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Overview


Napoleon Bonaparte died on May 5th, 1821 in exile on the island of Saint Helena (#Lin, et al, 2004). Prior to his death, Napoleon requested that his hair be distributed to members of his family and that a necropsy be performed (#Mari, et al, 2004). His father had died of gastric Cancer, and Napoleon believed that he too had gastric Cancer and was concerned about the risk of his children suffering a similar fate (#Mari, et al, 2004). Franchesco Antommarchi, the only trained anatomist on Saint Helena, performed the necropsy in front of sixteen observers, including seven British physicians, five of which signed the death certificate (#Keynes, 2004 and #Corso, et al, 2000). The most notable and consistent finding at necropsy was a cancerous growth that occupied the "whole of the remainder of the internal surface of the stomach" (#Corso, et al, 2000). Although there is suggestion that divergent opinions existed between the physicians as to the cause of death, the anatomical presence of the "ulcerating, invasive, gastric carcinoma with local extension and distant metastasis" was undisputed (#Mari, et al, 2004) .  (Picture - Napoleon in His Study by Jacques-Louis David (1812))

In 1961, Forshufvud et al. reported a high content of arsenic in samples they had obtained of Napoleon's hair, thus giving birth to the poisoning theory of Napoleon's cause of death (#Forshufved, et al, 1961). Over four decades latter, the competing theories of Napoleon's death are still at odds, with carefully detailed studies of the arsenic theory still appearing in the literature (#Weider, et al, 2000), followed by scathing accusations of bias for omitting the deadly gastric Cancer (#Corso, et al, 2000). Although it is ultimately next to impossible to confirm or refute the arsenic theory of Napoleon's death, much of the available information on the toxicology of arsenic can be used to infer the probability of this theory (#Corso, et al, 2000).

Arsenic is ubiquitous in nature and may occur as elemental arsenic (As0), trivalent arsenite (As3+), or pentavalent arsenate (As5+) (#Saady). Trivalent compounds of arsenic are the most toxic, followed by the pentavalent compounds and the relatively nontoxic elemental arsenic (#Saady). The acute toxicity of arsenic is generally characterized by multisystemic findings, including: gastrointestinal fluid loss (within hours postingestion), cardiac arrhythmias (torsades de pointes) (1 day to 1 week postingestion), and sensorimotor peripheral neuropathy (1 to 4 weeks postingestion) (#Kosnett). Subchronic arsenic toxicity is similar to that of acute arsenic toxicity but is generally less life-threatening. Signs of chronic arsenic toxicity may include the following: spotted hyperpigmentation, anemia and leucopenia, axonal peripheral neuropathy, and vascular disease (#Kosnett). Additionally, arsenic concentrates in nails and hair and may cause transverse white lines (known as Mees' lines) on the finger and toenails, which may appear about 6 weeks following the onset of toxicity (#Goyer and Clarkson and #Kosnett).

Analyses of authenticated hairs from Napoleon have offered equivocal support to the Arsenic Poisoning theory (Table 1). Although the methods employed for determining the concentration of arsenic in each hair sample posses the necessary sensitivity, the results must be viewed with caution. Even if the concerns raised by Corso et al. (2000) could be answered (See note 11), additional evidence to support the arsenic theory would be required. Napoleon's medical history was well documented, yet some of the classic signs of Arsenic Poisoning did not occur or were not recorded (#Corso, et al, 2000). For instance, hyperkeratosis of the palms of the hands or the soles of the feet was not indicated, nor was there indication of peripheral neuropathy or the presence of Mees' lines.

Arsenic Concentration in Hair Samples from Napoleon Bonaparte

Sample

Date of Hair

Sample Method of Analysis

Arsenic concentration (ppm) (Normal, <7 ppm)

Noverraz #2


Noverraz #1

May 5, 1821

Neutron Activation Analysis (NAA)

4.4-23.0


2.8-52.2

Hair Specimen #1


Hair Specimen #2

October 16, 1816

Graphite Furnace atomic absorption spectroscopy

33.3


16.8

Hair-1


Hair-2

May 6, 1821

NAA

1.85


3.05

Hair-A

1814

NAA

33.4

Conclusions


Although some of the signs and symptoms Napoleon experienced are suggestive of Arsenic Poisoning (e.g., weight loss and extreme thirst), they are not exclusive to Arsenic Poisoning (#Lugli, et al, 1999). In addition, Napoleon was given several other medications in the months prior to his death, including tartar emetic (antimony potassium tartrate), 'bark' (possibly Jesuit's bark which contains quinine), and on the day before his death, 10 grams of calomel (mercury chloride). According to Corso et al. (2000), the large dose of calomel may have caused Napoleon to die prematurely of hematomesis (#Corso, et al, 2000). Still yet, (#Mari, et al, 2004) have hypothesized that the combination of arsenic, quinine, and calomel, induced hypokalemia, and ultimately caused the fatal torsades de pointes.

In conclusion, without further confirmatory information that Napoleon was in fact administered arsenic with the intent to end his life, versus being exposed environmentally, or his hair being preserved with arsenic, etc, it cannot be concluded that he was murdered.

Current Events


January 17, 2007
A recent review of the material from Napoleon's autopsy has led a team of scientist to conclude he died of stomach cancer. See the Associated press article

External Links


References



Xilei Lin, D. Alber, and R. Henkelman, "Element Contents in Napoleon's Hair Cut Before and After His Death: Did Napoleon Die of Arsenic Poisoning?", Analytic and Bioanalytical Chemistry 379, (2004), 218.


Francesco Mari, et al., "Channeling the Emperor: What Really Killed Napoleon?", Journal of the Royal Society of Medicine 97, p. 397-398 (2004).


Philip F. Corso, et al, "The Death of Napoleon," The American Journal of Forensic Medicine and Pathology 21, (2000).


Milo Keynes, "The Death of Napoleon", Journal of the Royal Society of Medicine 97, p. 507 (2004).


S. Forshufvud, H. Smith, A. Wassen, "Arsenic Content of Napoleon I's Hair Probably Taken Immediately After His Death", Nature 192, p. 103-105 (1961).


Ben C.M. Weider, et al., "Activation Analysis of Authenticated Hairs of Napoleon Bonaparte Confirm Arsenic Poisoning, The American Journal of Forensic Medicine and Pathology 20, p. 378 (2000)


Joseph J. Saady, "Chapter 22: Metals", From Principles of Forensic Toxicology, 2nd Edition (Ed. Barry Levine).


Michael J. Kosnett, "Chapter 76: Arsenic", In Critical Care Toxicology (Eds. Jeffrey Brent, et al.).


Robert A. Goyer and Thomas W. Clarkson, "Chapter 23: Toxic Effects of Metals, In: +Casarett & Doull's Toxicology: The Basic Science of Poisons, 6th Edition (ed Curtis D. Klaassen), at 819. (The time of exposure may be estimated from measuring the distance of the line from the base of the nail and the rate of nail growth, which is about 0.3 cm per month or 0.1 mm per day. Arsenic in hair may also reflect past exposure, but intrinsic or systemically absorbed arsenic in hair must be distinguished from arsenic that is deposited from external sources.)


Cf. Amanda J. Jenkins, "Chapter 3: Forensic Drug Testing," In: Principles of Forensic Toxicology 2nd Edition, (Ed. Barry Levine), at 42. (Approximately 150-200 strands or 50 mg are needed for forensic testing.) Analyses were performed on individual strands of hair.


A. Lugli, et al., "Napoleon's Autopsy: New Perspectives," Human Pathology 36, (1999), p. 323. (Napoleon's weight loss of more than 10 kg in 7 months represents an "alarming sign" strongly suggestive of upper gastrointestinal neoplasia...)

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