When Napoleon was sent to St. Helena he was followed by a very few faithful friends, who seem to have spent their time in hating one another rather than in comforting their fallen idol. It is difficult to get at the truth of these last few years because, though most of the eye-witnesses have published their memoirs, each man seems to have been more concerned to assure the world of the greatness of his own sacrifice than to record the exact facts. Therefore, though Napoleon urged them to keep diaries, and thereby make great sums of money through their imprisonment, yet these diaries generally seem to have aimed rather at attacking the other faithful ones than at telling us exactly what happened.
The post-mortem examination of Napoleon’s body was performed by Francesco Antommarchi, a young Corsican physician, anatomist, and pathologist, who was sent to St. Helena about eighteen months before Napoleon’s death in the hope that he, being a Corsican, would be able to win the Emperor’s confidence and cure the illness of which he was already complaining. Unfortunately, Antommarchi was a very young man, and Napoleon suspected both his medical skill and the reason of his presence. Napoleon used to suffer from severe pains in his stomach; he would clasp himself, and groan, “O, mon pylore!” By that time he was suffering from cancer of the stomach, and Antommarchi did not suspect it. When Napoleon groaned and writhed in agony it is said that Antommarchi merely laughed, and prescribed him tartar emetic in lemonade. Napoleon was violently sick, and thought himself poisoned; he swore he would never again taste any of Antommarchi’s medicine. Once again Antommarchi attempted to give him tartar emetic in lemonade; it was not in vain that Napoleon had won a reputation for being a great strategist, for, when Antommarchi’s back was turned he handed the draught to the unsuspecting Montholon. In ten minutes that hero reacted in the usual manner, and extremely violently. Napoleon was horrified and outraged in his feelings; quite naturally he accused Antommarchi of trying to poison him, called him “assassin,” and refused to see him again. Another fault that Napoleon found with the unhappy young man was that whenever he wanted medical attendance Antommarchi was not to be found, but had to be ferreted out from Jamestown, three and a half miles away; so altogether Antommarchi’s attendance could not be called a success. Napoleon in his wrath was “terrible as an army with banners.” Even at St. Helena, where the resources of the whole world had been expended in the effort to cage him helpless, it must have been no joke to stand up before those awful eyes, that scorching tongue; and it is no wonder that Antommarchi preferred to spend the last few weeks idling about Jamestown rather than forcing unwelcome attention upon his terrible patient.
Worst of all, Antommarchi at first persuaded himself that Napoleon’s last illness was not serious. When Napoleon cried in his agony, “O, mon pylore!” and complained of a pain that shot through him like a knife, Antommarchi merely laughed and turned to his antimony with catastrophic results. It shakes our faith in Antommarchi’s professional skill to read that until the very last moment he would not believe that there was much the matter. The veriest blockhead—one would imagine—must have seen that the Emperor was seriously ill. Many a case of cancer of the stomach has been mistaken for simple dyspepsia in its early stages, but there comes a time when the true nature of the disease forces itself upon even the most casual observer. The rapid wasting, the cachexia, the vomiting, the pain, all impress themselves upon both patient and friends, and it is difficult to avoid the conclusion that Antommarchi must have been both careless and negligent. When the inevitable happened, and Napoleon died, it was Antommarchi who performed the autopsy, and found a condition which it is charitable to suppose may have masked the last symptoms and may have explained, if it did not excuse, the young anatomist’s mistaken confidence.
We conclude our brief sketch of the unhappy Antommarchi by saying that when he returned to Europe he published the least accurate and most disingenuous of all accounts of Napoleon’s last days. His object seems to have been rather to conceal his own shortcomings than to tell the truth. This book sets the seal on his character, and casts doubt on all else that comes from his pen. He may have been, as the Lancet says, a “trained and competent pathologist”; he was certainly a most unfortunate young man.
The post-mortem was performed in the presence of several British military surgeons, who appear to have been true sons of John Bull, with all the prejudice, ignorance, and cocksureness that in the eyes of other nations distinguish us so splendidly. Though truthfulness was not a strong point with Antommarchi, he seems to have known his pathology, and has left us an exceedingly good and well-written report of what he found. Strange to relate, the body was found to be still covered thickly with a superficial layer of fat, and the heart and omenta were also adipose. This would seem impossible in the body of a man who had just died from cancer of the stomach, but is corroborated by a report from a Dr. Henry, who was also present, and is not unknown. I remember the case of an old woman who, though hardly at all wasted, was found at the autopsy to have an extensive cancerous growth of the pylorus; the explanation was that the disease had been so acute that it slew her before there had been time to produce much wasting. At one point Napoleon’s cancerous ulcer had perforated the stomach, and the orifice had been sealed by adhesions. Dr. Henry proudly states that he himself was able to thrust his finger through it. The liver was large but not diseased; the spleen was large and “full of blood”—probably Antommarchi meant engorged. The intestine was covered by small bright-red patches, evidently showing inflammation of lymphatic tissue such as frequently occurs in general infections of the body. The bladder contained gravel and several definite calculi. There was hardly any secondary cancerous development, except for a few enlarged glands. Antommarchi and the French generally had diagnosed before death that he was suffering from some sort of hepatitis endemic to St. Helena, and the cancer was a great surprise to them—not that it would have mattered much from the point of view of treatment.
Napoleon’s hands and feet were extremely small; his skin was white and delicate; his body had feminine characteristics, such as wide hips and narrow shoulders; his reproductive organs were small and apparently atrophied. He is said to have been impotent for some time before he died. There was little hair on the body, and the hair of the head was fine, silky, and sparse. Twenty years later his body was exhumed and taken to France, and Dr. Guillard, who was permitted to make a brief examination, stated that the beard and nails appeared to have grown since death; there was very little sign of decomposition; men who had known him in life recognized his face immediately it was uncovered.
Leonard Guthrie points out that some of these signs seem to indicate a condition of hypo-pituitarism—the opposite to the condition of hyper-pituitarism which causes “giantism.” Far-fetched as this theory may appear, yet it is possible that there may be something in it.
The autopsy showed beyond cavil that the cause of death was cancer of the stomach, and it is difficult to see what more Antommarchi could have done in the way of treatment than he did, although certainly an irritant poison like tartar emetic would not have been good for a man with cancer of the stomach, even if it did not actually shorten his life. But Napoleon was not a good patient. He had seen too much of army surgery to have a great respect for our profession; indeed, it is probable that he had no respect for anybody but the Emperor Napoleon. He, at least, knew his business. He could manœuvre a great army in the field and win battles—and lose them too. But even a lost Napoleonic battle—there were not many—was better managed than a victory of any other man; whereas when you were dealing with these doctor fellows you could never tell whether their results were caused by their treatment or by the intervention of whatever gods there be. Decidedly Antommarchi was the last man in the world to be sent to treat the fallen, but still imperious, warrior.
The symptoms of impending death seem to have been masked by a continued fever, and probably Antommarchi was not really much to blame. This idea is to some extent borne out by a couple of specimens in the Museum of the Royal College of Surgeons, which are said to have belonged to the body of Napoleon. The story is that they were surreptitiously removed by Antommarchi, and handed by him to Barry O’Meara, who in his turn gave them to Sir Astley Cooper. That baronet handed them to the museum, where they are now preserved as of doubtful origin. But their genuineness depends upon whether we can believe that Antommarchi would or could have removed them, and whether O’Meara was telling the truth to Sir Astley Cooper. It is doubtful which of the two first-mentioned men is the less credible, and Cooper could not have known how untruthful O’Meara was to show himself, or he would probably not have thought for one moment that the specimens were genuine. O’Meara was a contentious Irishman who, like most other people, had fallen under the sway of Napoleon’s personal charm. He published a book in which he libelled Sir Hudson Lowe, whose hard fate it was to be Napoleon’s jailer at St. Helena—that isle of unrest. For some reason Lowe never took action against his traducer until it was too late, so that his own character, like most things connected with Napoleon, still remains a bone of contention. But O’Meara had definitely put himself on the side of the French against the English, and it was the object of the French to show that their demigod had died of some illness endemic to that devil’s island, aggravated by the barbarous ill-treatment of the brutal British. We on our side contended that St. Helena was a sort of earthly paradise, where one should live for ever. The fragments are from somebody’s ileum, and show little raised patches of inflamed lymphoid tissue; Sir William Leishman considers the post-mortem findings, apart from the cancer, those of some long-continued fever, such as Mediterranean fever.
Mediterranean or Malta fever is a curious specific fever due to the Micrococcus melitensis, which shows itself by recurrent bouts of pyrexia, accompanied by constipation, chronic anæmia, and wasting. Between the bouts the patient may appear perfectly well. There are three types—the “undulatory” here described; the “intermittent,” in which the attacks come on almost daily; and the “malignant,” in which the patient only lives for a week or ten days. It is now known to be contracted by drinking the infected milk of goats, and it is almost confined to the shores of the Mediterranean and certain parts of India. It may last for years, and it is quite possible that Napoleon caught it at Elba, of which Mediterranean island he was the unwilling emperor in 1814. Thence he returned to France, as it was said, because he had not elba-room on his little kingdom. It is certain that for years he had been subject to feverish attacks, which army surgeons would now possibly classify as “P.U.O.,” and it is quite possible that these may in reality have been manifestations of Malta fever.