What Killed Napoleon?

Jan. 17, 2007— -- Napoleon Bonaparte died in exile in 1821. But his story never does.

His personal physician reported on his death certificate that Napoleon died of stomach cancer, but scientists, historians and enthusiasts have questioned the conclusion repeatedly over the last two centuries. Surely, said many, he was poisoned.

They found locks of his hair, which, they said, contained toxic levels of arsenic. They went through his valet's diaries. They noted that when his body was unearthed in 1840, it was remarkably well-preserved.

So sorry to disappoint, says Dr. Robert Genta of Southwestern Medical Center at the University of Texas in Dallas. Napoleon's doctor got it right the first time: The defeated emperor died of advanced gastric cancer.

"It's become fashionable to ask if the course of history would have been changed if he had somehow escaped his exile, gone back to Paris, perhaps reconquered France," said Genta. "And the answer is probably no. His cancer was so advanced that even if somebody could have smuggled him out, he was in such terrible shape that he would have died very quickly."

How does one come to such a conclusion about a man who has been dead for so long? The answer is good old-fashioned detective work.

Able Was I Ere I Saw Elba

The facts -- to the extent historians can agree on them -- are these:

Having dominated Europe and been beaten back, Napoleon was finally defeated at the Battle of Waterloo in 1815. He was imprisoned and then exiled to Saint Helena, a remote island in the South Atlantic Ocean, 1,700 miles off the African coast.

His British captors wanted him far out of the way -- he had already escaped once from the Mediterranean island of Elba.

During the last six years of his life, he was often ill, and he had a rapid downturn in his final six months. His doctor, Francesco Antommarchi, reported that Napoleon had strong abdominal pain, nausea and vomiting, night sweats and progressive weakening. "For me," he was quoted as saying, "every activity is a Herculean task."

All these symptoms, Genta says, are consistent with stomach cancer.

Genta and his colleagues read Antommarchi's autopsy report, along with the accounts of several French assistants and British soldiers who were present for the examination. They all reported a large growth in his stomach, extending from one side to the other.

In the journal Nature Gastroenterology and Hepatology, the scientists wrote, "The stomach was filled with dark material that resembled coffee grounds, a strong indication of upper gastrointestinal bleeding that could have been the immediate cause of death."

Arsenic and Old…Pants

For the last 50 years, historians and history buffs have debated whether Napoleon's British captors tried to poison him with arsenic. In locks of his hair, preserved after his death, they found arsenic levels up to 38 times higher than normal.

Other researchers, though, found other hair samples dating back as far as 1805 -- and they too had high arsenic levels. If someone had been trying to poison him, says Genta, it would have worked long before 1821.

In a study lead by Ivan Ricordel, head of toxicology for the Paris Police, researchers suggested the arsenic levels came from wine and from hair tonic. In the early 1800s, arsenic was also used to treat syphilis, from which Napoleon -- reputed to have been less than faithful to the Empress Josephine -- may well have suffered.

What's more, says Genta from his Dallas office, the autopsy does not show other signs of arsenic poisoning. Napoleon's skin and fingernails were both described as pale; fatal doses of arsenic would have caused noticeable discoloration.

Genta's team tried one other thing: They searched Europe's museums for Napoleon's pants.

A man's trousers can reveal many secrets. They found twelve pairs belonging to Napoleon, eight of them from his years on Saint Helena. They reported that in the last six months of his life, his waist size shrank from 43 inches to 38.

Do some math (Napoleon was said to be 5 feet, 2 inches high), and Genta and his colleagues conclude Napoleon lost about 30 pounds in his final months -- something, again, that fits a diagnosis of stomach cancer but not arsenic.

"Even if he had been taken to one of today's best hospitals," says Genta, "he would not have survived."