Tuesday, 5 September 2017

The Sneaking Death: Gangrene

Gangrene causes tissue to decay most commonly due to issues with the blood supply or diabetes. Usually, when a limb is gangrened it becomes blue, purple or black. The most famous sufferer of gangrene at Versailles was Louis XIV - it would kill him in 1715.  Another prominent member of the royal family who suffered from it was the Grande Dauphine; when she died in 1690 her autopsy revealed that her stomach was severely gangrened. 

When Louis XIV contracted gangrene the doctors would also refer to it as "mortification". It shows just how feared the disease was that no one was willing to inform the king of his actual state; it was not until they had no other choice that the message was finally delivered. 

Dry gangrene of the foot and ankle Wellcome L0061216.jpg
A gangrenous foot

The doctors facing gangrene had few options. The one most agreed upon was amputation of the infected limb if possible. Obviously, in the case of the Grande Dauphine it would not have been an option. Considering not only the excruciating pain of having an amputation performed without anesthetics but also the high risk of infections it is little wonder that some people refused to undergo the procedure. One such was Lully. He actually gave himself gangrene during one of his performances in January 1687; the composer accidentally pierced his toe with his baton. The toe became infected but he refused to have it removed - it would be his death.

Amputation is still considered to be the most effective way of stopping gangrene. The scary part about this disease is that it will continue to spread if not checked beforehand. Suffering from the affliction is agonizing but also a rather smelly affair. When Louis XIV was on his deathbed the courtiers were unwilling to stay anywhere near his bedchamber due to the stench.
Billedresultat for gangrene historical illustration
Amputation of a gangrenous leg. No wonder the patient is praying ...

The example of Cardinal Dubois makes it more understandable why some might be hesitant to be operated on. The original cause for the surgery was an abscess on the bladder; consequently, the surgeons cut into his body to remove it. In the process they discovered that the organs in his lower body was terribly afflicted with gangrene. Whether due to the gangrene or the operation, the cardinal died shortly afterwards.

The Comte de Provence would be terribly plagued by gangrene after the French Revolution when he was king himself. It would eventually lead to his death, too. 

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