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Revolutionary Robespierre may have had rare immune disease

Source: Reuters - Fri, 20 Dec 2013 12:01 AM
Author: Reuters
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By Kate Kelland

LONDON, Dec 20 (Reuters) - He was riddled with jaundice, pock-marked, bloody and twitchy.

A new scientific analysis shows French revolutionary Maximilien de Robespierre was probably suffering from an organ-destroying immune disorder called sarcoidosis when he was executed by guillotine in 1794.

After reconstruction and examination of the death mask of the leader of the "reign of terror", forensic scientists Philippe Charlier and Philippe Froesch gave a retrospective diagnosis of the disease in which the body starts to attack its own tissues and organs.

"Several clinical signs were described by contemporary witnesses," the scientists wrote in The Lancet medical journal.

These included vision problems, nose bleeds - described in medical history documents which told of how he "covered his pillow of fresh blood each night" - jaundice - "yellow coloured skin and eyes" - continuous tiredness and recurrent leg ulcers.

"He also had permanent eye and mouth twitching," the scientists wrote, adding that "the symptoms worsened between 1790 and 1794". Robespierre was 36 when he was executed.

A funeral mask was moulded just after his decapitation, and a copy of it is held at the Granet Museum, in Aix-en-Provence, southern France.

Sarcoidosis causes small areas of inflammation in the body's tissues called granulomas, and most commonly affects the lungs, skin and lymph nodes, but also - in some forms of the disease - the eyes, liver and pancreas. It is often accompanied by tiredness and a general feeling of being unwell.

The causes of sarcoidosis are not well understood, the scientists said, but in many patients the illness eventually goes into remission without treatment.

Charlier and Froesch said that although there are other possible explanations for some of Robespierre's symptoms, such as tuberculosis or leprosy, they do not fit exactly with the description of his symptoms and evolution of the disease.

Sarcoidosis - first described in medical literature by British physician Sir Jonathan Hutchinson in 1877 - would appear to be the most likely cause, they concluded.

"We do not know which treatment was given by his personal physician Joseph Souberbielle, but fruits might have been included - in view of his very high consumption of oranges - along with baths and bloodletting."

"His disease did not play any part in his death," they added, "as judicial execution put the patient to death in a context of political crisis". (Editing by Mike Collett-White)

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