How Our Ancestors Conducted Dental Surgery

Modern dentistry is evolving rapidly with new technology, new treatments and innovative ideas about the future appearing day by day; however, if you go back through the ages, you may be surprised just how far we have come, from the days when blacksmiths and barbers would double up as dentists.

DentistThe practice of dentistry dates back thousands of years, with records of the Ancient Egyptians writing about tooth decay and the oldest filling found by archaeologists dating back more than 6,500 years. Hippocrates and Aristotle both wrote about the treatment of common dental ailments and discoveries from Ancient Egypt and Greece suggest that early versions of restorations were used and surgical methods practised to treat dental issues. Surgical equipment was more akin to tools, and restorative materials were used from natural substances, such as beeswax.

Sumerians, an ancient culture from the historical Mesopotamia region, believed a ‘Tooth Worm’ was responsible for tooth cavities. The idea later spread to Asia, and then Europe as late as the 14th Century.

Dentist registration and early dental surgery

It was only 150 years ago that the first dentist was officially registered; Sir John Tomes was the first official dentist and is regarded as a pioneer in his field. Sir Tomes had a wide range of interests including the anatomy and biology of the teeth and the development of dental equipment and is credited with making major advances in dentistry at the time.

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Johann Joseph Gassner – Exorcist Healer

In late eighteenth century southern Germany, in the middle of the Age of Enlightenment, a portly, balding catholic priest by the name of Johann Joseph Gassner shot to fame by claiming to heal thousands through the power of exorcism.

Treating patients from all walks of life including princes and peasants, the unassuming Father Gassner staged bombastic rituals in front of enthralled crowds, triggering a German catholic revival as well as provoking bitter responses from sceptical critics. In the face of eye-witness testimony and heated religious debate, scientific thinkers attempted to explain these seemingly miraculous cures through a strange new power dubbed ‘animal magnetism’ and engaged in some of the first discussions of the placebo effect in medicine.

Demons and Disease

‘[The Ancients believe] all things are full of demons, and that they are able to invade men and drive them mad.’

- Johann Salomo Semler

Johann Joseph GassnerBorn in the village of Braz in the Vorarlberg region of western Austria in 1727, Johann Joseph Gassner began his religious training with the Jesuit order in Prague before starting his own secular career in 1750. It was during his time as a priest in Klösterle however, that he discovered his power for healing. After suffering acute headaches and fainting spells for many years, from which he reported learned doctors could offer no relief, Gassner concluded that his maladies were being caused by the devil, and therefore decided to exorcise himself.

The belief that evil spirits, or the devil, lay behind human illness stretches far back into antiquity. Yet by the eighteenth century, reformed, protestant thinkers, such as Johann Salomo Semler, had begun to question the Christian basis of such ideas. Despite this, belief in medically meddling spirits remained strong and when Gassner’s self-exorcism seemed to work, he resolved to spend the next decade perfecting this method of healing.

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Herophilus and Erasistratus: The ‘Butchers’ of Alexandria

During the third century BCE, the city of Alexandria was home to a remarkable event in the development of ancient medicine as two physicians, named Herophilus and Erasistratus, conducted ground-breaking investigations into internal human anatomy. This research was important not only because it corrected many ancient misconceptions about the body, but because the doctors are believed to have reached their conclusions by dissecting human corpses, a practice outlawed in the Ancient World.

Although both doctors are known to have written several books, no complete work by either author survives. Our knowledge of the two physicians therefore comes from references and quotes by later writers.

Anatomy at Alexandria

‘Let it be your serious concern not only to learn accurately from books the shape of each bone, but also to carry out a keen visual examination of the human bones… This is very easy at Alexandria… [and] for this reason, if for no other, try a visit to the city.’ - Galen, On Anatomical Procedures

Founded in 331 BCE by Alexander the Great, the ancient city of Alexandria was the purpose-built capital of Greek-ruled Ptolemaic Egypt. Designed to act as a link between Greece and the fertile Nile Valley, Alexandria was located on Egypt’s Mediterranean coast and served as both an economic and cultural centre. Continue reading

Mary Seacole – a summary

This is how the story goes… Mary Seacole was born Mary Jane Grant in 1805, in Kingston, Jamaica to a Jamaican mother and a Scottish soldier: ‘I have good Scots blood coursing through my veins,’ as she wrote on page one of her memoir. Her mother, a freed black woman, kept a home, or a boarding house, for wounded soldiers (many of them British soldiers suffering from yellow fever) and installed in Mary a love of nursing and medicine.

Mary SeacoleA keen traveller, the young Mary journeyed widely with her parents, including two trips to Britain, expanding her medical knowledge.

In 1836, she married Edwin Horatio Seacole, a former guest at her mother’s boarding house. Edwin Seacole was believed, without substance, to have been either an illegitimate offspring of Lord Nelson and his mistress, Lady Hamilton, or Nelson’s godson. A sickly man, he died eight years later in 1844. Despite several offers, Mary never married again. As a couple, the Seacoles had maintained the boarding house established by Mary’s mother and, as a widow, Mary Seacole’s work intensified in 1850 when a cholera epidemic struck Jamaica, killing over 30,000 inhabitants.

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Louisa May Alcott and the American Civil War

Louisa May Alcott, author of Little Women, had the briefest of nursing careers: about six weeks, from start to finish.  Alcott being Alcott, she effectively morphed the experience into grist for her literary mill.

Alcott was not a Big Gun in nursing history. Her musings are not technically significant, like Florence Nightingale’s contemporaneous Notes on Nursing.  Her service does not resonate through Civil War history like that of her influential contemporaries, Dorothea Dix and Clara Barton. The product of Alcott’s nursing experience was Hospital Sketches (1863), the story of a bedside army nurse at a time when the bedside army nurse was also, typically, a Victorian spinster.  Alcott’s tale of grit and grace is as compelling now as it was in the nineteenth century.

Louisa May Alcott, daughter of philosopher Bronson Alcott, grew up in New England with prominent Transcendentalists such as Thoreau, Hawthorne, and Emerson as family friends. Unfortunately, Bronson Alcott’s philosophical proclivities often got in the way of his better judgment, and his family suffered real poverty and instability as a result. Louisa evolved from the chaos as her mother’s mainstay in keeping the family going. Thus, she learned service and selflessness early and perhaps a little too well.

“Decide to go to Washington as a nurse”

The Alcott family took human rights seriously; their home was a stop on the Underground Railroad, the means by which slaves were helped on their escapes to freedom.  Inevitably, Louisa felt called to serve when, in 1861, the Civil War broke out. The pioneering work of Florence Nightingale in the Crimean War (1853-1856) had paved the way for a female army nursing service in the United States, and a personal epiphany on her own thirtieth birthday cinched the deal for Louisa. She wrote in her Journal, “Thirty years old. Decide to go to Washington as a nurse if I could find a place.”

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The Plague of Athens

 ‘The disease began, it is said, beyond Egypt in Ethiopia… then it suddenly fell upon the city of Athens’
Thucydides 2.48

Between 430-426 BCE, the Greek city state of Athens suffered a mysterious and devastating plague. Highly contagious and often fatal, the disease is reputed to have reduced the population of Athens by up to a quarter. Although the cause of the epidemic is unknown, bubonic plague, smallpox, measles, anthrax and influenza have all been suggested as possible culprits. The symptoms exhibited in Athens however, do not exactly match those of any known disease and speculation as to the nature of the epidemic continues to the modern day.

Our sole contemporary source for information on the plague is the historian Thucydides, who claimed to have suffered from the condition himself, and catalogued its symptoms and effects in minute detail. Although the objectivity of Thucydides’ account has been called into question, his description of the sufferings endured by plague victims and the effects of the epidemic upon Athenian society as a whole have proven of great interest to both physicians and historians.

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Hippocrates and the Hippocratic Oath – a summary

 ‘Concerning disease, practice two things – to help, or at least to do no harm.’
Hippocrates, Epidemics 1.11

 

Considered by Seneca to be the ‘father of medicine’, Hippocrates was regarded by many ancient thinkers as the greatest physician of his time. Born on the Greek island of Kos sometime in the middle of the fifth century BCE , he gained near legendary reputation as the author of the Hippocratic Corpus, containing the Hippocratic Oath, a highly influential collection of medical writings which shaped the course of western medicine for over two thousand years.

The Hippocratic Corpus

The collection of texts known today as the Hippocratic Corpus takes the form of around sixty separate ‘books’, the styles of which differ widely throughout the anthology. While some texts seem almost to be lecture notes, detailing a single author’s teachings on a particular topic, others appear more like casebooks in which a doctor records a patient’s changing condition or the recognised symptoms of a known disease.  Some are slim documents, only a paragraph in length, whilst others run to several volumes.

Collected together in Alexandria during the third century BCE, the Corpus quickly became the standard reference for medical students throughout the western world with many of its teachings used well into the 19th century.

Although it is impossible to know whether the Corpus really represents the work of a single author, scholars in the Ancient and Early Modern worlds certainly believed it did and the  influence Hippocratic medicine has had upon the practice and development of medical science is unparalleled.

Medicine in Ancient Greece

‘Now all our diseases arise either from things inside the body, bile and phlegm, or from things outside it: from exertions and wounds, and from heat that makes it too hot, and cold that makes it too cold.’
Hippocrates, Diseases 1.2

Throughout human history, people have fallen ill and have tried to find both reasons for and ways of alleviating their symptoms. In many early societies, sickness and disease were blamed on the meddling of evil spirits or the wrath of the gods to whom sufferers then made desperate supplications in the hope of eliciting a divine cure.

In contrast to this, the Hippocratic Corpus is unique amongst ancient works for presenting a comprehensive philosophy of medicine centred on a belief that health and disease have physical, rather than divine or supernatural causes.

In Greek society, doctors were considered craftsmen, trained in thetechnê, the art or skill of healing the body. Hippocrates believed it was the duty of the doctor to use this skill to ‘speak the past, diagnose the present [and] predict the future’ (Epidemics 1), a feat achieved by paying careful attention to the smallest changes in those within their care. Observable differences were ascribed to imbalances between the four basic fluids, or humours within the body: yellow bile, black bile, blood and phlegm. Health could be described as the state in which the humours were in equilibrium and the Hippocratic doctor would often let blood or prescribe emetics in order to balance the humours and achieve this effect.

Hippocrates considered good health the natural state of Man. Moreover that health was a state entirely physical in origin and therefore wholly within a knowledgeable physician’s power to effect. He believed diseases had set life-cycles that could be predicted using a doctrine of critical days (see Aphorisms) and that climate, activity and diet could all affect a person’s humoural makeup and therefore health. In one of the most famous and contentious books in the Hippocratic CorpusOn the Sacred Disease, he also argues strongly against putting one’s faith in religious incantations and the quasi-magical rituals of charlatans and quacks.

The Hippocratic Oath

Possibly the most famous part of the Corpus, and certainly one of the most historically influential is the Oath, a pledge designed to be sworn by new doctors in order to govern their conduct. In it, the doctor swears to the healing gods Apollo, Asclepius, Hygieia and Panacea that he will preserve the life of his patients, proscribe medicines and treatments to the best of his knowledge but never poison those within his care nor intentionally set out to harm.

Since the ancient world had no regulation governing the use of the title ‘doctor’; any individual could claim the knowledge required to heal a sickness or wound. The Hippocratic Oath may therefore represent an attempt to form a guild-like association of medical professionals who could be recognised both by their patients and each other in what must have been a crowded and highly competitive medical marketplace.

We do not know whether the Hippocratic Oath was ever widely sworn in antiquity but the spirit contained within its lines is one familiar to us all today as the guiding ethos underlying the responsible use of medicine: a pledge to protect and extend life commonly referred to ‘Hippocratic’.

Ancient MedicineLiam A Faulkner

Liam is the author of Ancient Medicine: Sickness and Health in Greece and Rome.

See also article on the Plague of Athens.

Netley: Queen Victoria’s Great Hospital

It was in 1856 that construction began on a purpose-built hospital for injured British soldiers. Opened on 11 March 1863, the Royal Victoria Military Hospital at Netley, Southampton, was the largest of its kind in the world. Although the hospital was demolished in 1966, the chapel (pictured) - the only remaining build of the Netley site – stands as a reminder of Britain’s great military past and the enduring legacy of Queen Victoria.

Origins of Netley Hospital

The origins of Netley Hospital lay in the Crimean War (1854-1856), more specifically, the condition of the British military. When reports first hit the British press that nine in ten casualties were dying from disease, rather than wounds, a widespread feeling of outrage swept the nation. In a royal visit to Fort Pitt at Chatham, Queen Victoria witnessed first-hand the inadequate provisions made for her wounded soldiers. Furthermore, in a meeting with Florence Nightingale at Balmoral Castle in 1856, the Queen was deeply affected by stories of the hardships suffered by her soldiers in the Crimea. A brand new, purpose-built military hospital was, Queen Victoria stated, the only way to right this unacceptable wrong.

It was the Queen’s Surgeon, James Clark, who first suggested Netley as a possible site for the new hospital. Since the Middle Ages, Netley had been used as a mustering place, training ground and encampment for British troops so it already had a strong military association. A survey was then carried out by Captain Laffan of the War Department, and confirmed the site’s suitability. Five fields of the 109 acre site were purchased from Thomas Chamberlayne, the owner, for £15,000 in January, 1856, and, four months later, Victoria and Albert visited Netley to lay the foundation stone.

Although the foundations were now in place, a bitter conflict ensued over the design of the new hospital. When shown the plans for Netley by Lord Panmure, Secretary of State for War, Florence Nightingale (pictured) was outraged at what she saw. Small, cramped wards with few windows and quarter-mile-long corridors raised serious concerns about ventilation and the spread of infection. Nightingale immediately lobbied the Lord Palmerston, the Prime Minister, to halt building work until its design had been resolved. Successfully persuaded by Nightingale, Palmerston instructed Lord Panmure to down tools at Netley but his attempt was in vain and construction on the hospital continued unabated.

Netley Hospital Opens

By 1859 building at Netley was complete. This impressive site, costing £350,000, contained a reservoir, three wells, swimming pool, gasworks, stables, 138 wards and 1,000 beds. In addition, a chapel, school, married quarters, prison cells and a cemetery transformed Netley from a mere hospital to a community. In March 1859, the three existing general hospitals at Dublin, Cork and Woolwich were closed down while soldiers receiving treatment were transported to the new hospital.

Netley was more than just a treatment facility. Aside from numerous research labs for the study of tropical diseases, Netley was also home to the Army Medical School and the Army Nursing Service, and acted as a medical training centre for doctors. Queen Victoria’s visit to the hospital in 1863, her first public appearance since Albert’s death, emphasised both her attachment to Netley and its wider national importance. Victoria would make a further 22 visits to Netley throughout the remainder of her reign.

Netley and the World Wars

During World War One, Netley’s significance and importance grew. Aside from treating more than 50,000 sick and injured soldiers, the Red Cross built a series of hutted hospitals behind the main hospital, doubling its total capacity. (A dedicated train-line, built in 1900, enabled ambulance crews  to easily transport wounded soldiers from Southampton Docks to the doors of Netley hospital). In 1944, Netley was taken over by the United States and successfully treated 68,000 soldiers during the remainder of World War Two.

The End of Netley Hospital

In 1958 the government deemed Netley too expensive to maintain. When diggers and cranes moved in to demolish the site in 1966, workers retrieved a metal casket buried below the granite foundation block laid by Queen Victoria. This time capsule contained coins and a copy of The Times from Victoria’s reign, plans of the hospital and an early Victoria Cross. The items were then preserved and put on display at the Royal Army Medical Corps museum in Aldershot. Since 1980 the site has been opened up to public recreation by Hampshire County Council.

Sadly, the chapel is all that remains of Queen Victoria’s great military hospital but this beautiful building gives you an idea of what once was.

To find out more, visit the Royal Victoria Country Park website.

Kaye Jones

Kaye is author of three History In An Hour titles: 1066: History In An Hour, Dickens: History In An Hour and The Medieval Anarchy: History In An Hour 

A Brief History of Cancer

World Cancer DayToday, 4 February 2014, is World Cancer Day. To mark this occasion, here is a brief article that looks at the ‘history’ of cancer:

Cancer is one of the leading causes of death throughout the world.  In developed nations, an estimated 1 in 3 people will be diagnosed with cancer.  Today, as the disease becomes an increasing threat throughout the world, a focus is placed on research for treatment and cures.  A look back at the history of cancer sheds light on how societies before ours dealt with this formidable malady.

The first cancers

The oldest descriptions of cancer can be found in ancient manuscripts.  Fossilized bone tumors and the records of Egyptian mummies provide material evidence of ancient cancers.  The oldest known account of cancer was discovered in Egypt and dates from approximately 1600 B.C.E.  The papyrus in which this account is found described eight cases of tumors or ulcers of the breast that ancient physicians treated by cauterizing with a tool called the “fire drill.”  The papyrus continues the narrative by stating, “There is no [effective] treatment.”

Not until about twelve centuries afterward did such tumors gain their modern name—cancer.  The word “cancer” is credited to the Greek physician Hippocrates (460-370 B.C.E.).  Considered the “Father of Medicine,” Hippocrates employed the words carcinosand carcinoma in his descriptions of non-ulcer forming and ulcer forming tumors.  Hippocrates also believed that cancer resulted when the four “humors” (or bodily fluids—blood, phlegm, yellow bile, and black bile) fell out of balance with one another allowing black bile to collect in excess in whichever part of the body the cancer affected.

In Greek, carcinos refers to the familiar zodiac sign Cancer, the Crab.  The Greeks applied the term “crab” to the disease because of the tendril-like projections, which resemble the ten-legged sea creature.  In modern medicine, a carcinoma (arising from epithelial cells) is the most common type of cancer, the other types being sarcoma (from connective tissue), lymphoma (from blood cells), germ cell tumors (from totipotent, or reproductive, cells), and blastic tumors (from immature tissue).

The Renaissance

The next great wave in cancer scholarship and understanding came with the Renaissance when scholars began to refine their understanding of the human body.  Following the development of the modern scientific method in the Renaissance, scientists began to apply it to the study of disease.  The English physician and scientist William Harvey (1578-1657) used autopsies to identify and understand the circulatory system that had previously been a mystery.  Later, Italian anatomist Giovanni Morgagni (1682-1771) laid the foundations for scientific oncology (the study of cancer) by performing autopsies and relating the patient’s illness to the pathology found after death.

18th Century

Scottish surgeon John Hunter (1728-1793) suggested that some cancer could be cured with surgery and described how the surgeon should decide upon which cancers to operate.  If the tumor had not invaded nearby tissue and was pliable, he said, “There is no impropriety in removing it.”  The invention of anesthesia in the nineteenth century allowed the practice of oncological surgery to flourish and physicians developed what became standard cancer operations, such as the radical mastectomy.

19th Century

The invention of the modern optical microscope in the nineteenth century was another boon to scientific oncology.  The German physician Rudolf Virchow (1821-1902) combined Morgagni’s pathology techniques with the microscope to correlate the microscopic pathologic evidence of a patient’s illness.  The microscope facilitated the rise of precise cancer diagnoses in medicine.

After body tissues were removed, either from living patients via biopsy or deceased patients during an autopsy, the cells found could be examined under a microscope and differentiated—a technique that still forms the basis of cancer diagnosis today.  This differentiation allowed doctors to better understand how cancers functioned within the human body.  Because of these developments, much more accurate theories began to evolve during the late nineteenth century and early twentieth century as to the origins and pathways of cancer.

The theories of the origin of cancer were as varied as they were wrong throughout history.  Egyptians blamed cancer on the intervention of the gods.  Greek physicians relied on Hippocrates’ theory of cancer arising from an imbalance between the four humors of the body.  Roman medicine continued this humoral theory of cancer.  The prominent Roman physician Galen particularly embraced this teaching and it continued unchallenged for over thirteen centuries throughout the Middle Ages because restrictive social mores prohibited examination of the human body, especially through autopsies.

The Lymph Theory

Further theories preceding the invention of the modern microscope include the “lymph theory” of cancer.  This theory was one of the first theories to replace Hippocrates’ humoral theory.  The lymph theory purported in the early eighteenth century that cancer formed because of fermenting and degenerating lymphatic fluid.  John Hunter, the Scottish surgeon who anticipated the advent of oncological surgery, supported the lymph theory.

The Parasite Theory

Another theory in the seventeenth and eighteenth centuries was the “parasite theory.”  This theory alleged that cancer was an infectious disease that relied upon the transmission of an invisible contagion.  The parasite theory persisted off and on until the twentieth century.  In 1926 an oncological scientist named Johannes Fibiger earned a Nobel Prize for research erroneously finding that certain worms caused stomach cancer.  Later, other scientists disproved this theory.

Blastema Theory

More modern, scientifically sound theories replaced these previous theories.  One such theory was the “blastema theory.”  The German pathologist Johannes Müller (1801-1858), who mentored Rudolph Virchow, developed the blastema theory in 1838.  The blastema theory postulated that cancer was made up of cells and not lymphatic fluid and that cancer cells arose from budding elements (called blastema) between normal tissues.  Virchow then theorized that cancer spread like liquid through chronic irritation of tissues.  German surgeon Karl Thiersch (1822-1895) proved that cancers metastasize through the spread of malignant cells, not liquid.

Developed in the end of the nineteenth century and lasting through the 1920s, a further theory developed that hypothesized that cancer was caused by trauma or injury.  Scientists finally disproved this theory by failing to induce cancer on laboratory animals through injury.  All of these theories eventually faltered, but they paved the way for scientific advances to come.

DNA

The greatest leaps in scientific knowledge of the biology, treatment, and prevention of cancer came during the latter half of the twentieth century.  By about 1950, scientists possessed the instruments necessary to begin solving the chemical and biological complexities of cancer.  In 1953, James Watson (b. 1928) and Francis Crick (1916-2004) made the key discovery of the chemical structure of deoxyribonucleic acid (DNA).

DNA is the basis of the genetic code that directs cell activity.  Decoding DNA allowed scientists to understand how genes work and how mutations can damage them.  DNA showed that damage done to it by chemicals, radiation, viruses, and inherited disease sometimes cause cancer.  In other words, carcinogens can cause genetic damage in the form of mutation.  Mutations can lead to abnormal groups of cells, which evolve into more malignant cells over time.  Cancer progresses as the genetic mutation reproduces.  This discovery answered many questions that had troubled scientists for generations.

During the 1990s, medical scientists began to unlock the knowledge of which genes, if damaged by carcinogens or inherited mutations, could lead to cancer.  A notable example of this genetic identification was the case of the BRCA1 and BRCA2 genes in the early 1990s.  These genes, short for “BReast CAncer” types 1 and 2, indicate a considerably higher risk of developing breast cancer.  The discoveries of these two genes give hope that inherited and genetic susceptibility to cancer can be discovered early so that medicine can intervene.

Other genes discovered, so far, can be associated with many cancers that run in families such as cancers of the kidney, ovary, colon, rectum, esophagus, lymph nodes, pancreas, and skin.  While inherited cancers are not as common as spontaneous cancers, accounting for less than fifteen percent of all cancers, it is important to understand these cancers because continued genetic research may enable scientists to identify all persons at high risk, which in turn promotes prevention and early intervention.

The War on Cancer

Modern medicine’s war on cancer over the past 60 years has obscured the long history of cancer diagnosis, treatment, and prevention.  Written records trace the history of cancer over 3,600 years and archaeological evidence of cancers extends even farther into the past.  The devastating effects of cancer and scientists’ attempts to combat them over thousands of years put into perspective just what a potent enemy cancer is and has been throughout history.

Sarah Jane Bodell

Henry VIII’s Succession Problem: Syphilis or Bad Luck?

The tales of Henry VIII’s many wives and failed attempts to father a legitimate male heir to succeed him are legendary. Film studios have often taken on these stories, producing such films as Anne of the Thousand Days (1969), The Other Boleyn Girl (2008), and, most recently, the mini-series titled The Tudors (2007-2010). 

While many monarchs in different times and places have struggled to produce an heir, there is something notable about Henry VIII’s struggle. He is likely one of the first monarchs to suffer from syphilis, pass it along to his wife who in turn passed it along to their children in the form of congenital syphilis.

Henry’s health

Henry VIIIStories of Henry’s failing health in his later years are usually focused on his mammoth weight and the jousting injury he suffered that eventually became immensely ulcerated.  Some scholars have postulated that Henry suffered from type II diabetes, and it is possible that he had diabetes. The diabetes theory, however, does not explain the many tragic miscarriages, stillbirths, and early deaths of his children particularly with his first wife, Catherine of Aragon.

The pregnancies of Catherine of Aragon

Altogether, Catherine of Aragon is known to have had at least six pregnancies (and more that ended early in miscarriage), so she was not infertile, nor was King Henry.  Her first pregnancy resulted in a stillborn daughter. Her second resulted in a son, Henry, Duke of Cornwall, who lived only 52 days. Her third pregnancy resulted in a son who was either stillborn or died very soon after birth and her fourth child was a stillborn son. Finally, with her fifth pregnancy, Catherine delivered a daughter who survived infancy — Mary. Catherine’s sixth pregnancy resulted in a daughter who lived only a few hours. Soon after this last birth, Catherine ceased menstruating.

Of course, pre-natal care was limited in the sixteenth century and it was common for women to miscarry and have stillbirths. Many children did not outgrow infancy because widespread diseases. However, the King and Queen had access to more resources with which to both avoid and treat any ailments. So, even for that time period, the number of stillbirths, miscarriages, and infant deaths from Catherine and Henry’s union was high.  (Four of Henry VII’s children with Elizabeth of York survived infancy, including Henry VIII.) Although many of Henry’s own health problems (skin ulcers, boils, mental disturbances) can be explained by other theories of disease, there is still a solid argument to be made that he had syphilis.

A postmortem performed on Catherine revealed an abnormality of the heart described as “black and hideous with a black excrescence which clung closely to the outside.”  It is possible that this heart irregularity was a saccular syphilitic aneurysm low in the aorta. Syphilis infects the heart affecting the aorta. Syphilis is generally not as transmissible after two years of infection when it enters the latent stage. So, it is possible that Catherine became infected with syphilis and none of Henry’s subsequent wives (or mistresses) became infected. (Thus, Elizabeth I and Edward VI were less likely to have been infected with syphilis.)

According to the CDC (Centers for Disease Control and Prevention), today 40% of births to syphilitic mothers are stillborn, 40-70% of the survivors will be infected, and 12% of these will subsequently die in infancy. Now, compare these figures to Catherine:  50% were stillborn, 33% died as infants, and 17% (Mary) lived.

Mary’s health

There is strong evidence that indicates Mary I may have had congenital syphilis. Mary was sickly as a child suffering from poor eyesight, sinus conditions, and severe headaches—all of which can point to congenital syphilis. Mary is also known to have had dental abnormalities, a very strong indictor of congenital syphilis.Mary complained of illness throughout her life and even had two phantom pregnancies, ultimately remaining childless. It is possible that congenital syphilis led to secondary problems, as there are various theories that Mary had a tumor on her pituitary gland and that she died of ovarian cancer.

Mercury

There is no evidence that Henry was treated for syphilis, which, before the twentieth century, was treated with mercury. However, the treatment of syphilis with mercury did not originate until the early 1530s when the physician Paracelsus first prescribed it. If Henry VIII had syphilis as early as 1509 when he married Catherine (or from early in their marriage), his syphilis would likely have been latent (no visible symptoms) by the time Paracelsus first used mercury as a treatment. Therefore it is not likely that Henry would have been treated with mercury unless he contracted syphilis closer to 1530.

Neither is there evidence that Catherine or Mary were treated with mercury. Catherine would have suffered from syphilis on a similar timeline as Henry and so would have missed mercury treatments, too. Mary would have had congenital syphilis, which would not manifest in the same way. So she may have had syphilis in spite of not receiving mercury treatments.

In the end, without physical evidence, it is impossible to say with certainty what medical problems Henry, his wives, and their children suffered. What can be said, though, is that syphilis cannot be ruled out. Thus, syphilis may have played a major part in the succession problems of the English monarchy in the sixteenth century.

Sarah Jane Bodell

Read more about the life of Henry VIII and his six wives in Henry VIII’s Wives: History In An Hour published by Harper Press and available in various digital formats.