualitative”, not “quantitative” as were the previous tests. The claim was that it was rat poison and not natural arsenic that was in Napoleon's hair at his death. In fact, France awarded Ben Weider, then the President of the International Napoleonic Society, the Legion of Honor for the discovery, which they viewed as conclusive evidence that Napoleon was poisoned. (Ben Weider passed away in October, 2008.)
Then there is the argument that Napoleon's alleged obesity confirms arsenic poisoning. But was he obese at death compared to his former self?
Swiss researchers now say his trousers show he lost weight prior to his death, confirming he had cancer. They report:
“Napoleon's apparent obesity at the time of his demise was interpreted as a strong argument against stomach cancer as the cause of death. To test the hypothesis that Napoleon's weight at death could be compatible with a diagnosis of terminal gastric cancer, we performed several studies to determine: a) Napoleon's weight at death; and b) the changes of his weight during the last twenty years of his life. Our weight modeling was based on the collection of twelve different pairs of trousers worn by Napoleon between 1800 and 1821, the year of his death. Modeling trouser sizes with control data suggested a weight increase from 67 kg to 90 kg by 1820. The trousers worn at the time of death suggested a subsequent weight loss of 11 kg (to 79 kg) during the last year of his life. This weight was confirmed by a second modeling approach based on the subcutaneous fat measurement performed at autopsy (1.5 inches) and a control group of 270 men dying from various causes. This provides a reasonable validation for both weight measurement methods.”
The research, by scientists from the anatomical pathology department of the University Hospital in Basel and the Institute of Medical History at the University of Zurich, looked at twelve pairs of Napoleon's trousers. Four were from before his exile and eight were pairs he wore during the six years he spent in exile on St Helena, including the pair he wore while dying.
The researchers also collated information from post mortems on the weights of patients who had died of stomach cancer. They then measured the waists of healthy people to work out the correlation between that measurement and their actual weight. This information was then used to calculate Napoleon's weight in the months leading up to his death. The largest pair of trousers Napoleon wore had a waist measurement of 110cm (43″); those he wore just before his death measured 98cm (38″). This, they say, shows he lost between 11kg and 15kg over the last six months of his life.
The Swiss team also says the presence of inorganic arsenic in Napoleon's hair, the source of the poisoning theory, was linked to his enthusiasm for wine. At the time, it was the custom of winemakers to dry their casks and basins with arsenic as well as spread arsenic in the vineyards as a pesticide.
Dr Alessandro Lugli, who carried out the study which appeared in the American Review of Human Pathology, told the BBC News website he thought theories about alternative explanations for Napoleon's death would continue to be put forward. But he said: “We are sure that the autopsy report speaks clearly in favour of gastric [stomach] cancer.” Last year, researchers from the San Francisco Medical Examiner's Department said in New Scientist magazine that it was regular doses of antimony potassium tartrate, or tartar emetic, a poisonous colourless salt which was used to make him vomit, that killed him. That is completely incorrect however, as Napoleon was never given antimony potassium tartrate recorded in any of the medical reports, records, or memoirs! Napoleon was given Calomel, which is entirely different. (See Postscript)
He was also given regular enemas. “The researchers, led by forensic pathologist Steven Karch, say this would have caused a serious potassium deficiency, which can lead to a potentially fatal heart condition called Torsades de Pointes in which rapid heartbeats disrupt blood flow to the brain.” This is absolutely correct! In the last months of his life Napoleon was subjected to repeated enemas, on many occasions multiple times a day, without any replacement of his diminished electrolytes. He had repeated symptoms of vertigo, nausea, and rapid heart beats after these enemas.
Dr Karch told BBC News Online at the time that he studied similar modern cases. He said: “There is a very strong argument for this – but it's not as sexy as the idea that he was murdered. The arsenic wasn't killing him – his doctors did him in!” (Emphasis added)
Who were the doctors who administered to Napoleon on St. Helena?
Each and every one was a military “surgeon”, including of course Dr O'Meara, but not including Dr Francesco Antommarchi, who was only an anatomist, not a “surgeon” or “physician”. His experience was carving up cadavers teaching anatomy. Military surgeons had very little experience as general practice physicians and therefore had only minimal knowledge of symptomatic treatments such as were administered to Napoleon in the last months of his life. Military surgeons were essentially trained in battlefield medicine, gunshot wounds, and amputations, using pain medicine such as Laudanum, an opium derivative. Soldiers merely in “sickbay” were given combinations of remedies such as Calomel, bitter almond extract, and were also subjected to “bleeding”, a common practice at the time thought to stimulate the production of red blood cells to prop up immune systems and reduce fever. Had Napoleon been correctly diagnosed with the very real gastric carcinoma found at his autopsy, and from which his grandfather, father, brother Lucien, and all of his sisters died, they might have tried to make him more comfortable, at least in his final days.
The British military surgeons present at Napoleon's autopsy were Dr Archibald Arnott, Dr Francis Burton, Dr Walter Henry, Dr Matthew Livingstone, Dr Charles Mitchell, Dr George Rutledge, and Dr Thomas Shortt, all “M.D.s”. But, were they qualified?
Dr Arnott (1771-1855) was the military “surgeon” to the 20th Regiment of Foot. At the age of twenty-seven he was promoted “surgeon” to the 20th after only serving three years as assistant surgeon to the 11th Light Dragoons. Arnott was present at numerous battles including many important battles in the Peninsular Campaign. He had eight battle clasps on his campaign medal ribbon. He arrived at St. Helena with the 20th in 1819. He actually saw Napoleon for the first time on April 1, 1821, shortly before the former French emperor's death. He and Napoleon got on well, albeit too late. In 1822 he published An Account of the Last Illness of Napoleon. His contemporaneous notes about Napoleon are in the British Library's “Lowe Papers”, Add. MSS 20,157. Oddly, they differ widely from the information in his book.
Dr Burton (1784-1828), the actual creator of Napoleon's death mask, was the military surgeon to the 66th Regiment. He studied medicine in Dublin entering army service in 1805 aged twenty-one. He too served much time during the Peninsular Campaign. In 1813 he was promoted surgeon to the 4th Regiment of Foot. In 1819, he was promoted surgeon to the 66th arriving at St. Helena on March 31, 1821, like Dr Arnott, shortly before Napoleon's death. Burton was responsible for writing a letter explaining why Dr Antommarchi refused to sign his own autopsy report. It can be found in the “Lowe Papers”, Add. MSS 20,214.
Dr Henry (1791-1860) was the assistant surgeon to Dr Burton and the 66th. He studied medicine in Scotland and in 1811 joined the 66th as assistant surgeon aged twenty. He too served in the Peninsular Campaign arriving on St. Helena July 5, 1817, well before any of the others. He wrote his memoirs, Events of a Military Life, published in 1843, in which he intricately describes his medical association with Napoleon on St. Helena. Found in the “Lowe Papers”, Add. MSS 20,214, is his detailed account of the autopsy proceedings.
Dr Livingstone (1773-1850) was the East India Company's surgeon on St. Helena. He arrived on St. Helena in 1815 and died there on October 10, 1821, some five months after Napoleon. He mainly attended to the Bertrands and Montholons. He attended Napoleon's autopsy, but left it due to ill health before it was completed.
Dr Mitchell (1783-1856) was the Naval surgeon for HMS “Vigo”, the flagship of the St. Helena station from 1820-1821. In 1806 he was promoted surgeon, aged twenty-three. Two days before Napoleon's death he was asked to consult with doctors Short, Arnott and Antommarchi, but was never permitted to see Napoleon.
Dr Rutledge (1789-1833) was the assistant surgeon to the 20th Regiment of Foot. He was promoted assistant surgeon in 1815 aged twenty-six. He reported to Dr Arnott and arrived at St. Helena in 1819. He was also the person appointed by Colonel Sir Thomas Reade to watch over the body of Napoleon after he died until Napoleon was safely sealed in his coffin. Dr Rutledge was also the only person to write a medical criticism of Dr Antommarchi's autopsy, Les Derniers Moments de Napoléon.
Lastly we have Dr Shortt (1788-1843), the chief medical officer on St. Helena. Shortt joined the Army in 1806 as assistant surgeon to the 10th Regiment of Foot, aged eighteen! In 1813 he was promoted surgeon to the 20th Light Dragoons. In 1819 he was appointed Physician Extraordinary to the King in Scotland. Most of his Army service was spent in Italy, Sicily, and Egypt. He arrived at St. Helena in December, 1820 assuming the post of chief medical officer. Shortt never saw Napoleon professionally, but was consulted repeatedly by the other doctors. Dr Shortt however, was responsible for drafting the official autopsy report.
However, it was Antommarchi who performed the autopsy in the presence of the numerous British military surgeons who were there, but who had no such experience. History must be indebted to Antommarchi for his autopsy expertise and autopsy record, but ironically Antommarchi refused to sign the official autopsy report. Only the British doctors signed it. The reason was political on both sides, just as the arsenic poisoning claims are versus the stomach cancer cited in the autopsy report. Napoleon had “politically” complained of a “liver ailment” (Hepatitis) the entire time he was on St. Helena to garner sympathy from the outside world. Antommarchi's autopsy report, in addition to the stomach cancer signs, makes mention of Napoleon having a large liver. This however was a red rag to a bull for Hudson Lowe. The governor felt he could not allow Napoleon to die of hepatitis (as implied by an enlarged liver), for if the emperor had died of liver failure, then it was the island of St Helena which had caused this, and as a result the sending of Napoleon to St Helena could then have been interpreted as a death sentence. So Lowe forced the doctors to remove the sentence regarding the enlarged liver from the autopsy. Antommarchi consequently refused to sign the document.
Let us now review the reports of Napoleon's autopsy on May 6, 1821.
The official report reads as follows:
Longwood, St. Helena, May 6th, 1821
Report of Appearances on Dissection of the Body of Napoleon Bonaparte
On a superficial view the body appeared very fat, which state was confirmed by the first incision down its centre [sic], where the fat was upwards of one inch thick over the sternum, and one inch and a half over the abdomen.
On cutting through the cartilages of the ribs, and exposing the cavity of the thorax, a trifling adhesion of the left pleura to the pleura costalis was found; about three ounces of reddish fluid were contained in the left cavity, and nearly eight ounces on the right.
The lungs were quite sound.
The pericardium was natural, and contained about an ounce of fluid.
The heart was of the natural size, but thickly covered with fat; the auricles and ventricles exhibited nothing extraordinary, except that the muscular parts appeared rather paler than natural.
Upon opening the abdomen, the omentum was found remarkably fat; and on exposing the stomach, that viscus was found the seat of extensive disease; strong adhesions connected the whole superior surface, particularly about the pyloric extremity, to the concave surface of the left lobe of the liver; and on separating these, an ulcer, which penetrated the coats of the stomach, was discovered one inch from the pylorus, sufficient to allow the passage of the little finger. The internal surface of the stomach, to nearly its whole extent, was a mass of cancerous disease, or schirrous portions, advancing to cancer; this was particularly noticed near the pylorus. The cardiac extremity, for a small space near the termination of the oesophagus [sic], was the only part appearing in a healthy state. The stomach was found nearly filled with a large quantity of fluid, resembling coffee grounds.
The convex surface of the left lobe of the liver adhered to the diaphragm, but with the exception of the adhesions occasioned by the disease in the stomach, no unhealthy appearance presented itself in the liver.
The remainder of the abdominal viscera were in a healthy state.
A slight peculiarity in the formation of the left kidney was observed.
THOMAS SHORTT, Physician and P.M.O.
ARCH. ARNOTT, M.D., Surg. 20th regt.
CHARLES MITCHELL, M.D., Surg. H.M.S. Vigo.
FRANCIS BURTON, M.D., Surgeon 66th regiment.
MATTHEW LIVINGSTONE, Surg. H.C. Service.
Then there is the report sent by Dr Antommarchi to Napoleon's family dated May 8, 1821.
Report of Dr Antommarchi, charged with the opening of the emperor's body
I, the undersigned, Francois Antommarchi, surgeon in ordinary to the Emperor Napoleon, in execution of the orders given me by the Counts Bertrand and Montholon, proceeded to open the body of the Emperor. Having opened the cavities of the thorax and stomach, I observed what follows:
1. The exterior convex surface of the left lung adhering at different points to the corresponding costal pleura.
2. About three ounces of lymphatic humour [sic] in the bag of the left costal pleura.
3. About eight ounces of the same lymphatic liquid in the bag of the right costal pleura.
4. The lungs in a natural state.
5. The heart in a good state, enveloped in its pericardium, and covered with a little fat.
6. The stomach, intestines, liver, spleen, and large omentum, in their natural place.
7. The upper convex surface of the left lobe of the liver adhering to the corresponding part of the concave surface of the diaphragm.
8. The interior concave surface of the lobe strongly adhering to the fore-surface and to the small curve of the stomach, as well as the little omentum.
9. Having carefully detached, partly with the scalpel and partly with the fingers, the said adherences, I observed, that the adherence of the concave surface of the left lobe of the liver formed a hole of about three lines in diameter in the fore-surface of the stomach, near its right extremity.
10. Having opened the stomach behind its large curve, I observed that it was partly filled with a liquid blackish substance, which had a sharp and disagreeable smell.
11. Having removed the said liquid, I observed a very extended cancerous ulcer, which occupied particularly the upper part of the internal surface of the stomach, and extending from the orifice of the cardia to within an inch of the pylorus.
12. On the edge of this ulcer, towards the pylorus, I perceived the hole mentioned (Art. 9), produced by an ulcerous corrosion of the partitions of the stomach.
13. The ulcerous partitions of the stomach were considerably swelled and hardened.
14. Between the ulcer and the pylorus, and contiguous to the ulcer, I observed a scirrhous [sic] swelling and hardness of some lines in breadth, which circularly occupied the right extremity of the stomach.
15. The liver was obstructed, and of an unnatural size.
16. All the intestines were in a good state, but filled with air.
Longwood, May 8, 1821
So where does all of this information and conjecture lead us? From a symptomatic treatment point of view, it is necessary to review such documents as the diary of Count Bertrand for example, kept from January, 1821 to the death of Napoleon on May 5, 1821. It is a contemporaneous diary of each day's events as they occurred in the medical treatment of Napoleon's condition. We will also have to review the diaries of Napoleon's valet, Marchand, as well as the medical report of Dr Arnott. We will also need to refer to the memoirs of Napoleon's doctors prior to his arriving on St. Helena, doctors such as Larrey and Corvisart, in order to develop a complete medical history of Napoleon, including that of his family. (It is thought that Napoleon even suffered from mild epilepsy having suffered numerous Petit Mal seizures in his life rendering him unconscious in each case documented.)
Let's begin with Napoleon's family. (Again, he lost his grandfather, father, his brother Lucien, and three sisters to gastric cancer!)
The Bonaparte family was of Italian origin. It can be traced back as far as 1235 to Guillaume “Buona Parte” (“Good Family”) who lived in Florence. In 1529 however, we find the first mention of a Bonaparte in Corsica, Francesco Bonaparte, a soldier. Napoleon Bonaparte is his direct descendant. The descendancy went through Francesco to Jerome, to Gabriel, to Francesco II, then Charles-Marie, then Sebastien. Sebastien had three sons, Joseph (1713-1760), Napoleon, and Lucien. Joseph married Maria Paravicini and had two children, a daughter and a son named Charles-Marie Bonaparte (1746-1785), the Father of Napoleon. Napoleon was the first in the family to be born “French” as in June, 1769 Corsica was ceded to France, two months prior to his birth. It was Napoleon's grandfather Joseph and his father Charles-Marie who died of gastric cancer. Of the thirteen children born to Napoleon's parents, only eight survived to adulthood. Two died in infancy before Joseph and Napoleon were born. Three died immediately after Napoleon's birth, with the rest surviving into adulthood.
When Napoleon's father died at the age of thirty-eight, and an autopsy was performed the day following his death. The autopsy report, still in existence (here translated from the French by Dr James Kemble), reveals that:
“The opening of the body of Monsieur Bonaparte has confirmed the opinion of the Doctors of Ajaccio, as to the cause of the persistent, stubborn and 'hereditary' vomiting which carried him off. When he arrived in this town and consulted us, we could only agree with the opinion of the Doctors, and we recognized, as they did, that the large tumour in his abdomen (bas-ventre) was located in the walls of the stomach, near its distal opening, and that there was reason to believe that the pylorus was involved there. The autopsy was performed by Monsieur Bousquet, surgeon-in-chief of the Vermandois regiment, and Monsieur Fabre, student in surgery of this town; who signed here with us, in the presence of several officers of that regiment.”
“All the organs of the abdomen were found to be healthy enough, with the exception of the stomach, which was distended with the fluid which the patient had taken. The distal opening of this organ formed a tumour the length and size of a large potato, or of a large elongated pear, this tumour was very hard and of semi-cartilaginous consistency. This tumour did not extend at all beyond the pylorus; the duodenum was normal.”
This final autopsy report was signed and submitted on February 25, 1785, and signed by “Farjon, Lamure, Bousquet, and Fabre”. Napoleon's father, Charles-Marie Bonaparte, died from gastric cancer, a tumor located at the pylorus.
Napoleon was very small as an infant and, in modern medical terms, “failed to thrive”. As Napoleon's mother was unable to breastfeed Napoleon, he was given over to a “wet-nurse”, another mother who could breast-feed the child. A girl named Camilla Ilari was chosen, and Napoleon began to gain weight and “thrive”. Not knowing Camilla's medical history, we can't be certain about what she might have passed along to Napoleon during that time she was his wet-nurse. We only know that she was healthy. (As an aside, it is known that Camilla's son, Ignazio, became a sailor in the British Navy fighting against Napoleon! Also, Camilla was much loved by Napoleon and she received an invitation to be present at Napoleon's coronation and was to receive an interview with Pope Pius VII. Josephine even gave her some diamonds.)
Napoleon's medical history is fairly clear during his childhood to age ten. He had no recorded accidents or illnesses. He did have the usual childhood bowel issues such as constipation. He had dry skin and a “sallow” complexion.
On December 15, 1778, Napoleon left Corsica with his father for France, accompanied by his older brother, Joseph. They arrived on January 1, 1779 and both boys were placed in the College of Autun in Burgundy – Napoleon was nine. For the next four months he was immersed in learning to speak French. Napoleon left Autun and went to Brienne on May 12, 1779 to the Ecole Royale Militaire. Joseph remained at Autun for an additional five years. (It was at Brienne that Napoleon met Fauvelet de Bourrienne, his best friend and secretary for many years.)
The next record of Napoleon's medical history dates to September, 1783 when a report was made by the Inspector-General of the military schools. The Chevalier de Keralio wrote:
“M. de Bounaparte, born 15 August 1769, height four feet ten inches ten lines… of good constitution and excellent health… he will make an excellent sailor.”
On October 30, 1784 Napoleon left Brienne for the Ecole Militaire in Paris – he was fifteen. Less than four months after his arrival his father died. During Napoleon's period in Paris his health, by his own admission in his letter of condolence to his mother, was excellent.
After graduation from the Ecole Militaire in Paris, Napoleon was assigned to the regiment at Valence. He was described at that time as “small, beardless, pale, thin…” Napoleon was sixteen.
On September 1, 1786 Napoleon took his first leave and sailed for Corsica arriving on the 15th. From Napoleon's own hand we find that, while at Corsica on leave, he contracted a fever, “fièvre tierce”, which he suffered all through March. He might have meant “tertian malaria”, but it is not certain, although Napoleon does mention deriving relief from Quinine while on St. Helena. He then requested an additional five months leave from his commanding officer enclosing a doctor's letter which recommended that leave was needed because of this “fever” and the ongoing treatment. The additional leave was granted. On September 12, 1787, Napoleon left Corsica for Paris.
Napoleon finally went back to his regiment in June, 1788. He had actually been on leave for twenty-one months. He had received two extensions and had revisited Corsica. His regiment had relocated from Valence to Auxonne while he was gone. On August 28, 1788 he wrote to his uncle Fesch, “I am ill…” He was treated by the regimental surgeon and kept in bed. He was again suffering from the “fever” he had originally contracted in Corsica. On January 12, 1789 he wrote to his mother:
“My health is at last improved and I can now write to you at greater length. The district here is very unhealthy, on account of the marsh lands around and the frequent overflowing of the river. This fills all the ditches with water which gives off stinking vapours. I have had attacks of persistent fever from time to time. The fever subsides for some four days and then relapses lasting for about the same time again. These have made me weak and delirious and I have suffered a long convalescence.”
Napoleon's fever was variously recorded in the medical records as “fièvre miasmatique”, (Mountain Fever) “fièvre de marais”, (Botanic Fever) and “infection palustre” (Malaria). “Mal Aria” was originally thought to be caused by the inhaling of stagnant air from swamps and marshes. The treatment for it at that time was chewing on “Jesuit's Bark”, the bark of some trees the Jesuits brought back from Peru. In any case, the fever continuously suffered by Napoleon left him in bad health for many months. In July, 1789 Napoleon wrote to a friend:
“Since my illness I have slept very little. I go to bed at 10 o'clock and I get up at 4 in the morning. I only take one meal a day, at 3 o'clock in the afternoon, that is best for my health.”
In September, 1789, right after the start of the Revolution, Napoleon again took leave and returned to Corsica. Shortly after arriving Napoleon, Joseph and their little brother Lucien were stricken with fever and all three nearly died. It is suspected that it was a respiratory infection possibly passed from one to the other. He again applied for and received an extension of his leave.
While on Corsica Napoleon received treatment for a series of skin rashes. The medical records indicate that, between August 5th and August 30, 1790, Napoleon was treated for neuro-dermatitis. He was prescribed baths, suggesting the rashes were all over his body, with mercury ointment and potassium nitrate. (Later historians suggested Napoleon suffered from scabies, but the well-known drug for scabies was sulphur, and there is no record of it having been given to Napoleon until much later.) He celebrated his 21st birthday with body rashes and a dose of rhubarb!
He again rejoined his regiment in Auxonne on February 12, 1791. During the next four months he was free of any illness. In August he was promoted to 1st Lieutenant and sent to Valence to a new regiment. In September he went back to Corsica on leave again.
Napoleon returned to Paris on May 28, 1792, right in the middle of the Revolutionary crisis. On September 21st King Louis had been deposed ending the French monarchy. The “Republic” was proclaimed. Napoleon again returned to Corsica on leave. Four months later King Louis would be executed. The Reign of Terror began. France's new Assembly declared that Corsica would not be granted independence. Napoleon sided with France and the Bonaparte home in Ajaccio was ransacked as a result. On June 11, 1793 the entire Bonaparte family left Corsica for France forever. They arrived at Toulon and went to live in Marseilles.
The next item in Napoleon's medical history is contained in a pamphlet entitled, “Le Souper de Beaucaire” written by Napoleon on July 29, 1793. In the pamphlet he mentions that he was ill which afforded him the time to write. No specific details exist describing the illness though. In this pamphlet, written while he was in the town of Beaucaire, he makes an appeal to other towns for a united France under the Jacobin Republic. However, Toulon resisted joining the new Republic and fought off the Republican troops trying to occupy it. It was on September 7, 1793 that Napoleon was ordered to join the Republican troops at Toulon. One must recall that British frigates had anchored in Toulon harbor and were supporting the Royalists against the Republicans. As Las Cases wrote later on, “From that date history took him up, never to let him go. Then began his immortality.”
During the battle for Toulon Napoleon was wounded several times. The first was on his forehead, and it bled profusely. On the night of December 16th his horse was shot out from under him and he was wounded in the chest, but it was minor. On December 17th, in the final assault on Fort Mulgrave, Napoleon suffered a bayonet thrust on the inner side of his left thigh just above his knee. It was so severe that for a time amputation of his leg was considered. (Antommarchi mentions both wound scars in Napoleon's autopsy.) In fact, though not requiring amputation, this wound became seriously infected leaving a large discolored mark on the skin. It gave Napoleon a great deal of trouble later on being a site of intermittent opening and “discharge”. On St. Helena, in the presence of Dr Antommarchi, Napoleon was able to pull the wound apart allowing blood and what appeared to be “lymphatic material” to run out.
Also at the battle of Toulon, Napoleon caught another malady – “the itch” known in French as “La Gale”. He caught scabies from a wounded gunner whom he tried to help. He had lifted the wounded man to safety, but he failed to see that the man was covered with scabies. Being covered himself with perspiration, Napoleon contracted the scabies. It was very common among the troops at that time, and as a result wound up in the highest levels of society. The French at that time also preferred cologne to good old soap and water, which didn't help the situation. Even Empress Marie-Louise had contracted “La Gale”. Sulphur ointment was the cure. The real cause was not known during Napoleon's time though. It was not until 1834 that the little tick was actually discovered. Napoleon was given sulphur ointment which apparently cured him. We do know that Napoleon suffered from intermittent skin eruptions during his lifetime. Napoleon was now promoted General, age twenty-four.
The next illness suffered by Napoleon was on February 16, 1797 when he wrote to Josephine from Montebello, “Mon rhume dure toujours”, (“I've still got a cold”). He had a continuing cough for several months. During the Italian Campaign Napoleon began to suffer repeated attacks of migraine, which frequently resulted in him being bed-ridden with fever. Of course, at that time, he was “tense of nerve and highly strung” having just assumed command of the destitute Army of Italy, and worrying about the fidelity of his new wife, Josephine.
On June 29, 1797 Napoleon landed near Alexandria, Egypt. He brought with him his Chief Medical Officer, Baron Larrey. They immediately determined they had not “medically” prepared for the Egyptian campaign once in country. The lack of potable water for the troops in the desert environment was a significant problem. Diseases currently unknown in France began to pop up; plague, dysentery, typhoid, typhus, hepatitis, scurvy, and trachoma. Unusual sexually-transmitted diseases also popped up, also unknown in France. It kept Larrey and the other 106 medical officers very busy. When many troops contracted the plague, Napoleon seemed immune to it even after being with these men in close quarters. In the fifteen months Napoleon spent in country in the Middle East “he had suffered not so much as a minor wound, nor had serious illness claimed a single day.”
Napoleon landed back in France on October 9, 1799 proceeding directly to Paris. His new valet, Constant Wairy, in his memoirs describes him as:
“… extremely thin and very sallow almost copper-coloured in complexion. His chestnut brown hair was thin and already receding over the temples and his blue eyes were deep set so that they had a somewhat piercing appearance.”
Constant, who purchased Napoleon's hats for him, describes the size of Napoleon's head as being 23-1/2 inches in circumference, and his height as 5 feet 6-1/2 inches, exactly as confirmed in Dr Antommarchi's autopsy report and Andrew Darling's measurements used for constructing Napoleon's inner coffin. Constant also mentions that Napoleon bit his nails and always ate very fast, usually in ten minutes or less, mostly using his fingers instead of utensils so that he could eat faster. Many times his eating habit caused him severe stomach pain followed by vomiting. Constant frequently found him lying on the floor with his head in Josephine's lap while she rubbed his stomach.
Napoleon developed an aversion to all medicines by this time regardless of any complaint. He preferred to bathe and rest and allow the complaint to takes its course. He often mentioned to Dr Corvisart that he could not feel his heartbeat or pulse.
The next medical occurrence is recorded at the battle of Marengo. Napoleon was wounded by an errant cannon shot which hit him in the left leg. It was a minor injury mainly tearing away his boot and lacerating the skin. As Napoleon confided to Dr O'Meara at St. Helena, “I used no other application to it than a piece of linen dipped in salt and water.”
Once Napoleon was confirmed as First Consul on August 3, 1802, he took as his personal physician Dr Corvisart (1755-1821), the Chair of Clinical Medicine in France. He had been introduced to Dr Corvisart in 1798 at a party given by Paul Barras. In 1802 Napoleon's longtime friend and secretary, Fauvelet de Bourrienne, wrote in his memoirs:
“About the commencement of the year 1802 Napoleon began to feel acute pains in his right side. I have often seen him at Malmaison, when sitting up at night, lean against the right arm of his chair and unbuttoning his waistcoat, exclaim 'What pain I feel!'. He asked me who was my physician. I told him M. Corvisart.”
Bourrienne went on to write:
“I have now little doubt, from the nature of his sufferings, that they were occasioned by the commencement of that malady which terminated his life at St. Helena.”
Is it possible that perhaps many of the events that consumed the Napoleonic Era were affected by his medical condition?
On August 16, 1803, while in Brussels contemplating the invasion of England, Napoleon became seriously ill with a severe cough, coughing up blood! Corvisart diagnosed it as “congestion of the lungs”. Corvisart told him, “Your rash has gone inwards. It is necessary to draw it to the surface. A few days blistering will suffice.” In fact, Corvisart applied several blisters to Napoleon's chest and the cough subsided. Corvisart recommended a mixture of powder, olive oil, and alcohol, rubbing it all over Napoleon's body. The following year Corvisart was appointed First Physician to Napoleon. He attended Josephine too as well as other members of Napoleon's court. He was created Baron of the Empire by Napoleon in 1808.
Madame de Remusat wrote in her memoirs that Corvisart told her Napoleon always had a “slow pulse” and that his blood ran “sluggishly”. However, nowhere in Corvisart's memoirs does he mention “bradycardia” with respect to Napoleon.
In January, 1803, while at St. Cloud, Napoleon suffered an “epileptic” seizure. It involved a “tryst” Napoleon was having with Mademoiselle George (Marguerite Weimar), an actress of some renown. She was only sixteen. After her Paris performance in Racine's Iphigenie, attended by Napoleon, he invited her back to St. Cloud. It was during their entrevue nocturne, at about 2 o'clock in the morning, that Napoleon went into a violent seizure.
Mademoiselle George's screams and constant pulling on the bedroom bell rope brought numerous servants running to the room. Napoleon was rendered completely unconscious for nearly thirty minutes. Unfortunately, the commotion also brought Josephine to the bedroom where she found Mademoiselle George still naked in the bed! Mademoiselle George was hurried from the room and was never to return. When the doctors arrived they found Napoleon's veins “distended”, along with “violent spasms of the limbs”.
The next epileptic-type attack that occurred was on September 9, 1804 when Napoleon and Josephine were in Coblenz. One of Josephine's servants, assumed to be Madame de Remusat, reports the episode in her memoirs:
“He had been suffering a good while before Josephine ventured to call for help. After a while the Emperor's fit passed. Napoleon has forbidden Josephine to say a single word about it.”
The next epileptic-type episode occurred in September, 1805 in the presence of Talleyrand. Right after dinner Napoleon fell to the floor in convulsions! Talleyrand doused Napoleon's face with some eau-de-Cologne to bring him around. M. de Remusat records that she and Talleyrand then brought him a glass of water. It was a minor seizure as Napoleon shortly left for Ulm and Austerlitz.
To be fair and balanced, Bourrienne denies that Napoleon suffered from epilepsy. Constant mentions that, in spite of his observed “fits and seizures”, Napoleon was not epileptic. They both, as well as others who knew Napoleon personally, state that once he made up his mind about a particular course of action, any obstacle would throw him into a rage! He would stamp his feet and beat on his head, sometimes falling to the floor in anger. However, none of these people are physicians, and they certainly had something to gain by siding with Napoleon. But, there are also no medical records that exist that accurately describe these seizures. No records of Napoleon biting his tongue, frothing at the mouth, no letting go of bodily functions – all symptoms of epilepsy.
Epilepsy can be triggered by accidents, especially blows to the head that renders unconsciousness. At St. Cloud in July, 1803 Napoleon was involved in an accident. He was driving around the grounds in a carriage handled by his favorite driver, Caesar. At some point Napoleon decided to take the reins. The horses immediately went into a full gallop. Josephine and Cambaceres were in the back seat of the carriage, she screaming and Cambaceres shouting. As they neared the gates to the grounds the horses turned abruptly, throwing Napoleon from the driver's seat. He was thrown nearly ten yards and landed on his stomach. When they got to him he was unconscious. Back in the palace he recovered, and they all had a good laugh.
On October 9, 1808, while in Erfurt, Napoleon wrote to Josephine, “My health is good, in spite of some little indispositions.” These little indispositions seem to have been recurrent colds which were cured by hot baths and sweatings.
On April 23, 1809 Napoleon was wounded at the battle of Ratisbon. A rifle shot hit him on his big toe. They had to cut off his boot and there was a considerable amount of blood. After being bandaged however, he mounted his horse and rode through his troops to let them see he was okay. The autopsy at St. Helena indicates it was his left foot. Napoleon however, shortly thereafter wrote to Josephine stating the wound was on his Achilles tendon.
In May, 1809, while at Schonbrunn, Napoleon developed a serious boil on his neck. Dr Frank, a noted Viennese physician, was called in. Frank told him it was very “grave”. Napoleon dismissed him and sent to Paris for Dr Corvisart! Corvisart applied a blister and the boil disappeared in a few days.
His next wound was suffered at the battle of Wagram on July 6, 1809. Again, a rifle shot pierced his left boot and lacerated the skin underneath. His horse was next shot from under him and Napoleon went down.
By the time of Napoleon's 40th birthday on August 15, 1809 his outward appearance had begun to change. He was no longer the thin and pale person as he was previously described. In the words of Baron Fain, “The change in his figure was accompanied by an obvious change in his character. His eyes lost their vivacity, his chin became more rounded and less prominent, his body developed in size but not his legs, his movements became slower, his words more hesitant, his voice less imperious, his bursts of anger occurred less often. The change in his temperament was apparent to all.”
Napoleon may have put it best in a letter to Josephine, “Forty years is forty years.”
It was thought by many that Napoleon's constant taking of very hot baths contributed to his enlarging stature. He relied completely on hot baths to cure all ailments, including his chronic constipation from which he had suffered all his life. However, medically, hot baths should have reduced his weight. His growing obesity was undoubtedly due to his diet. According to Constant and others close to him, Napoleon's diet consisted of fricassee of chicken, (Chicken Marengo), leg of mutton, and grilled lamb chops. He was also fond of beans and peas. However, he had very little interest in food as such. He always ate quickly, which cannot have helped his digestion. With his meals he would take a glass of wine diluted with water, usually Chambertin. He consumed large amounts of coffee, but no liquor. But he was very fond of chocolate! It is difficult, considering this diet, to blame it for his growing obesity. The reason must lay elsewhere.
Starting at age forty, Napoleon began to change in figure. He had become obese, which was apparent to everyone around him. He was a different man. Dr Henry commented on this post-mortem ten years later:
“The whole surface of his body was deeply covered with fat. Indeed the whole body was slender and effeminate. There was scarcely any hair on the body and that on the head was thin, fine, and silky. The shoulders were narrow and the hips wide.”
Napoleon's next encounter with medical science occurred on the Russian campaign. On September 5, 1812 Napoleon suffered an acute attack of dysuria, unable to “pass water” without great pain and effort. His campaign physician, Dr Mestivier, was immediately called. The following day Napoleon developed a dry cough, irregular breathing, and was only able to pass his urine in small drops and with great pain. It was thick with sediment too. His legs were distended from fluid and his pulse was intermittently febrile every few beats. No specific diagnosis was recorded, but notes were made by Dr Mestivier as well as Dr Yvan to the effect that Napoleon was very susceptible to changes in weather. He would “develop a cough and retention of urine”. He also developed a fever. They thought it was related to his chronic skin condition. At the time Napoleon was bivouacked in the field in a rain storm. As a matter of fact, on the night of September 6th, just before the battle of Moscow, Napoleon suffered both bladder and stomach distress. But then, maybe anyone might consider what was about to occur. Constant writes:
“At four o'clock in the morning an hour before the battle, Napoleon became suddenly indisposed. He had shivering fits, though unaccompanied by fever, and he was obliged to lie down on his bed. For some time he had been suffering from a severe cold, which the continual fatigues of this memorable day only served to increase. All the while the battle of Moskowa lasted, the Emperor suffered from attacks of dysentery.”
This urinary attack was the worst in his life to that point. He continued to have “gross pyuria” in his urine for several weeks. The problem became chronic and continued to the end of his life. At St. Helena he was repeatedly observed “standing with his head leaning forward against a wall or tree, endeavoring to pass his water, which he only succeeded with pain, difficulty, and a small dribbling stream.” In fact, the autopsy indicated that his bladder was “much contracted, contained a certain quantity of gravel, mixed with some small calculi. Numerous red spots were scattered upon its mucous membrane, and the coats of the organ were in a diseased state.”
The next attack occurred right after the battle of Dresden on August 28, 1813. There had been a deluge of rain for nearly the entire time, and when Napoleon returned to the palace in Dresden, Constant states that he was drenched to the bone. Napoleon suffered an immediate and acute attack of vomiting and diarrhea. Napoleon thought it was due to something he ate. The diarrhea gave him a serious case of “piles”. He was bedridden for several days.
On the night of October 17, 1813 Napoleon had another attack of stomach pain. Napoleon was involved in the defense of Leipzig, but was so distressed he could not get out of bed. The following day he resumed command. He finally arrived back in Paris a few weeks later. But, the Allies were closing in.
On April 11, 1814 Napoleon abdicated. On the night of April 12th Napoleon attempted suicide rather than be taken prisoner. Napoleon, according to Constant, had gone to bed about ten o'clock. Shortly afterwards Napoleon was heard to open his chest of drawers. He was seen to take a glass, pour something into it, and drink it. Napoleon got back into bed just as Constant arrived. Napoleon had drunk the poison that he had carried ever since the Egyptian campaign. However, Napoleon began to “twitch convulsively, and he started vomiting”. But, the poison had lost its potency after all those years – it just made Napoleon very sick. After a few cups of tea he regained his composure and went back to sleep. He had some breakfast in the morning, and then he signed the abdication.
Napoleon arrived at Elba, his 'island of exile', on May 4, 1814. It had been very difficult to find a physician to go to Elba with him. Dr Foureau de Beauregard finally was found and he accompanied Napoleon and remained his personal physician during his time on Elba. Foureau de Beauregard had been a military surgeon posted to the Imperial Guard. It was fortunate for Napoleon however, that he suffered no major illnesses while on Elba because Beauregard spent more time in bars and with the ladies than tending to Napoleon!
On February 26, 1815 Napoleon left Elba with one thousand of his devoted soldiers in seven small boats. They landed in Cannes three days later and began a march to Paris. However, Napoleon fell ill at Grasse, just after leaving Cannes. He had begun the march on horseback so he could be seen by everyone along the way, but his pain was so great he had to continue in a carriage. The bad roads and potholes made things worse. He rested for a while and then continued on horseback. Reports indicate that his “dysuria” had returned, undoubtedly a recurrence of the attack suffered at Borodino earlier. It has also been alleged that the attack was due to prolapsed hemorrhoids. The attack lasted two days, and then the march to Paris was resumed. Napoleon arrived in Paris on March 20th.
Napoleon was tired. After a few hours of work he needed rest, unlike his former vigor. He often sat silently and appeared sad. Between March and May his health grew much worse. He also had repeated attacks of dysuria. He recalled Dr Corvisart to his side, but the latter's own health was failing too.
Napoleon now was aware that the Congress of Vienna was breaking up, and the Allies were positioning themselves to destroy him once and for all. Napoleon had to take action if he was to survive. He left Paris on June 12, 1815 and headed for Charleroi in Belgium to confront the British and Prussians. It would be the beginning of the end, literally, for Napoleon.
The night after the battle of Ligny on June 16-17, 1815, Napoleon fell seriously ill. He was at the castle of Fleurus near Charleroi. Napoleon was completely exhausted and was unable to rise from his bed for many hours. In the morning he was too weak to even issue important orders to Marshal Grouchy until well after 8am. Napoleon had become obese and was also suffering from another illness, much more immediately serious – prolapsed bleeding hemorrhoids. He had had hemorrhoids for many years, probably due to his chronic constipation and constant riding for long hours in the saddle. It had, however, been some eighteen years since he had suffered “prolapsed” hemorrhoids. On May 26, 1807 he had written to his brother Jerome:
“I hear you have hemorrhoids. The simplest way to get rid of them is to apply three or four leeches. Since I first employed this remedy, ten years ago, I have been no more troubled.”
He had had a recurrence of “piles” in August, 1813 while at Dresden right after Duroc was killed at the battle of Bautzen. When leeches were unavailable, and Dr. Larrey always carried some, hot baths were substituted. Larrey had also prepared the original “Preparation H” for Napoleon, a lotion made up of 10-15% sub-acetate of lead having been boiled in distilled water. Larrey called it “Eau Blanche”. Larrey also warned Napoleon not to use sponges in his bath, but use clean flannel. Sponges carried “impurities” that could cause infection.
On the night after Ligny however, Napoleon was suffering from seriously strangulated piles – prolapsed hemorrhoids pushed outside of his anal sphincter. He had spent most of the day during the battle of Ligny on horseback, which was certainly a credit to his endurance, but it must have been horrendous for him, certainly distracting. This “secret” was kept confidential until Adolph Thiers interviewed both Jerome and Marchand when authoring his Histoire du Consulat et de l'Empire. During the interview, Jerome was very unspecific, stating that Napoleon had a “little weakness of the blood vessels”. However, Jerome really spilled the beans just before his death in 1860 telling the whole truth about the incident.
On June 18, 1815 the battle of Waterloo commenced. Napoleon rose at 4am to look at the battlefield. Only 800 yards separated the French from the British and her allies, except for the Prussians of course who had retreated to the East after being beaten at Ligny. The front line however, extended nearly two miles long. At 8am Napoleon dined with his marshals and generals. At 10am he went back to sleep. Jerome woke him at 11am, and the first cannon fired at 11.30am.
Napoleon spent the greater part of the day at Waterloo sitting at a table with maps overlooking the battlefield. He was frequently seen to rest his head on his arms. On numerous occasions stood up and walked around, but always returned to the table. About 3pm the bleeding and pain from his hemorrhoids was so severe Dr Larrey insisted that Napoleon return to the farm at Caillou so he could apply some “Eau Blanche” to ease the pain and stop the bleeding. At about 4.30pm, Napoleon returned to the battle. Jerome corroborated this to Adolph Thiers in 1858. It was also corroborated by members of the Old Guard who assisted Napoleon at the farm. By 7pm the battle had shifted away from Napoleon, especially after the arrival of the Prussians. By 9pm it was mostly over and the French were in full retreat.
Napoleon arrived back in Paris in the early morning of June 21st. He was utterly fatigued and mentally exhausted. He was in psychological distress complaining to General Caulaincourt, “I am suffocating here.” He immediately sat in a hot bath. By 10am he was meeting with his ministers who admonished him that they would no longer support him. They told him he could either abdicate or be dethroned by decree. He chose abdication, and immediately left Paris for Malmaison. The only person he immediately found there was Hortense. He remained at Malmaison for four days and then left for Rochefort. On July 15th, after “negotiations” between Las Cases, Gourgoud, and Captain Maitland, he boarded Bellerophon, immediately sailing for England. During the voyage Napoleon ate well and his digestion did not bother him. The ship arrived in Torbay on July 24th. None of the French was allowed to disembark. They were told that they would be transferred to Northumberland, and then leave immediately for exile on St. Helena. The transfer took place on August 7th. Northumberland left England for St. Helena on August 9th. The voyage took nine weeks during which Napoleon only suffered minor seasickness on August 11th, just short of his birthday on the 15th. Northumberland arrived at St. Helena on October 15, 1815.
Most of the population of St. Helena resided in or very near to the only town, Jamestown, which had the only port, on the Northwest side of the island. The home that would ultimately be Napoleon's, Longwood, was situated on a high plateau about nine miles East of Jamestown. It had been the residence of the Lieutenant Governor Colonel John Skelton and his family until Napoleon arrived.
For the first seven weeks, before Longwood could be ready to receive Napoleon and his French entourage, Napoleon lived at the Briars, the home of William Balcolmbe, the local agent of the East India Company, and his family. Napoleon was accompanied at the Briars by Count de Las Cases and his young son.
On December 9, 1815, Napoleon and his entourage moved into Longwood house. Historians have described Longwood in differing terms, but it was really no different that most of the buildings on St. Helena. One of Napoleon's entourage was a British Navy doctor, Barry O'Meara. He too occupied a small room at Longwood not far from Napoleon's. O'Meara had become Napoleon's physician when the French doctor who should have accompanied the emperor, Maingeaud, refused to go on the voyage to St Helena because he suffered from seasickness. O'Meara was asked if he would replace Maingeaud and he agreed. Dr O'Meara happened to be on the Bellerophon making the passage from Rochefort to England. Napoleon and O'Meara got very well. Otherwise, Napoleon had absolutely no use for any British doctors.
Between the time of Napoleon's arrival on St. Helena and when the new Governor, General Sir Hudson Lowe arrived on April 14, 1816, Napoleon was in relatively good health. From that point on, there was a frustrating and debilitating “state-of-war” between Lowe and Napoleon. In the 5-1/2 years Napoleon and Lowe were on St. Helena together, they only met face-to-face six times, and that was only in the first four months! Everything else took place through intermediaries.
During the first two years Napoleon and his entourage engaged in politics in the assumption that the possibility existed that public opinion might effect Napoleon's release. Dr. O'Meara was convinced by Napoleon to aid him in this process because of bad blood between O'Meara and Lowe. Lowe required O'Meara, as well as the British orderly living at Longwood, to provide timely reports on Napoleon's health and whereabouts. As the relationship deteriorated between Napoleon and Lowe, Napoleon became more and more reclusive giving rise to speculation about his health. Besides the usual minor ailments Napoleon suffered such maladies as headaches, sore throats, and colds, and the rumor that Napoleon was suffering symptoms of hepatitis. However, in 1816 hepatitis did not have the same medical connotation it has today. In 1816 it was the clinical diagnosis for most all gastric distress. However, it was assumed by Lowe and Lord Bathurst in London as Napoleon's bid for release due to ill-health. Ironically, it was to portend something much worse for Napoleon even though his symptoms of gastric distress were real.
Napoleon's major medical issue in October, 1817 was a toothache in his “right upper wisdom tooth”. His face was swollen, his gums were inflamed and bled at the touch, and soon it developed into a boil that burst. O'Meara finally convinced Napoleon to let him remove the tooth on November 16th. Napoleon's tooth today remains a relic. Napoleon had a second tooth extracted on January 26, 1818, but its whereabouts are unknown.
The first symptoms of a major medical problem occurred in September, 1817. Napoleon's legs were sore and swollen. On October 1st Napoleon complained to O'Meara about pain in his “hypochondriac region” and pain in his right shoulder. He said he had pain in his right side that he had never had before. O'Meara diagnosed it as “constipation”, but he prognosticated that it might be the beginning of a “hepatitis”. Napoleon allowed O'Meara to fully examine him, and O'Meara discovered that Napoleon's right abdomen was harder than the left. O'Meara also discovered a “tumefaction” (a swelling) that was tender to the touch and caused Napoleon some pain. Napoleon mentioned that he noticed it at least two months before, but said nothing. Because pain was now associated with it, O'Meara mentioned that it might be due to an enlarged liver. This was the first mention of the liver (“hepatitis”) in official documents. Napoleon then parlayed this into a political process with propaganda value.
For Napoleon's “hepatitis” O'Meara prescribed calomel, “a colorless, white or brown tasteless compound, Hg2Cl2, used as a purgative and insecticide, also called mercurous chloride.” He also proscribed hot baths and more exercise. O'Meara was required by Lowe to report all changes in Napoleon's health, and Napoleon edited the reports submitted to his own advantage! O'Meara even warned Lowe that Napoleon might die within six months if he were not taken off the island!
O'Meara, with the connivance of Napoleon, continued to issue reports to Lowe about the seriousness of Napoleon's hepatitis. O'Meara reported that Napoleon's abdominal pain, constipation, and “flatulence” were getting consistently worse, and that he was satisfied that it was hepatitis. Finally, Lowe had enough and sent O'Meara back to England on August 2, 1818. Napoleon then spent the next five months without a doctor in attendance.
On the night of January 16, 1819 Napoleon was taken seriously ill. He suffered vertigo and feinting spells. Lowe sent Dr John Stokoe, the surgeon from the Navy flagship Conqueror in port, to see Napoleon. When Dr. Stokoe arrived in the early morning Napoleon complained of severe abdominal pain and constipation. Now Stokoe diagnosed hepatitis and thought that Napoleon might have a stroke shortly. He recommended “bleeding” Napoleon, which Napoleon finally allowed him to do. He also recommended an enema, which Napoleon also allowed. Stokoe also gave Napoleon a mixture of sodium sulphate, magnesium sulphate, and common salt. Because Dr Stokoe's report to Lowe mentioned hepatitis, Stokoe was removed from administering to Napoleon. Stokoe wound up being court-martialed and cashiered from the Navy! Lowe and the Admiralty refused to countenance any reference to the island's climate having anything to do with Napoleon's health.
Lord Bathurst in London now allowed Napoleon's family to recommend a doctor. Napoleon's mother and her half-brother, Cardinal Fesch, decided on a Corsican anatomist, Dr Francesco Antommarchi. He arrived at St. Helena on September 18, 1819. Antommarchi was only thirty, but he had studied anatomy under the famous Professor Pietro Mascagni in Florence. While Antommarchi was granted his diploma as Doctor of Surgery when he was only twenty-five, he had no experience as a general physician, only teaching anatomy. Since he was in trouble with the police in Florence, he accepted the commission immediately. Once residing at Longwood, Antommarchi quarreled with everyone. Napoleon found him presumptuous and arrogant, and correctly, having no clinical experience. Antommarchi, impressed with administering to the former “Master of the World”, was easily convinced by Napoleon that the diagnosis should be hepatitis, which Napoleon attributed of course to the climate of St. Helena. After Antommarchi was with Napoleon for about three weeks he reported to Lowe that Napoleon was suffering from hepatitis. But since he was French, Lowe left him alone to deal with Napoleon.
During the next few months Napoleon's medical complaints included constipation, colic, and abdominal pain in the area of his liver. Antommarchi prescribed hot baths and frequent enemas, but Napoleon refused any mixtures of drugs. It was about this time that Napoleon began going out-of-doors more often, especially to work in his new garden. He also had a fish pond built near the garden providing fresh fish to eat along with the garden vegetables. To prevent the rats from eating the garden produce, Napoleon had arsenic (rat poison) sprinkled around the garden!
Up to this time only three doctors had personally attended Napoleon on St. Helena, O'Meara, Stokoe, and now Antommarchi. All of them had made reports to Lowe diagnosing Napoleon's illness as hepatitis. But what did they mean by “hepatitis”? Again, back then hepatitis was the diagnosis for any gastro-intestinal disorder. Dysentery was rampant among the British troops who came along with Napoleon. The “bugs” in England were different than those on St. Helena just above the Equator. General Gourgoud and Dr. O'Meara had suffered bouts with dysentery shortly after arriving. At that time most doctors diagnosed dysentery to cover all illnesses when the main symptom of diarrhea was involved. They had no knowledge of any specific organisms that cause the numerous types of bowel distress we know today. It was undoubtedly bacillary dysentery. He had no symptoms of what we today know as hepatitis. One thing that kept Napoleon mostly healthy, with a lack of diarrhea, was that he had all his drinking water boiled! The water at Longwood was so bad that he refused to drink it otherwise. Montholon wrote in his memoirs:
“The water at Longwood became unfit for drinking, it stagnated in the reservoirs, and we were already, obliged to send the horses to water more than a mile beyond the limits of the grounds. There was no water to supply the Emperor's baths. The unfortunate soldiers in the camp at Dead Wood (guarding Longwood) received the water merely by pails, and were thus exposed to dreadful sufferings.”
But, constipation was his nemesis! People living in the Tropics suffer either diarrhea or constipation. They suffer from “thirst, anorexia, lethargy, colic, flatulence, and a feeling of heaviness in the region of the liver.” Napoleon suffered from all of these symptoms.
Napoleon was his own worst enemy on St. Helena. His “cold war” with Hudson Lowe forced him into seclusion just to irritate Lowe. However, it was the worst thing Napoleon could have done if he wanted to prolong his life. He needed fresh air and exercise to support his immune system, which Antommarchi consistently prescribed, but Napoleon ignored him. Aside from the continuing constipation, Napoleon was in reasonably good health from November, 1819 until July, 1820. (Many of Napoleon's close entourage had left St. Helena. Only the Bertrands, Montholon, and his valet, Marchand were left.) His symptoms of “hepatitis” had all but disappeared during this eight-month period.
In July, 1820 Napoleon now suffered what appeared to be a new illness. He was overcome with nausea, severe pain in his upper abdomen after eating, and other symptoms including fever, and pain in his legs. Antommarchi wrote in his memoirs:
“Violent fever – deep and acute pain in the liver – active and pulsative pain in the articulation between the right leg and foot – erysipelatous ('an acute infectious disease of the skin or mucous membranes caused by a streptococcus and characterized by local inflammation and fever') inflammation extending along the back of the foot and a third part of the lower extremity of the leg. I do not hesitate to affirm that these affections are produced by a disordered state of the digestive, and an alteration of the functions of the biliary ('the duct system that creates, transports, stores, and releases bile into the duodenum for digestion includes the liver, gallbladder') organs.”
During the next few days Napoleon suffered from dry coughs, headaches, and difficulty breathing. The problem in his leg was undoubtedly phlebitis. After ten days the symptoms subsided to a tolerable degree. However, other symptoms appeared during this time that were more serious for the future: “anorexia, constant nausea, frequent vomiting, and pain in the right hypochondriac and gastric regions.” He became even more constipated as these symptoms increased. Antommarchi continued to diagnose the problem as a “hepatitis”, which was entirely wrong! Antommarchi failed completely to recognize these new symptoms as a change in the nature of Napoleon's health. Even Count Bertrand noticed this change, writing in his diary:
“This illness had no connection with the old liver problem.”
Even Montholon noticed the change writing in his memoirs:
“The health of the Emperor began to change; want of exercise sensibly affected the lymphatic system.”
Hudson Lowe remarked when he was notified of Napoleon's new illness:
“I have no wish that he should die of an attack of apoplexy – that would be very embarrassing both to me and the government; I would much rather he die of a tedious disease which our physicians could properly declare to be natural. Apoplexy furnishes too many grounds for comment.”
On October 4, 1820 Napoleon organized a picnic at Sandy Bay on the South coast of the island. Passing the home of William Doveton on the way, Doveton invited everyone into his home for a rest stop. Instead of proceeding to Sandy Bay, Napoleon decided to have the picnic there. This was the last time that Napoleon left Longwood. Doveton describes Napoleon later as being “fat in figure, his body and thighs round and plump.” Napoleon had originally made the outbound journey by horseback, but was so distressed after the picnic, he returned to Longwood by carriage. He immediately went to bed, his pulse being “low and irregular”. He now complained that his legs and feet felt cold. Hot towels were applied which gave some relief.
During October, 1820 Napoleon's vomiting and upper abdomen pain became more acute. He would work in his garden among the vegetables and rat poison when he could. Otherwise he would sit in the garden and read. Starting in December he had great difficulty in urinating with attendant pain lasting several days. On January 20th he was violently nauseous. He ate only a fresh egg and some weak tea for breakfast. He ate nothing until later that night when he had a small chicken wing and some lemonade. The following morning Antommarchi found him with a rapid pulse. Antommarchi continued to recommend “blisters”, which did no good at all. By the end of January, 1821 Napoleon was reduced to “fluid forms of nourishment”. The symptoms of anorexia, nausea, flatulence, vomiting, gastric pain, and constipation were now present daily. Antommarchi continued to prescribe various concoctions, but Napoleon refused them. His countenance began to change too. His eyes became deep-set and dim, and his complexion took on a grey “cadaverous” tint. He appeared to still be obese, but it was undoubtedly due to his abdominal distension.
Antommarchi never made any recognition of the possibility of gastric cancer, of which all these symptoms indicated.
Napoleon's “Clinical History” on St. Helena can be summed up in phases:
Phases 1-3 spanned October 1816 to September 1820. In general, Napoleon's health was satisfactory during the first 2 years of this period but in September 1817 and January 1819 he complained of severe gastric pain, pain in the right scapula, nausea, and headaches. His physicians reported emesis, paleness, and constipation alternating with diarrhea. He experienced sporadic episodes of fever, chills, and jaundice with dark urine, which were indicative of a biliary condition. This condition was later supported by the postmortem finding of biliary sludge, described as a “distended gall bladder containing very thick and lumpy bile.”
In phase 4 (October 1820-February 1821), Napoleon's health deteriorated rapidly. He experienced persistent abdominal pain, emesis, nausea (with aversion to meat), dysphagia, constipation, night sweats, fever, progressive weakness, and weight loss. One of Napoleon's remarks recorded at that time is highly significant: “For me, every activity is a Herculean task.” Montholon noted in a letter dated 5 December 1820: “The illness of the Emperor has definitively worsened. His pulse is weak, his gums, lips and nails are colourless.”
Phase 5, the two months that immediately preceded Napoleon's death (March 1821-May 1821), is well documented in Dr Antommarchi's memoirs: “the Emperor suffered from strong, diffuse, abdominal pain (present in 48 of 48 days); fever (present in 36 of 48 days); emesis (present in 32 of 48 days); night sweats (Napoleon had to change clothes several times every night); hematemesis and melena on 5 April 1821; and tachycardia (112 beats per minute) on 1 May 1821. Napoleon died 4 days later.”
We are fortunate to have the contemporaneous diary kept by Count Bertrand covering January, 1821 to Napoleon's death on May 5, 1821, and the memoirs of Napoleon's valet, Marchand, and Count Montholon to know exactly what occurred day by day for the last few months of Napoleon's life, as well as others such as Antommarchi and Dr Arnott.
An interesting mystery is the historical references to Napoleon having been given “bitter almonds”, which contain cyanide. None of the source references make any mention of such a remedy other than Napoleon once asked if there were bitter almonds on St. Helena. He was told there were not. Some writers have suggested Napoleon was given a “cocktail” on May 3rd that combined bitter almonds with the 10 grains of calomel. There was no source evidence of this actually taking place.
Let us now review some of the memoirs involved.
Dr Barry O'Meara left a detailed report for Dr Antommarchi dated July 9, 1818. In his report he mentions the following with regard to the health of Napoleon:
“Acute pain, heat, sensation of heaviness in the right hypochondriac region (abdomen), accompanied by dyspepsia (nausea and heartburn) and costiveness (constipation).”
“The pain, which at first was slight, has become so violent that an inflammatory hepatitis (stomach infection) may be feared. This aggravation of the disorder proceeds from a violent catarrh (infection).”
O'Meara goes on to say that Napoleon appeared to be suffering from a “scorbutic” (scurvy) appearance. He also notes that Napoleon had three decayed molars, which O'Meara extracted over the next few weeks. He goes on to state that,
“In the months of April and May (1818)… (Napoleon) became irregular, and produced costiveness (constipation), diarrhea, abundant evacuations of bilious and mucous matter, cholic, and flatulency, accompanied with loss of appetite, sensations of heaviness, uneasiness, and oppression at the pit of the stomach.”
O'Meara notes further:
“(Napoleon) experienced heat in the right hypochondriac region; nausea, sometimes followed by vomiting of bilious matter, acrid and viscous, and which increased with the pain; almost total absence of sleep; extreme weakness.”
At the end of May, 1818 O'Meara writes:
“The swelling of the legs again appeared, but in less degree than at first. Head-ach, uneasiness, anxiety, oppression in the gastric (abdominal) and precordial (chest) region, paroxysm of fever in the earlier part of the night; skin hot, thirst, nausea, pulse quick.”
“The fever leaves (Napoleon) after an abundant perspiration.”
“(Napoleon's) tongue is almost constantly white.”
On June 11, 1818 Dr O'Meara administered pure “mercury” pills to Napoleon, and continued this treatment until June 16th. He gave Napoleon pills in the morning and at night. On June 16th O'Meara began to administer calomel instead of the mercury, but it caused severe vomiting, nausea, and cholic. O'Meara immediately stopped the calomel, but again administered it on June 19th, with the same side effects. O'Meara then restarted the mercury pills, which continued until June 27th when he stopped them altogether. On July 2nd O'Meara again tried the mercury pills, but again stopped them on July 9th.
Antommarchi was not yet at St. Helena when O'Meara rendered the aforementioned medical report. It had been transmitted secretly to Napoleon's mother and his uncle, Cardinal Fesch in Rome. Upon receiving it they submitted it to several noted physicians in Rome, including Paul-Baptist Mucchelli, the physician to the Pope. He, and four university medical professors, reviewed O'Meara's report and made certain decisions as to future treatment to which Antommarchi was to obey. They recommended:
“A diet tempered by the use of fresh vegetables, subacid fruits, and animal substances of easy digestion, and calculated to produce chyle (lymphatic fluid) of an emollient nature.”
“The use of mild remedies which do not irritate the system. Preference should, however, be given to the extract of cicuta (hemlock!), acetate of potass (postassium acetate, an antacid and preservative, the most famous use of which was to preserve Lenin's body!), and a little salt mineral water.”
“If these remedies should not open the bowels, a small dose of pills, composed of soap, rhubarb, sulphate of soda or potass, and mixed with an extract of taraxicum (Dandelion), might be administered to the patient three times a week before supper.”
None of these recommendations were ever followed by any of the doctors tending to Napoleon, including Antommarchi.
Around January, 1819 Antommarchi was getting very concerned that Napoleon was not responding to anything he was doing. He requested help, which came in the form of one Dr John Stokoe, one of the military surgeons. Dr Stokoe first personally visited Napoleon on January 17, 1819 and filed the following report to Sir Hudson Lowe,
“I have visited Napoleon this morning, and found him in a state of extreme weakness. He suffered great pain in the right side, in the hepatic (abdominal) region, and shooting pains in the shoulder. In the middle of the night he had a violent head-ach, followed by vertigoes, which lasted a quarter of an hour.”
To Count Bertrand Stokoe wrote on January 18, 1819:
“Notwithstanding the symptoms of chronic hepatitis which first appeared sixteen months ago, and the disorders they have produced, I do not think there is any imminent danger. The disease assumes every day a more unfavourable character, and will, in all probability, terminate Napoleon's life.”
On January 19th Stokoe reported to Lowe:
“The fever continued the same, the heat of the skin was considerable, the head-ache had increased, and he had had no motion for twenty-four hours.”
“(Napoleon) manifested repugnance to my prescriptions, and preferred an enema.”
“I strongly insisted on his being bled: (Napoleon) consented, and experienced almost immediate relief. He also took a strong dose of Cheltenham salts (special salt from Cheltenham, England mixed with carbonate of soda).”
What got Dr. Stokoe thrown off St. Helena, and subsequently court-martialed and dismissed from the service was his closing statement:
“I am now convinced that the liver is seriously affected.”
Napoleon, O'Meara, and the Longwood residents had stated continuously since they arrived on St. Helena that hepatitis, the liver disease, was endemic to the island, and Napoleon's continued residence would condemn him. Dr Stokoe, putting this in writing to Lowe, instead condemned himself.
Click here for a day-to-day summary of Napoleon's ailments and treatments, as recorded in the “source” journals beginning January 1, 1821.
So what are we left with as a logical conclusion, which must be based upon scientific logic and empirical evidence otherwise it is mere conjecture. Several questions need to be answered:
1. How could inorganic arsenic get into Napoleon's hair medulla?
This is not at all difficult now that we know what occurred. Arsenic usually can only be traced in hair back about six months. During this period in Napoleon's life he did a lot of gardening at Longwood. Due to the rat infestation large quantities of rat poison (inorganic arsenic) was spread in the garden as a pesticide. Napoleon ate the vegetables from the garden ingesting inorganic arsenic. Furthermore, with the amount of rat poison consistently in use on St. Helena, there is a very good chance it was not only in the dirt used to grow food, but also in the drinking water. The diarrhea suffered by those living at Longwood, and the soldiers tenting at Deadwood nearby, while diagnosed mainly as amoebic dysentery, could also have been caused by the ingestion of quantities of inorganic arsenic in the food they ate and what they drank. People back then did not wash their food as well as we do today. Napoleon had been eating the vegetables coming from his garden for nearly two years. During that time Madame Bertrand had become very ill as had Marchand – both nearly died! Others in Napoleon's retinue were also sick with gastric illnesses during the same period such as Gourgaud, Montholon, and especially Cipriani who died.
With respect to the amount of rat poison allegedly in the hair of Napoleon at his death (not nearly enough to kill him), it is not unusual that it was present. In that regard, from what other persons at Longwood were hairs tested who also ate the vegetables and drank the wine? The testing of Napoleon's hairs, and we can not conclusively be assured they are actually from Napoleon, proves only that the hairs tested contained levels of inorganic arsenic, not that it was, or contributed to the cause of his death. There was never a baseline created using hairs from known persons who were there at the time, and who had to have died shortly before or after Napoleon to be considered scientific proof of poisoning.
The question as to how inorganic arsenic came to be discovered in the medulla of, allegedly, Napoleon's hair therefore becomes immaterial. Further, if the hairs tested all came from Napoleon, why were different levels of arsenic discovered? Again, the arsenic found in these hairs alleged to have been Napoleon's appears merely a red herring to further a point of view. It is far more intriguing to allege that Napoleon died as the result of some conspiracy than accepting the clear fact that the great man expired from natural causes, hurried up by simple medical ignorance.
2. Did the 10 grains of calomel kill Napoleon?
On May 3, 1821 British Doctor Arnott, together with Dr. Antommarchi, administered 10 grains (650mg) of calomel to Napoleon in a “heroic” attempt to revitalize his gastrointestinal tract. It was administered after a consultation with other British military doctors shortly before.
In a prior letter written by Count Montholon to his wife, Albine, who had left St. Helena earlier, he mentioned that he would be home soon because calomel would do Napoleon in!
What is calomel?
Calomel has been in existence since the 1600s. It is a chlorine salt of mercury. It has had a very long and varied past. There was even a song written about it:
Ye doctors all of every rank
With their long bills that break the bank,
Of wisdom's learning, art, and skill
Seems all composed of calomel.
Since calomel has been their toast,
How many patients have they lost,
How many hundreds have they killed,
Or poisoned with their calomel.
If any fatal wretch be sick
Go call the doctor, haste, be quick,
The doctor comes with drop and pill
But don't forget his calomel.
He enters, by the bed he stands,
He takes the patient by the hand,
Looks wise, sits down his pulse to feel
And then takes out his calomel.
Next, turning to his patient's wife,
He calls for paper and a knife.
“I think your husband would do well
To take a dose of calomel.”
The man grows worse, grows bad indeed
“Go call the doctor, ride with speed.”
The doctor comes, the wife to tell
To double the dose of calomel.
The man begins in death to groan,
The fatal job for him is done,
The soul must go to heaven or hell,
A sacrifice to calomel.
The doctors of the present day
Mind not what an old woman say,
Nor do they mind me when I tell
I am no friend to calomel.
Well, if I must resign my breath,
Pray let me die a natural death
And if I must bid all farewell,
Don't hurry me with calomel.
(American Antiquarian Society, American Ballads and Songs c.1800)
Many writers wrote about calomel in their novels – writers such as F. Scott Fitzgerald who wrote, “Bitter calomel under the thin sugar of love's exaltation”. Others such as Ralph Waldo Emerson, Herman Melville, and Walt Whitman, to mention just a few, used “calomel” in their writings to make a negative point understood.
One of the main drugs carried by Lewis and Clark on their Westward expedition in 1803 was Calomel tablets. It was a well-known “cure” for venereal disease, especially syphilis. It was used extensively by sailors around the world who took it before plying the brothels in each port to prevent venereal disease. It was issued by the US Army during the Mexican War in 1846 and then extensively during the American Civil War by both sides. The armies issued it as a prevention of venereal disease so that manpower would not be reduced. An American Navy Secretary tried to prohibit its use because he felt it would encourage immorality by the sailors!
One of the greatest purveyors of the use of calomel was Dr Benjamin Rush – the same Dr Rush who was a signer of the American Declaration of Independence in 1776. (Rush was a delegate from Pennsylvania along with Benjamin Franklin.)
Dr Rush was born near Philadelphia in 1745. He spoke fluent Greek and Latin and attended Princeton in New Jersey, graduating in 1760 at age fifteen. He then began a study of medicine in Edinburgh, Scotland where he graduated in 1768 with an M.D. degree. Returning to Philadelphia in 1769 he was elected professor of chemistry at the college of Philadelphia. In 1791, Rush was designated professor of the institutes and clinical practice at the University of Pennsylvania. He was very popular and respected. It was at this time that Dr Rush developed his theory on “heroic” medicine.
Rush believed that cathartics and bleeding would cure most ailments. His theory had been published worldwide, and he lectured on the subject at every opportunity. His cathartic of choice was Calomel giving it the name, “The Samson of the Materia Medica.”
In 1793 Philadelphia was deluged with Yellow Fever. It was widespread and people were dying with no relief. It eluded the skills of many of the best doctors. Over 4000 died from the disease in a six-week period. Rush weighed in with his “heroic” theory and began to treat the dying with a combination of Calomel and “jalap” saving the first four out of five patients. He discovered that many of the doctors had been using small doses of calomel together with “bark, wine, and laudanum”, without positive results. Rush was inundated with orders for Calomel, which he gladly compounded and sold. However, other doctors misused the calomel causing many people to die from it. Purging and bleeding continued in use throughout the epidemic. Out of some 10,000 people who contracted Yellow Fever, some 50% were actually saved. Dr Rush's medical practice thrived!
The relevance of the use of calomel by Dr Benjamin Rush is that he was introduced to it when he studied medicine in Scotland. The majority of the British doctors in attendance upon Napoleon also studied medicine in Scotland.
Calomel was still in widespread use to prevent venereal disease as late as 1956 when the writer Jack Kerouac referred to “Sanitubes” of Calomel he was using to frequent the prostitutes in Mexico City. Calomel did not kill Napoleon, it just hurried up the process!
3. Did Napoleon actually die from gastric cancer?
It may not be that simple. In 1683 Polish physicians isolated a new gastric bacterium, Helicobacter Pylori, “H. pylori” for short. These Polish doctors actually published their findings, but they published in Polish! Nobody outside ever translated their work so it remained unknown outside Poland for over 200 years. Dr Jeannette Guarner wrote in 2004 in the Current Gastroenterology Reports (441-445), Current Science, Inc.:
“Helicobacter pylori is the most frequent infection of the stomach worldwide. Some of the people infected with H. pylori develop symptoms of dyspepsia that correlate with pathologic evidence of gastritis and peptic ulcers. In addition, H. pylori has been associated with preneoplastic lesions and with two neoplasis: intestinal-type gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma. Rarely, gastric pathology can also be caused by other infectious agents including fungi, other bacteria, parasites, and viruses.”
She wrote further:
“In industrialized countries, infection occurs in 40% to 50% of adults older than fifty years and in 5% of children younger than ten years. In developing countries rates of infection are far higher. In adults they exceed 85% and in children they are above 30%. H. pylori infection is usually acquired during childhood, and left untreated, it persists throughout the person's lifetime.”
“Not all people infected with H. pylori will develop symptoms; however, H. pylori has been associated with a variety of pathologies in the stomach that range from gastritis to cancer.” (Emphasis added)
Now it gets really interesting;
“Since the early 1800s, bacteria were described in the stomach and were considered normal gastric flora similar to bacteria present in the intestines. Thus, gastritis was classified on the basis of the type of inflammation (acute or chronic), site, and accompanying features (e.g. superficial or atrophic) and did not consider an etiologic agent. It was not until 1984 that Marshall and Warren established the association of Campylobacter pyloridis (as it was then known) with active chronic gastritis and revolutionized our understanding of pathogenic processes in the stomach.”
So what actually is the H. pylori bacterium? Dr Guarner explains:
“Helicobacter pylori is a gram-negative spiral bacterium that has the ability to thrive in the hostile acidic environment of the stomach by producing large quantities of urease and surrounding itself with an ammonia cloud. The organism is usually found between the mucous layer of the stomach and the gastric epithelium. The organism does not invade the epithelium, but it causes degeneration of the cell surface. The inflammatory reaction progresses to what is considered a chronic active gastritis.” (Emphasis added)
Based upon many reputable medical experts, H. pylori survives in stomach acid because of the secretion of the protective fluid by the bacteria. The bacterium burrows its way into the stomach's mucous lining and remains there. However, if the person's stomach is susceptible to lesions (ulcers), or develops ulcers during the course of a lifetime, the bacterium attacks the weak spot making it even weaker and more susceptible to an ulcer. Depending upon the person's life-style and eating habits, the ulcer is susceptible to perforation causing death.
Where does H. pylori come from, and why is it so prevalent?
It is found in nature and ingested with dirty food or water, prepared in an unclean environment. This is why more than 85% of people living in 3rd World countries are infected. In most cases they do not even know it because it only presents symptoms under certain conditions. Once those conditions are relieved, it becomes dormant again until it is again aggravated. According to the Mayo Clinic:
“Helicobacter pylori (H. pylori) is the bacteria responsible for most ulcers and many cases of stomach inflammation. The bacteria can weaken the protective coating of the stomach, allowing digestive juices to irritate the sensitive stomach lining. If you are a carrier of H. pylori, you may have no symptoms. If you have an ulcer or gastritis, you may have some of the following symptoms:
• Abdominal pain
• Bloating and fullness
• Dyspepsia or indigestion
• Feeling very hungry 1 to 3 hours after eating
• Mild nausea (may be relieved by vomiting)”
Other symptoms include, all of which have been mentioned in reference to Napoleon:
• Weight loss
• Poor appetite
Medical assistance is recommended if an individual displays any of the following symptoms (once again, all of the following have been attributed to Napoleon at some point):
• Sharp, sudden, persistent stomach pain radiating into a shoulder
• Bloody or black stools
• Bloody vomit or vomit that looks like coffee grounds
These can be signs of a serious problem, such as:
• Perforation — when the ulcer burrows through the stomach or duodenal wall
• Bleeding — when acid or the ulcer breaks a blood vessel
• Obstruction — when the ulcer blocks the path of food trying to leave the stomach
In order to treat Napoleon, his “doctors” gave him calomel and other purgatives to induce vomiting – the very worst thing they could have done! It only irritated the chronic ulcer he already had, which was verified at the autopsy. The constant administration of purgatives in an empty stomach finally wore a hole through it, which is what ultimately did for Napoleon. Too bad Nexium was not available! On the other hand, there were solutions available for chronic gastritis, such as sodium bicarbonate and bismuth subsalicylate: Pepto Bismol!
The last question logically must be:
3. If Napoleon had been left alone to his own devices without benefit of medical interference, how long would he have survived?
If Napoleon had not consumed purgatives, especially calomel, and had he not had constant enemas depleting his electrolytes the probability is that he could have survived for at least another six months by controlling his diet. It turns out that Napoleon was far smarter than the doctors attempting to treat a condition of which they had little knowledge. It should not be forgotten that they were all military surgeons, and Antommarchi was a “cadaver cutter”, not a practicing physician with knowledge of diagnostic principles and symptom treatments.
So what are we left with as to the cause of Napoleon's death? It appears far simpler than one would expect! Napoleon Bonaparte died from a perforated gastric ulcer – his death caused prematurely by medical ignorance! As Sir Hudson Lowe stated on May 6, 1821:
“He was England's greatest enemy, and mine too; but I forgive him everything. On the death of a Great Man Like him, we should only feel deep concern and regret.”
The Lowe Papers, British Library, Add. MSS nos. 20107-20240
Monographs & memoirs:
Antommarchi, Francesco, M.D., The Last Days of the Emperor Napoleon, (English Ed.), 2 vols. London, 1825.
Arnott, Archibald, M.D., An Account of the Last Illness of… Napoleon, London, John Murray, 1822. (39 pages)
Chaplin, Arnold, M.D., A St. Helena Who's Who, Chaplin, London, 1914.
Chaplin, Arnold, M.D., The Illness and Death of Napoleon Bonaparte, London, 1913.
Correspondence de Napoleon I, Vol. 15, 12635.
Corso, Philip F., M.D., Hindmarsh, Thomas, Science Progress (1996), 79 (2), pp 89-96.
Forsyth, William, History of the Captivity of Napoleon at St. Helena, London, 1853.
Fremeaux, Paul, With Napoleon at St. Helena, (English Ed.), London, 1902.
Friedman, R., The Emperor's Itch, New York, 1940.
Gourgaud, Baron, Memoirs of the History of France During the Reign of Napoleon ,Vol. 1, London, 1823.
Gourgaud, Baron, Talks of Napoleon a St. Helena, Chicago, 1903.
Henry, Walter, M.D., Events of a Military Life, 2 vols., Quebec, 1843.
Kemble, James, M.D., Napoleon Immortal, John Murray, London, 1959.
La Chronique Medicale, May 15, 1903.
Las Cases, Count de, Memoirs of… Count de Las Casas, London, 1818.
Las Cases, Count de, Letters from the Count de Las Cases, London, 1819.
MacLaurin, Charles, Post Mortem: Essays, Historical and Medical, London, 1923.
Marchand, Louis-Joseph, In Napoleon's Shadow, Proctor Jones, San Francisco, 1998.
Masson, Frederick, Napoleon and the Fair Sex, (English Ed.), London, 1894.
Masson, Frederick, Napoleon at Home, (English Ed.), London, 1894.
Masson, Frederick, Napoleon at St. Helena, (English Ed.), Oxford, 1949.
Montholon, Count, History of the Captivity of Napoleon at St. Helena, Carey and Hart, Philadelphia, 1847.
O'Meara, Barry, M.D., Napoleon in Exile-A Voice from St. Helena, 2 vols., London, 1822.
Priest, W. M., The Post Mortem on Napoleon Bonaparte, London, 1929.
Seaton, R.C., Napoleon's Captivity in Relation to Sir Hudson Lowe, London, 1903.
Sokoloff, B., Napoleon: A Medical Approach, London, 1938.
Swiderski, Richard M., Calomel in America, Brown Walker Press, Florida, 2009.
Watson, G.L. de St. M., The Story of Napoleon's Death Mask, New York, 1915.
Internet (all external links):