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Arsenic and old caudillos

29 July 2011

After an exhaustive post-mortem exam (like… post-post-post mortem) , it appears that Simón Bolívar probably died of the finest in medical treatment… or TB …or both.

Almost immediate following Bolívar’s death  on  17 December 1830,  in Santa Marta, Colombia, there have been rumors that the 47 year-old liberator’s end was not the result of tuberculosis —which he did suffer from (and was a fatal illness) — but was shuffled out of his mortal coil by political enemies.

The rumors have persisted to this day, given new impetus by Venezuelan President Hugo Chavez and speculation among medical historians stemming from a 2006 presentation at a medical conference on the famous accidental poisonings.  Specifically arsenic poisoning.

“President Chávez and I do share the belief that tuberculosis was not the cause of Bolívar’s death,” says the man who originally presented the arsenic hypothesis, Dr. Paul Auwaerter, an infectious-diseases expert at the Johns Hopkins School of Medicine in Baltimore. “However, our explanations for how he did die couldn’t be more different.” Auwaerter, reached in Switzerland on Friday, said Bolívar most likely ingested too much arsenic — either from the Andes rivers or from doses given by physicians who at the time considered the poison to be a tonic. (One of Bolívar’s contemporaries, the “mad” British King George III, may also have died from arsenicosis.)

Time Magazine, 17 July 2010

Add Napoléon Bonaparte to the list of suspected arsenic poisoning victims. A similar conspiracy theory surrounds the French Emperor’s  death, supposedly of stomach cancer at the age of 51, was also said to have been hastened by intentional (or unintentional) arsenic poisoning.

While no one ever seriously considered digging up Napoléon, there are plenty of  hair samples from from various periods in his life, as well as hair from Josephine and from his son (who definitely did die of TB at the age of 21).  In 2008, the hair samples were tested for arsenic at the Italian National Institute of Nuclear Physics.   New York Times science correspondent William Broad wrote:

The big surprise was that the old levels were roughly 100 times the readings that the scientists obtained for comparison from the hairs of living people.

“The concentrations of arsenic in the hair taken from Napoleon after his death were much higher,” the scientists wrote. But the levels were “quite comparable with that found not only in the hair of the emperor in other periods of his life, but also in those of his son and first wife.”

The results, they added, “undoubtedly reveal a chronic exposure that we believe can be simply attributed to environmental factors, unfortunately no longer easily identifiable, or habits involving food and therapeutics.”

One popular theory on Napoleón’s relatively early death — besides the always favored idea that his British captors got tired of him and spiked his drinks, was that his bedroom on Saint Helena had green wallpaper.  The dyes used to tint wall-paper green were full of arsenic, and the bedroom was full of mold… so,  if he was poisoned, the wall-paper done it.

Or, as the Italians suggested, he just had a lot of arsenic in his system anyway, but it was stomach cancer that did him in.

Bolívar exhumation, July 2010

Last 16 July, Bolívar’s remains were exhumed — both to confirm that the body was that of Simón Bolívar, and to test for poisoning.  It appears there were signs of poisoning, but it may not have been intentional… arsenic was a common medication at the time, and apparently, it wasn’t that uncommon to be exposed to relatively high levels of arsenic at the time.

While the examination of Bolívar’s remains also uncovered arsenic, as well as other elements now considered poisonous, if they didn’t just get into his system through normal exposure, they may have been administered by Dr. Alexander Reverend.  Reverend — called to attend the general in his labyrinth at Santa Marta (now in Colombia) wrote of his initial examination on 1 December 1830:

I found him in the following state: very skinny and debilitated body, the painful semblance and a restlessness of constant spirit. The hoarse voice, a deep cough with viscous sputum of greenish color. The compressed pulse. The laborious digestion. The frequent impressions of the patient indicated moral sufferings. Finally, the disease of its Excellence seemed to me to be of most serious, and my first impression was that he had damaged lungs … ”

Doctor Reverend autopsied Bolívar, and his description sounds to this lay-person like TB*… and it’s known that both of Bolívar’s parents (and one of his siblings) died of the same 19th century “white plague”.  Paul  Auwaerter, the John Hopkins lung specialist notes, however, that the lesions found could have been from any number of bacterial infections.

And, the arsenic could have come from environmental sources.  Or maybe Napoléon done the deed.  Bolívar, as a young man, lived in Paris, where he was something of a protege to Alexander von Humbolt (who among his many contributions to the Americas, told young Simón: “I believe that your country is ready for its independence. But I can not see the man who is to achieve it”).  Though Humboldt, Bolívar was introduced to Napoléon and was present at the Emperor’s coronation on 2 December 1804.  Where, perhaps the ceremony being rather long — and Simón properly appalled by the French caudillo’s willingness to be a crowned head of state, needed a pick-me-up… which, a few conquests and crossings of the Andes later, would prove fatal.

With the inconclusive results, the best we can say is that Bolívar had TB, and there was arsenic in his system, and he is still dead.

* My late brother, Dr. James Grabman, working for the Indian Health Services treated more TB patients than most U.S. physicians in the late 20th century.  TB is still a killer, these days found especially among people with inadequate housing and diet… the basic conditions under which people live on  Indian Reservations and in Alaska native communities.  The Grabman TB Fund (c/o American Lung Association 1057 West Fireweed Suite 201. Anchorage, AK 99503) provides funding for TB and related disease research and education.

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