The Pharmaceutical Journal Vol 265 No 7109 p238
August 12, 2000 Letters

Napoleon

Folk history

From Mr W. A. Jackson, FRPharmS

SIR,-In your July 15 issue (p76), "Onlooker" reported that the vexed question of the cause of Napoleon's death was raised once more in Paris at a meeting of the International Napoleonic Society.
There seems to be little evidence that he was poisoned by arsenic, whether by ingestion or by inhalation of gaseous trimethyl-arsine emanating from damp wallpaper which contained a green arsenical pigment.¹ Cooper² lists the symptoms of chronic arsenical poisoning as: "Polyneuritis with paraesthesias and anaesthesias of hands and feet. The skin is bronzed and oedematous, with hyperkeratosis of palms and soles. Nausea, vomiting, abdominal cramps and salivation are accompanied by liver cirrhosis, anaemia, weight ioss, chronic nephritis, with loss of hair and garlic breath. Termination is by cardiac failure." Richard Gordon³ was of the opinion that Napoleon "offered no signs of arsenic poisoning in life or death". The diarrhoea and vomiting were not accompanied by laryngitis, and there are no reports that he suffered from smarting eyes, eczema, skin pigmentation or numbness of the arms and legs due to neuritis. The post mortem showed that his heart was in good condition and the body was fat.
It has also been suggested that Napoleon died from cancer of the stomach. Gordon advances the hypothesis that he died from a non-malignant peptic ulcer which perforated the stomach wall. The post mortem was carried out by Francesco Antommarchi, assisted by seven British doctors. An ulcer ran almost the whole length of the upper edge of the stomach, the usual site for a non-malignant ulcer; cancers are normally found at one end of the stomach. The ulcer had perforated the stomach wall as often occurs with peptic ulcers, whereas cancerous ones are shallow and do not. No secondary cancers were found.
Antommarchi, who attended Napoleon towards the end of his life, was a fellow Corsican who had been sent to Elba by Napoleon's mother. It is unlikely that he was in league with the British to poison his patient, and would surely have noticed and reported symptoms of arsenical poisoning.
I believe that Gordon makes out a good case for the cause of Napoleon's death having been a perforated peptic ulcer, but the idea that he was poisoned by the British seems to have become part of French folk history, and it is probable that the subject will continue to be debated for many years to come.

W. A. Jackson
Manchester

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