Mad, Bad and Dangerous to Know: Henry VIII’s medical history

HENRY VIII is arguably our most famous king whose reign of almost four decades in the sixteenth-century laid the foundations of the nation we know today.

Everyone remembers him as the monarch who had six wives but Henry changed his realm from being a group of remote islands on the edge of the known world into a major player in European politics and diplomacy, as well as establishing the Anglican Church in the break from Rome.

He came to the throne in 1509, a few weeks short of his eighteenth-birthday, as a fit, athletic sportsman – regarded by his besotted subjects as very much the David Beckham of his day. But Henry was much more than a champion jouster – he was a Renaissance Prince, fervently interested in science and the arts, particularly music.

One of his great interests was in medicine, in the sixteenth-century  based more on superstition or religious doctrine, as it was firmly in the hands of doctors licensed by the church or practiced by quacks – blacksmiths, ‘wise women’ or white witches.

Their outlandish cures should not be replicated today. Don’t try them at home as there are some very dangerous ingredients!

• For headaches – drink a mixture of lavender, sage, marjoram, rose petals and rue – or to press a hangman’s rope to your head

• For deafness, mix the gall of a hare with fat from a fox. Warm the ointment and press it to the ear.

• Jaundice – swallow nine wood lice mixed with ale each morning for a week.

• Gout – apply a mixture of worms, pig’s marrow and herbs, boiled together with the carcass of a red-haired dog.

It was also believed that the position and movement of celestial bodies like planets could determine a patient’s health – or the appropriate cure for their maladies.

Doctors maintained that the new king, born under the astrological sign of Cancer, was governed by the maternal cycles of the moon and Henry’s horoscope suggested he was vulnerable to coughs, fevers, quinsy, rheumatism, smallpox and kidney stones.

His birth chart had cast him as a cheerful, frivolous and flirty child who would grow up to become a man of action. He would be short-tempered, eat and drink to excess, prickly if criticized, and have a healthy libido and he would suffer from acute constipation and poor sleeping. Ironically, many of these predictions became true as the king grew older.  (Maybe there is more truth in astrology than we thought!)

During his son-less marriages to Katherine of Aragon and Anne Boleyn, Henry was painfully aware that the future of the insecure Tudor dynasty was fragile. It could collapse abruptly with his illness or death – or by being overthrown in a coup d’etat, launched by another, stronger, claimant to the throne of England.

Even after the birth of Prince Edward, on 12 October 1537, there was no ‘spare heir’ to allow the king to sleep easier at night.

Therefore the king’s health dictated the stability of the realm and symbolized the power of the monarch.

No wonder Henry VIII became obsessed with his own health and medical care – displaying all the signs and symptoms of a hypochondriac.

Tudor diseases

With epidemics in 1509-10, 1516, 1527-30, 1532 and 1544-46, Henry was particularly paranoiac about bubonic plague. When his court went on progress, messengers were sent ahead to check whether towns en route were infected. At Windsor and Calais, the sick were dragged out of their houses and left to die in the fields.

Another dangerous disease was the English ‘sweating sickness’ – probably introduced into England by the French mercenaries of Henry VII before the Battle of Bosworth in 1485.  There were major epidemics in 1485, 1508, 1517, 1528 and 1551 of this disease which we now know was a type of viral pneumonia.

Symptoms included headaches, muscular pain, fever, copious sweating and laboured breathing. The victim became leaden-limbed and drowsy. Delirium and vomiting followed with palpitations of the heart. And they were often dead within 12-24 hours of showing the first symptoms.

The disease claimed a very high proportion of victims among young wealthy males living in towns: 50 people a day died in London in the 1528 outbreak, probably including Thomas Cromwell’s wife and daughter. Anne Boleyn and Thomas Wolsey also went down with this disease – but both recovered.

Other Tudor killer diseases included:

• Tuberculosis – killed Henry VII, (probably Prince Arthur, Henry VIII’s elder brother), his illegitimate son Henry Fitzroy and Edward VI (coupled with measles and possibly smallpox).

• Malaria, or ‘tertiary fever’ – few marshes were drained, so mosquitos, which can carry the disease, flourished. Spider’s webs were among ingredients of a cure for this in the Tudor period.

• Typhus – ‘jail fever’, caused by lice living on humans. During the ‘Black Assizes’ in Cambridge in 1522, all the judges died of this disease.

• Dysentery, or ‘the bloody flux’ – caused by bacteria in water or poor hygiene in food preparation.

• Influenza – first epidemic in 1510.

• Smallpox – Henry VIII contracted it, as did Anne of Cleves and Elizabeth I. Epidemics became more frequent and lethal during the sixteenth-century.

• Scurvy – especially prevalent in rich households as they did not eat vegetables – an important source of vitamin C.

Overall, life expectancy was much worse than today – only around 10% of Tudors lived beyond their 40th birthday.

The birth of modern medicine

Henry tried to rationalize medical science and structure the profession in a number of measures during his reign. He established the Royal College of Physicians on 23 September 1518 to ‘withstand the attempts … of those wicked men who shall profess medicine more for the sake of their avarice than from the assurance of any good conscience’.

These wicked persons included ‘common artificers [such] as smiths, weavers and women who boldly and customarily take upon themselves great cures… They use sorcery and apply medicines very noxious to the displeasure of God… and grievous hurt to the king’s liege people… who cannot discern the cunning from the uncunning’.

In 1540, Henry granted a royal charter to the ‘United Company of Barber Surgeons’ which placed physicians firmly at the top of the profession. Surgeons were now prohibited from prescribing ‘inward remedies’ especially for sciatica, syphilis, ulcers or any kind of wound’ but could undertake blood-letting and cutting into a patient’s body. At the bottom, barbers were limited to shaving and pulling teeth.

Medical theory and practice

In Tudor times, medical theory was rooted in the beliefs of a Greek doctor called Aelius Galenus who lived in the Roman period. As well as the seasons of the year and the twelve astrological signs, one’s health and choice of medical treatment were influenced by the four bodily ‘humours’ –  blood, phlegm, black bile (melancholy) and yellow bile.

It was thought that red-haired people – like Henry VIII and his children – showed the predominance of yellow bile, providing them with fiery emotions. Certainly, an unpredictable temper seems to have been part of the Tudor genes.

A healthy bodily balance could be restored by manipulating the body’s liquids: through sweating, urinating and blood-letting.

Some doctors however recommended ‘lusty singing’ by patients to aid recovery. The sick room could become a noisy place.

Other treatments included:

• Constipation: enemas applied with a pig’s bladder attached to a greased copper tube. Weak solution of more than a pint of salt and infused herbs, or rhubarb, to be retained for between one and two hours.

• Honey and cow’s milk used to treat haemorrhoids – common as riders were in the saddle in all weathers.

• Wounds were cleaned with honey and turpentine.

• Amputations were aimed to be done in one to two minutes otherwise patient died of shock. There was, of course, no anaesthetic.  An operation to cut off a leg took 10 minutes in total including sealing the arteries and veins.

• Treatment of ‘humours’ or skin ulcers was based on principle of counter-irritation; draining them through a chronic inflammatory reaction.

• Dysentery was treated by a ‘curative’ drink made up with blackberry juice.

Henry himself experimented with his own cures for a variety of diseases. The British Library still has a book which contains 100 of his recipes for a range of nostrums, balms and poultices, including ‘The King’s Own Grey Plaster’ ‘to take away inflammation, cease pain and heal ulcers’. Its ingredients include roots, buds, stone-less raisins, linseed, vinegar, rosewater, long garden worms, ivory scrapings, powdered pearls [highly poisonous] red lead, suet of hens and fat from the thighbone of calves.

Henry’s medical history

In trying to discover what medical conditions afflicted Henry VIII we have two major problems to overcome. Firstly, medical science was less advanced than it is today and the king’s doctors had very limited means of discovering exactly what maladies were afflicting him – except for diseases such as the plague, smallpox or sweating sickness with which they were all too familiar.  Secondly, we have to rely on descriptions of the king’s symptoms in accounts by witnesses completely ignorant of any medical knowledge, such as his courtiers or gossipy foreign ambassadors attached to his court.

Even given these problems, we can build a reasonably accurate picture of Henry’s medical history:

• December 1513 – Smallpox. His physicians ‘were afraid of his life [but] he is risen from his bed, fierce against France,’ according to the Venetian ambassador.

• May 1521 – Bout of malaria.

• 10 March 1524 – injured in a jousting accident, tilting against his great friend Charles Brandon. The king rode with his visor raised and Brandon’s lance caught him above the eye, causing prominent bruising. With typical Tudor bravado, Henry runs six more courses that day but suffered migraines afterwards.

• 1525 – Henry almost drowns when he uses a stave to vault a water-filled ditch whilst hawking near Hitchin, Herts. It suddenly broke ‘so that if Edmond Moody, a footman, had not leapt into the water and lifted up his head which was fast in the clay he [would] have drowned’.

• 1527 – Hurts his foot while playing real tennis at Westminster. Following month he is forced to wear a black slipper to ease the pain. Weakness in tendon of ankle – and wrenched his foot again two years later.

• 1527-28 – Confined to bed at Canterbury with a ‘sore leg’ believed to be a varicose ulcer on the left leg, caused by the constrictive garter he wore beneath the knee, or possibly a traumatic injury sustained during jousting. A local surgeon, Thomas Vicary, heals the ulcer quickly.

• 1528 – Another bout of malaria.

• 24 January 1536 – Henry injured while jousting at Greenwich. He lay ‘for two hours without speech’, possibly through severe concussion or bruising of the cerebral cortex. Probably broke open the varicose ulcer from 1527/8.  Anne Boleyn miscarries a healthy male foetus of about three months after hearing the news of the accident.

• 1537 – Evidence of ulcers now on both legs.

• 14 May 1538 – One of the fistulas closes up in one leg. ‘For 10 or 12 days, the humours which had no outlet were like to have stifled him so that he was some time without speaking’.  Reported ‘black in the face and in great danger’ – possibly because of a lung infection.

• Easter 1539 – Henry creeps to the cross from the door of the Chapel Royal, doubtless in agony from the pain in his legs. He serves at the altar during Mass ‘with his own person, kneeling on his grace’s knees’.

• September 1539 – Henry suffers acute constipation.

• Late February 1541 – Another severe infection probably caused by fistulas closing up in his legs. French ambassador reports: ‘One of his legs, formerly open… suddenly closed to his great alarm. This time prompt remedy was applied and he is now well and the fever gone. Besides the bodily malady, he had a mal d’espirit’.

‘The king’s life was really thought in danger, not from the fever but from the leg which often troubles him because he is very stout and marvellously excessive in eating and drinking so that people worth credit say he is often of a different opinion in the morning than after dinner’.

• 1541 – The former Carthusian monk Andrew Boorde examines Henry  and finds him ‘fleshy’ with large arteries, ruddy cheeks and pale skin, with his ‘hair plenty and red, pulse great and full digestion perfect, anger short [and] sweat abundant. He is alarmed by Henry’s obesity.

• March 1544 – Ulcers flare up again, confining him to bed with a fever. By June, well enough to lead invasion of France.

• 1545 – Use of the ‘dry stamp’ for Henry’s signature. This was a wooden block with the king’s signature carved in relief upon its base. It is pressed onto a document to signify his approval and the imprint of the letters is inked in.  Henry now finds it difficult to ride and so, on his beloved hunting trips, stags are brought before him to shoot.

• Spring 1546 – Henry’s mobility is impaired. Two ‘king’s trams’ – rather like sedan chairs – are purchased to carry him around the royal apartments. A hoist may have been used to lift him up from the ground floor of his palaces – to avoid using stairs.

His first wife, Katherine of Aragon’s tragic natal record of a succession of miscarriages and still-borns has led to much speculation about the king’s ability to father children. This is something of a red herring as it ignores, of course, his success in fathering his illegitimate son Henry Fitzroy, Princesses Mary and Elizabeth and Prince Edward.

Some have suggested that Henry had a translocation of his chromosomes which meant that his sperm cells had extra or missing genetic material which could cause miscarriages. Another theory is that he had a rare blood group which had a similar effect.

More likely, given the poor nature of Tudor hygiene and diet, is that Katherine of Aragon and Anne Boleyn suffered nutritional imbalances, or simply viral or bacteriological infections like listeriosis, which also manifests itself as meningitis or pneumonia in new-borns. Significantly, perhaps, the two boys that Katherine safey delivered in 1511 and 1513 died shortly after their births.

The Royal diet

Henry consumed three meals a day.  He was particularly fond of galantines, game pies and haggis and drank wine, beer and gin. The slaughter of birds for the Tudor table was prodigious: larks, stork, gannet, heron, snipe, bustard, quail, partridge, capons, teal, crane and pheasants were all eaten. Sparrow pie was an especial favourite on menus for the court.

Salted and fresh fish followed the meat course: cod, herrings, eels, salmon, porpoises, dolphin and ling. Fresh fruit was shunned as it was believed to cause diarrhoea and fever – but Henry liked cherries. Green vegetables also avoided as ‘they engender wind and melancholy’ but cucumbers, lettuces and the herb parslane eaten as a first course.

Did Henry suffer from syphilis?

Supporters of this theory suggest his ulcer of 1527-8 was a broken-down gumma, a symptom of tertiary syphilis. The disease can cause miscarriages and still-births. But the leg is unusual location for a gumma, and this ulcer was painful, whilst gummata are not.  What’s more, there is no sign of syphilis in his children.

The sixteenth-century treatment for ‘French Pox’ was six weeks of sweating and administration of doses of poisonous mercury (mixed with the spittle of a fasting man) which made the patients’ gums red and sore and created copious flows of saliva.  But Henry had no lengthy absence from public view reported by the gaggle of ambassadors at his court – nor did he display any symptoms of this horrible treatment. Furthermore, there were no purchases of mercury in surviving apothecary’s or doctors’ accounts.

I believe the symptoms reported by his courtiers and evidence of his dramatic change in appearance in the early 1540s indicate that he was suffering from a disease just as invidious as syphilis.

Cushing’s Syndrome

This is an endocrine abnormality, which today affects 10-15 people in a million and can be treated very successfully with modern medicine. Henry’s doctors of course did not possess the ability to diagnose or control the disease.

Its symptoms includes gross obesity in the body trunk, increased fat around the necks, a ‘moon face’, buffalo hump to back. They suffer slow and poor healing of wounds and their bones are weakened and the muscles around the hips become wasted.  They have high blood pressure and diabetes.

The victims display irritability, depression, anxiety, insomnia and sudden mood swings. In around 20% of cases, they become psychotic, exhibiting paranoia that drives a deep suspicion of everyone around them. They are quarrelsome, unnaturally aggressive and become emotionally detached from loved ones or those close to them.

Henry displays many of these symptoms. He has a sudden increase of fat in his trunk, his face becomes round, and his wounds are slow to heal. His mobility is sharply decreased – he walks with a staff after 1541 – and later, he readily agrees to destroy his wife and closest friend, but then abruptly changes his mind.

In November 1545, the king agreed to Archbishop Thomas Cranmer’s arrest for heresy but summoned him to Whitehall palace at 11 o’clock at night to warn him of the planned arrest the following day at a Privy Council meeting. When the conspirators made their move against the archbishop, Henry slapped them  down, saying: ‘I believe Canterbury as faithful man towards me as ever was prelate in this realm… who so loves me will regard him so’.

His sixth queen Katherine Parr, with her reformist religious beliefs, also became a target for conservative plotters.  The odious Stephen Gardiner, bishop of Winchester told Henry in 1546 that the Queen’s views were heresy under law and he could ‘disclose such treasons cloaked with this heresy’. Henry was happy to sign her arrest warrant but when the Lord Chancellor came to arrest her in the Privy Gardens at Whitehall, he boxed his ears shouting ‘Arrant knave, beast and fool’ and sent him packing.

Henry’s Last Days

Henry retired to his palace at Whitehall in December 1546 and began his final journey to meet his maker.  His last days were painful: his legs were sometimes cauterized – seared with hot irons – by his doctors – Messrs. Wendy, Owen and Huicke.

On 17 January, the king briefly saw the Spanish and French ambassadors and talked of diplomatic and military matters. He seemed ‘fairly well’. Two days later he was said to be planning the investiture of his nine-year-old Edward as Prince of Wales.

Then Henry began to drift in and out of consciousness. In mid-morning on 27 January, he received communion from his confessor John Boole and discussed matters of state with some councillors.

His doctors were afraid to tell Henry that he was dying. Under Cromwell’s laws, it was treason to predict the king’s death.

That evening, Sir Anthony Denny, chief gentleman of the Privy Chamber, came into the king’s bedroom and knelt by the great walnut bed of estate. He warned the king ‘that in man’s judgment you are not like to live’ and exhorted him to prepare himself for death. Denny urged the king to remember his sins ‘as becomes every good Christian man to do’.

Henry said he believed ‘the mercy of Christ is able to pardon me all my sins, yea, though they were greater than they be’. Denny asked if the king wanted to see ‘any learned man to confer withal and open his mind unto’. Henry nodded and said: ‘If I had any, it should be Dr. Cranmer but I will first take a little sleep. And then, as I feel myself, I will advise upon the matter’. These were his last known words.

Shortly afterwards Henry lost the power of speech and probably passed into an uraemic coma.

Cranmer, at his palace in Croydon, Surrey, was summoned to give Henry the last rites. But it was a terribly cold night and the icy roads held up his progress to London. The archbishop arrived at Whitehall in the early hours and clambered up on the king’s great bed. He grasped Henry’s hand and whispered in the ear of the unconscious king: ‘Do you die in the faith of Christ?’  Cranmer claimed he felt Henry’s hand squeeze his own as a sign, a token of his acknowledgement.

Henry died around 2am on 28 January 1547, aged 55 and 7 months, from renal and liver failure, coupled with effects of obesity.

 

Further reading:  Robert Hutchinson, Last Days of Henry VIII, Phoenix, London 2006

Robert Hutchinson, Young Henry, Phoenix, London 2012

Clifford Brewer, The Death of Kings, London 2000

Robert Hutchinson will be speaking on “The Spanish Armada” at the Chalke Valley History Festival on Tuesday, 24th June 2014.

Useful links:

http://www.andrewlownie.co.uk/authors/robert-hutchinson

http://www.sal.org.uk/newsandevents/Lecture%20Archive/lecturerecordings/lecture28january2014