What Killed Jane Austen?: And Other Medical Mysteries (2 page)

Apart from prolactinaemia, with her stressful, lonely and deprived childhood there must have been a psychological overlay.

In 1994 a research team in Lisbon found that the unusual conditions of a prolactin-producing tumour and excessive secretion of the hormone prolactin for no known reason are more common in women reared without a father, or at least one who is violent and alcoholic. It is a strange connection, but Mary could fit it on the score of paternal deprivation.

But from what has been positively observed, she had lack of menses, no eyebrows, a dry skin, a hoarse voice and ever-diminishing vision. The conglomerate of signs and symptoms together with her mode of death would seem to indicate a pituitary disorder, probably a tumour (possibly a prolactinoma) in that small but important gland in the brain.

The status of prolactin in the scheme of things medical and its place in a successful pregnancy was not elucidated until the 1970s, so Mary never stood a chance as far as a successful pregnancy was concerned.

What we need is a peek at the skull, especially the bony cavity or fossa wherein lies the pituitary gland. If our theory is correct, this would still show the erosion of the bony walls from an expanding tumour, even though the pituitary itself has long since rotted away.

The tomb was opened about 100 years ago, but the attendant Dean of Westminster was no pathologist, so the type of conclusion we are after did not emerge. The Queen is the custodian of the Abbey and decides such things as who opens tombs. Her permission to settle our idle curiosity is unlikely.

We are left to speculate—if Mary had received treatment for her condition, perhaps she would have had an heir and Elizabeth I would not have ascended the English throne.

What about Philip?

‘Workaholic’ is what today’s critics would label him. Hendrik van Loon just calls him ‘obnoxious’. According to
The Larousse Encyclopedia of Modern History
, Philip was ‘Lacking tact and intuition, he ruled his empire through a vast intelligence network and was a slave to paper-work.’ Still other critics considered him dull.

But such dismissals do not do Philip justice; as historian J.H. Plumb writes:

Indeed Philip enjoyed fishing and hunting, and appreciated gardens, buildings, music, and birds and other animals. He had the largest private library in the Western world, and also collected coins, medals, musical instruments, jewellery and paintings. He also received respect and even love from many of his Spanish subjects.

He was a devoutly religious man, leading a serious, purposeful life. As well as God, Philip had to contend with the figure of his father, forever watching over his shoulder.

1558, the year of Mary’s death, was a watershed for both Spain and England. Charles’s death from gout finally ended Philip’s apprenticeship. The same year, Elizabeth I succeeded her half-sister, Mary Tudor, as England’s ruler.

The English alliance was as short-lived as the marriage of Philip and Mary.

The rivalry of Catholic Spain under Philip II and Protestant England under Elizabeth I dominated European politics for the rest of the 16th century.

Protestantism for Philip II meant rebellion and chaos, while Catholicism meant unity and devotion.

Elizabeth always tried to avoid open conflict. According to the historian S.T. Bindoff, ‘She would cheerfully have fought Spain to the last drop of French blood.’

The struggle ran for decades—a subtle, shifting game that Elizabeth played so well.

At times Philip worked to overthrow Elizabeth. But he also negotiated to marry her, and she led him on. While he lived in hope, he appeased her. So when he was not plotting against her, Philip the Catholic monarch protected Elizabeth (an arch-heretic) from the Pope’s plan to depose her by force!

But Elizabeth showed little gratitude. She kept supporting his rebellious Dutch Protestant subjects and encouraged Sir Francis Drake to plunder and destroy Spanish ships not only in the New World, but even in Spain itself.

Finally, in 1587, Elizabeth reluctantly executed her cousin, the Catholic Mary, Queen of Scots, who had been plotting to kill Elizabeth and seize the throne.

All this was too much for Philip. After 30 years of struggling with Elizabeth, he finally sent the ‘Invincible Armada’ against England. Its failure was a bitter blow to him.

According to J.H. Plumb:

The problems that faced Philip were as great as his empire. He was constantly at war … The Turks were an unending menace … the Dutch and the English were officially or unofficially at war with him for decades Philip could never be sure whether the English pirates might not appear—burning, ravishing and robbing …

Apart from Spain itself, he ruled an empire of 50 million subjects. From Madrid, it took two weeks to send a letter to Milan or Brussels; two months to Mexico, and a year to the Philippines, which Spain was annexing.

Philip distrusted people, and did not like to delegate. No wonder that he dealt with up to 400 documents a day.

And his health? Philip’s pallor and fair hair had always made him look sickly. His diet was neither healthy nor varied. There were only two meals a day, both offering the same choice: soup, white bread, chicken, partridge, pigeon, venison or other game, beef and fish (on Fridays). Fruit and vegetables were not popular.

For his constipation, Philip received turpentine, emetics and enemas. He reputedly had piles, asthma, gallstones and bouts of malaria (some have also said syphilis).

The gouty arthritis that had killed his father Charles also ravaged Philip. By his mid-thirties, he had his first acute attack; within a decade, the gout had become chronic.

As his health grew worse, so did his political fortunes. Marshall Dale believes that Philip saw his gout:

… as God’s rebuke to a servant who was not properly diligent in the holy work of exterminating heretics and winning converts to the one true faith. His disease… largely explains the unspeakable cruelties inflicted by a man who was not basically inhumane upon the hapless victims of the Spanish Inquisition.

Some 35 years after his first attack of gout, Philip’s episodes gradually became more frequent and more severe.

By his late sixties, one arm was nearly useless; one knee was rigid, and he could only just hobble around. But no one ever heard him complain.

By the age of 70, he was nearly bedfast; he could neither dress nor toilet himself.

His surgeons bled him over and over. To drain his swollen knee, they reportedly inserted threads which produced open, weeping sores. Infection wasted his frail body.

Philip did not want to die in Madrid, but in the Escorial—the palace, church, monastery and school that he himself had built to honour God—about 40 kilometres away. To save him the agony of a jolting coach, litter-bearers carried him all the way.

From his couch in the Escorial, Philip could draw comfort from the sight of the altar.

Bedsores and ulcers now made it too painful to move him at all; the stench kept away most visitors.

While the sun rose on 13 September 1598, Philip II, King of Spain for 42 years, clutched his father’s crucifix. As the children of his seminary began to sing Mass, he won final release from his sufferings.

(GB & JL)

The year 1993 saw the 200th anniversary of the beheading of Louis XVI (21 January) and his Austrian wife, Marie Antoinette (16 October). To compile an essay on the medical history of beheading would be difficult, its swift finality leaves no room for conjecture, but aspects of the royal couple’s earlier life together do provide us with a few fascinating clinical morsels.

In 1768 Marie Antoinette became betrothed to Louis, then Dauphin of France. She was 13 and he 14 years old. Marriage could not take place until after her first menstrual period, and as this did not manifest itself until February 1770, the ceremony was delayed until May that year.

She was an attractive young woman, petite, blonde, and amiable. He was gawky, overweight, uncouth, painfully self-conscious, and described by the Austrian envoy as showing ‘only limited intelligence. Nature seems to have refused him everything’. His only accomplishments seem to have been an ability to hunt stag and to make locks in his private forge.

Not a propitious beginning, but worse was to come.

The nuptial bed was blessed by the Archbishop of Rheims; and King Louis XV, the groom’s grandfather, gave Louis his nightshirt. As the monarch was a well-known lecher whose string of conquests had included Madame Pompadour and Madame Du Barry, it may not have had much wear.

The couple retired, and, half dreading, half curious at what was to come, Marie Antoinette waited. And waited. The bulky form beside her lay still, asleep. Night after night the same ritual was repeated. The chambermaids searched the dauphine’s bedclothes in vain for the telltale signs of loss of virginity, and the coy beginning soon became a matter of common gossip.

Spies from the Viennese court reported back that Louis was ‘very much like a eunuch in his figure, and possibly a eunuch in fact’. The royal doctors were consulted and made reassuring noises, considering he was not yet mature and that in time, together with the right food and exercise, all would be well.

To handle the royal genitals seems to have been outside the doctors’ brief, for they missed the vital clue—the unfortunate bridegroom’s phimosis. This is an inability to retract the foreskin or prepuce; during an erection, constriction of the penis by its non-retractable skin sheath causes excruciating pain. The remedy is a fairly simple operation.

So, not having the gumption to seek help, the youth opted out of his marital duties altogether. Mind you, there was no anaesthetic then, and the thought of knives flashing so close to the crown jewels would have caught the breath of even the most insensitive lad. So a stalemate was produced by name and by nature.

To her credit, Marie Antoinette maintained her composure, at least outwardly. The two apparently discussed the problem, and surgery was agreed upon. But Louis decided to postpone things until his 16th birthday, 23 August 1770; and then, wham.

Louis’ birthday came and went. The surgeon was not called and the shared virginity persisted.

There was similar vacillation when he became king in 1774. As the surgeon spread out the instruments, the terrified patient fainted (surely that would have been just the moment to act!).

After seven barren years, Marie Antoinette’s eccentric brother, Joseph, decided to journey from Vienna and sort them out. For the first time here was someone who did not mince matters. After a heart-to-heart he wrote to his brother that Louis was able ‘to have strong well conditioned erections’, but not complete the act. ‘He introduces the member, stays there without moving for perhaps two minutes, withdraws without ejaculating but still erect, and says good night.’ Pain for Louis, disappointment for Marie Antoinette and frustration for both.

The forthright Joseph went on in his blunt way: ‘This is incomprehensible because with all that he sometimes has nightly emissions, but once in place and going at it, never; he says plainly that he does it from a sense of duty but never from pleasure. They are two complete blunderers.’ He wanted to whip Louis ‘so that he would ejaculate out of sheer rage like a donkey’.

Joseph persuaded the dauphin to have the dreaded operation and advised his sister thereafter to entice her husband into bed in the afternoon when he still had energy; as later, after a meal, he would flag. Her brother then went off to reaffirm his faith in human nature by sampling the delights of the Parisian demimondes.

Now, with the prodding of his brother-in-law, the deed was done, and when all was healed the seven-year-old marriage was finally consummated.

At the end of August 1777 Antoinette wrote to her mother: ‘more than eight days since my marriage was perfectly consummated; the proof has been repeated and yesterday even more completely than the first time.’ Smiles all round. Eventually, she went on to have four children, but only one survived to adulthood.

But Marie Antoinette had other medical problems. When writing to her mother her whimsy was always to use the euphemism ‘General Krottendorf’ when referring to her periods, and from her correspondence it is apparent that she had no menses for the first four months after arriving in France. With the upheaval and subsequent sexual stresses that is not perhaps surprising.

But the reverse happened when Marie was incarcerated in her dank cell in the Conciergerie from 2 August 1793, when she suffered from menorrhagia, or excessively heavy periods. To add to her overall ignominy the queen, by now 37 years old and white haired, had to beg for linen rags from her attendant to help staunch the flow. The maid tore up her own chemises for the purpose.

On the day of her execution the queen asked the guard if she could change her stained petticoat in private. He refused, so she took it off in front of him, rolled it up and stuffed it into a chink in the cell wall. The cell today is as she left it, chill and austere; I am not so sure about the undergarment.

As she left to mount the tumbrel, the queen felt a need to go to the toilet. Her hands were unbound by Sanson, the executioner, and she relieved herself against the prison wall and before a clutch of bemused onlookers. Her humiliation was complete. It was sealed by her being trundled to the scaffold, where waited an inglorious end to a tragic and unfulfilled life.

(JL)

History has not dealt kindly with King George III. At school we learnt that his decision to transport convicts led to British colonisation of Australia, and that he lost the American colonies and then his wits. But historian John Clarke has called him ‘the only Hanoverian who could be called a genuinely decent and good man’.