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Cancer killed Napoleon, study concludes

Jan. 23, 2007
Courtesy UT Southwestern Medical Center
and World Science staff

A new in­ves­ti­ga­tion may put to rest near­ly 200 years of lin­ger­ing mys­ter­ies about the ill­ness that killed Na­po­le­on Bo­na­parte dur­ing his is­land ex­ile, a sci­ent­ist re­ports.

Re­search­ers ap­plied mod­ern path­o­lo­g­i­cal meth­ods to his­tor­i­cal ac­counts and said they found that the French em­per­or died of gas­tric can­cer stem­ming from an ulcer-causing, bac­te­ri­al stom­ach in­fec­tion.

Napoléon crossing the Alps, by Jacques-Louis David (1748-1825).
The anal­y­sis al­so re­futes ru­mors of ar­se­nic poi­son­ing, the au­thors of the study said.

The study shows that even if Na­po­le­on had not been ex­iled or es­caped, “his ter­mi­nal con­di­tion would have pre­vented him from play­ing a fur­ther ma­jor role” in his­to­ry, said Rob­ert Genta of Uni­ver­si­ty of Tex­as South­west­ern and sen­ior au­thor of the stu­dy. 

“Even if treated to­day, he’d have been dead with­in a year.” 

Na­po­le­on, born Aug. 15, 1769, ruled France in the late 1700s and ear­ly 1800s. He con­quered much of Eu­rope, but he was ul­ti­mate­ly de­feated at the bat­tle of Wa­ter­loo in 1815. The Brit­ish then ex­iled him to St. Hel­e­na, an is­land in the South At­lan­tic Ocean. He died May 5, 1821.

The cause of his death has been high­ly scru­ti­nized over the years. Genta and his col­leagues, whose re­search fo­cus­es on gas­tri­tis and gas­tric can­cer, in­ves­t­i­gated the case be­cause of their in­ter­est in the way dis­ease af­fects the be­hav­ior of his­tor­i­cal fig­ures and, in turn, the course of his­to­ry. In Na­po­le­on’s case, they were in­trigued by a pop­u­lar no­tion that Na­po­le­on could have al­tered the bal­ance of Eu­ropean pow­er had he es­caped his ex­ile.

An au­top­sy at the time of death cit­ed stom­ach can­cer as the cause. A 1938 study in­di­cat­ed that Na­po­le­on’s fa­ther died of stom­ach can­cer. In 1961, an el­e­vat­ed lev­el of ar­se­nic was found in hair tak­en from Na­po­le­on, in­spir­ing ru­mors of ar­se­nic poi­son­ing.

To find an­swers, Genta and the oth­er re­search­ers com­bined cur­rent med­i­cal knowl­edge and au­top­sy re­ports, mem­oirs of the physi­cians who treated Na­po­le­on on the is­land, eye­wit­ness ac­counts and med­i­cal his­to­ries of fam­i­ly mem­bers. Au­top­sy and phy­si­cian de­scrip­tions re­vealed no tell­tale signs of ar­se­nic poi­son­ing, such as hem­or­rhag­ing in the lin­ing in­side the heart, and no skin, lung or blad­der can­cers were pre­s­ent, Genta said.

Gas­tric can­cer was more like­ly at fault, Genta said. Oth­er schol­ars have re­cent­ly found that the plump em­per­or lost at least 20 pounds in the last six months of his life, a sign of gas­tric can­cer. The au­top­sy de­scrip­tions show that Na­po­le­on’s stom­ach was filled with a dark ma­te­ri­al that re­sem­bled cof­fee grounds, an in­di­ca­tion of gas­tro­in­tes­tinal bleed­ing that like­ly was the im­me­di­ate cause of death, Genta added. The most im­por­tant de­scrip­tion was of a large, ul­cer­at­ed le­sion on his stom­ach, and a smaller ul­cer­at­ed le­sion in anoth­er part of his stom­ach that had pen­e­trated the wall and reached the liv­er.

“It was a huge mass from the en­trance of his stom­ach to the ex­it. It was at least 10 cen­time­ters long. Size alone sug­gests the le­sion was can­cer,” Genta said. The study was pub­lished in the Jan­u­ary edi­tion of Na­ture Clin­i­cal Prac­tice Gas­tro­en­ter­ & Hep­a­tol­ogy.

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A new invest igation may put to rest nearly 200 years of lingering mysteries about the illness that killed Napoleon Bonaparte during his island exile, a scientist reports. Researchers applied modern pathological methods to historical accounts and said they found that the French emperor died of gastric cancer stemming from an ulcer-causing, bacterial stomach infection. The analysis also refutes rumors of arsenic poisoning, the authors of the study said. The study shows that even if Napoleon had not been exiled or escaped, “his terminal condition would have prevented him from playing a further major role” in history, said Robert Genta of University of Texas Southwestern and senior author of the study. “Even if treated today, he’d have been dead within a year.” Napoleon, born Aug. 15, 1769, ruled France in the late 1700s and early 1800s. He conquered much of Europe, but he was ultimately defeated at the battle of Waterloo in 1815. The British then exiled him to St. Helena, an island in the South Atlantic Ocean. He died May 5, 1821. The cause of his death has been highly scrutinized over the years. Genta and his colleagues, whose research focuses on gastritis and gastric cancer, invest igated the case because of their interest in the way disease affects the behavior of historical figures and, in turn, the course of history. In Napoleon’s case, they were intrigued by a popular notion that Napoleon could have altered the balance of European power had he escaped his exile. An autopsy at the time cited stomach cancer as the cause of death. A study done in 1938 indicated that Napoleon’s father died of stomach cancer. In 1961, an elevated level of arsenic was found in hair taken from Napoleon, inspiring rumors of arsenic poisoning. To find answers, Genta and the other researchers combined current medical knowledge and autopsy reports, memoirs of the physicians who treated Napoleon on the island, eyewitness accounts and medical histories of family members. Autopsy and physician descriptions revealed no telltale signs of arsenic poisoning, such as hemorrhaging in the lining inside the heart, and no skin, lung or bladder cancers were present, Genta said. Gastric cancer was more likely at fault, Genta said. Other scholars have recently found that the plump emperor lost at least 20 pounds in the last six months of his life, a sign of gastric cancer. The autopsy descriptions show that Napoleon’s stomach was filled with a dark material that resembled coffee grounds, an indication of gastrointestinal bleeding that likely was the immediate cause of death, Genta added. The most important description was of a large, ulcerated lesion on his stomach, and a smaller ulcerated lesion in another part of his stomach that had penetrated the wall and reached the liver. “It was a huge mass from the entrance of his stomach to the exit. It was at least 10 centimeters long. Size alone suggests the lesion was cancer,” Genta said. The study was published in the January edition of Nature Clinical Practice Gastroenterology & Hepatology.