# Death of Napoleon I

The death of Napoleon I took place on May 5, 1821, at Longwood on the island of St. Helena, during his exile, at the age of 51. It was due to stomach cancer, resulting from the aggravation of an ulcer. From the 1950s onwards, some authors disputed this version, proposing a criminal cause following arsenic poisoning. This thesis is refuted by historians specializing in Napoleon I.

## Circumstances of Napoleon's death

Bedridden since March 17, Napoleon I suffered from excruciating stomach pains. He accepted less and less food, with regular vomiting making him weaker by the day. He got up on May 1, 1821, but weakness forced him to go back to bed. He had a bust of his son placed opposite his bed, with his eyes constantly fixed on it.
On May 3, the symptoms became more alarming. On May 4, there was some hope following a high dose of calomel (toxic mercury chloride) administered by his English physician Archibald Arnott and two of his colleagues, but against the advice of Corsican physician François Antommarchi. The effect, however, was extremely violent.
During the night of May 4-5, Napoleon was in a comatose state. Barely conscious, he seemed to utter the words “tête... armée...” (head... army...). In the morning, his companions gathered at his bedside, suspecting that this would be his last day. He died on Saturday, May 5, 1821, at 5:49 p.m., aged fifty-one years, eight months, twenty-one days.
The next day, the governor of the island, Sir Hudson Lowe, came in person with his staff and the French commissioner, the Marquis de Montchenu, to officially declare the death of “General Bonaparte”. On leaving Longwood, he declared to his entourage: “Well, gentlemen, he was England's greatest enemy, and mine too; but I forgive him everything. At the death of such a great man, one should feel only deep sorrow and profound regret.”

## Autopsy

In accordance with Napoleon's wishes, his body was opened on May 6, 1821, at 2 p.m. by François Antommarchi (an experienced prosector), assisted by seven British physicians, in order to ascertain the physical cause of his illness and to take advantage of this document in the event of his son being attacked by some ailment offering analogies with the illness that was about to take him: for Napoleon was convinced that he would die of a disease similar to that which had taken his father Charles Bonaparte, namely cancer of the stomach.
His autopsy, however, gave rise to much controversy since 1821, caused by the many reports, official and unofficial, including no less than three, all different, from Doctor Antommarchi alone.
Before the corpse was closed, the heart and stomach were removed and placed in silver cups containing wine spirits.
Once the operation was complete, the body was dressed in the uniform of the Mounted Chasseurs of the Imperial Guard, adorned with all the orders the deceased had created or received during his reign, after which it was placed on the iron bed he customarily had his retinue carry on his campaigns; the silver-embroidered blue coat he wore at the battle of Marengo served as his mortuary sheet.

## Contemporary analysis

The British governor of the island, Hudson Lowe, reached a consensus between the British and French autopsy reports: he concluded that the cause of death was stomach cancer.
Today, this official version has been called into question. The circumstances of his death have been the subject of much speculation, especially since arsenic poisoning was suggested in 1961 by Sten Forshufvud, a Swedish dentist and toxicology expert.

### Aggravated ulcer

The Corsican physician François Antommarchi and five English doctors note in their autopsy reports the existence of a chronic perforated gastric ulcer (which would have caused fatal peritonitis), probably evolving into cancer, and pulmonary lesions linked to tuberculosis. Another report drawn up 2 years later on September 12, 1823, by Dr. Walter Henry confirms this ulcer, aggravated by the presence of “masses of cancerous ulcerations or squirrels”. Thierry Lentz and Jacques Macé consider this thesis, which corresponds to the initial report, to be the most historically credible.
If all the autopsy reports were compared, it becomes clear that the large perforated gastric ulcer, blocked by the left lobe of the liver, did not cause the Emperor's death. The fact that Dr. Antommarchi had difficulty separating the outer wall of the stomach from the liver argues in favor of an old fibrosis, dating from several weeks or months before death. On the other hand, all witnesses, doctors and non-physicians alike, described a gastric mucosa in poor condition over virtually its entire surface, with a “mass of ulcerations”. This pathology was well described a few years later by Jean Cruveilhier, in 1830, under the name of “gastrorrhagia”. It causes chronic microscopic bleeding, leading to iron deficiency, anemia, and death from exsanguination (loss of more than 40% of total blood volume).

### Stomach cancer

A study published in 2007 in Nature Clinical Practice Gastroenterology and Hepatology suggests that Napoleon had a gastric tumor lesion compatible with stomach cancer. This study is based on descriptions made by Antommarchi in his second autopsy report, published in 1825, four years after the autopsy. However, it has been shown that this autopsy report plagiarizes, in part, a medical article published in May 1823 by Dr. Rullier in the journal Archives Générales de Médecine, entitled “Note sur un petit engorgement cancéreux de l'estomac, extrêmement circonscrit, perforé à son center, et suivi de l'épanchement des aliments dans l'abdomen (Note on a small cancerous engorgement of the stomach, extremely circumscribed, perforated at its center, and followed by effusion of food into the abdomen)”. In addition to being a plagiarism, Antommarchi's 1825 report is a forgery.
Bastien and Jeandel's article demonstrates the unreliability of Antommarchi's 1825 autopsy report. But, for some authors, there are at least four arguments against the diagnosis of cancer as a cause of death:
* The definition of cancer in 1821 was not based on a cellular, i.e. microscopic, diagnosis, as it is today. Furthermore, in the autopsy report on Charles Bonaparte, the Emperor's father, the word “tumor” appears 4 times, but not once the words “cancer” or “squirrhe”. His stomach had been obstructed by a benign tumor “the length and volume of a large potato, or of a large elongated winter pear... renitent and of a half-cartilaginous consistency”.
* The diagnosis of cancer was whispered by Napoleon to his doctors. When Dr Arnott told him that his ailment was in the stomach, he immediately thought of his father's death, whose autopsy report had revealed the existence of a stomach tumor which, by obstructing the pylorus, had led to death from cachexia. This diagnosis of cancer suited Hudson Lowe, as it ruled out any responsibility on the part of the Helena climate and the British for the death of their worst enemy.
* Finally, the key argument is that the word “tumor” does not appear in any of the autopsy reports. However, gastric cancer is first and foremost a proliferation of malignant cells, i.e. a tumor, a term well known in the early 19th century. The English refer to an “ulcer in the process of carcinogenesis”, which is possible, but can in no way explain the death on May 5, 1821.
* In the case of gastric cancer in the 1800s, death occurred through one of the following mechanisms: massive internal hemorrhage, complete obstruction prohibiting all nutrition, or metastasis affecting a vital organ and rendering it inactive. There are no symptoms or autoptic findings to support this theory.
However, based on the report of clinical descriptions (notably the loss of around ten kilos in the last six months of his life), this study also concludes that he had terminal stomach cancer, caused by an ulcer of bacterial origin (Helicobacter pylori).

### Arsenic poisoning theory

Sten Forshufvud, a Swedish stomatologist, proposed this hypothesis around 1955 when reading the memoirs of Louis Joseph Marchand, Napoleon's personal valet, which had just been published by his descendants in 1952 and 1955. Twenty-eight of the 31 symptoms described by Marchand (including the disappearance of the hair system) resembled those caused by arsenic poisoning.
Forshufvud obtained from various sources several locks of hair claimed to belong to Napoleon, and had them analyzed by Professor Hamilton Smith of Glasgow University: by cutting the hair into small segments and analyzing each segment, then referring to the dates on which the hair was said to have been collected, and connecting all this data, he made a histogram showing the evolution of arsenic concentration in Napoleon's body before and during his exile. Napoleon was said to have suffered chronic arsenic poisoning since 1805, which, combined with the island's climate, weakened him to the point where the medical treatments of the time, notably calomel administered in the last days of his life, finished him off.
This thesis was nevertheless called into question by a scientific study in 1998 (suggesting that Napoleon had gastric carcinoma and that his death was due to an internal hemorrhage caused by the ingestion of calomel), and severely criticized by medical historians Paul Gainière and Guy Godlweski and historian Thierry Lentz, for whom Napoleon died “of his own accord”, or even “of boredom”, and who, with Jean Tulard, published a collective work entitled Autour de l'empoisonnement de Napoléon, in which he expressed doubts about the legitimacy of the hair samples taken, the methodology and the interpretation of the results. Interviewed by him and having been able to reread their interviews, Drs. Kintz and Fornix, who carried out the toxicological analyses, declare that they never spoke of Napoleon's “assassination”, but of exposure to arsenic, which is not the same thing.
In June 2010, a book was published that includes previously unpublished English reports confirming Dr. Thomas Shortt's accusations. Shortt diagnosed chronic liver disease in Napoleon, giving rise to the theory that he eventually died of a liver abscess complicated by amoebic dysentery, and that the island's governor, Hudson Lowe, was responsible for wanting to put an end to the illustrious captive's life. These accusations led to the Irish doctor's disbarment from the Royal Navy's medical services.

### Arsenic poisoning

With funding from Ben Weider, an analysis was carried out by Dr. Pascal Kintz, President of the Association Internationale des Toxicologues de Médecine Légale, who concluded in 2003 that the Emperor had been intoxicated with arsenic, which he found to be present in massive doses, not on the surface as had been the case in previous analyses, but in the medulla, the core of the sovereign's hair.
Two years later, at the ChemTox laboratories in Strasbourg, Dr. Kintz carried out three series of investigations on five different strands of hair, all from different collections around the world:
* Global measurement of arsenic in five strands of hair by atomic absorption spectrophotometry.
* Anatomical localization of arsenic in hair by Nano-SIMS.
* Complete mineral analysis with speciation, a method for accurately determining the nature of the toxic product, in this case arsenic.
With these new analyses, Dr. Kintz deepened his study by determining a chronology in the administration of the toxic agent (whose “spikes” were compatible with the symptomatology observed and noted by the Emperor's companions in exile), and identified it as the most toxic mineral arsenic, found in the form of rat poison.
The results of these analyses were presented in detail by Dr. Kintz on June 2, 2005, in Illkirch-Graffenstaden near Strasbourg. In his conclusion, Dr. Kintz testifies: “In all the Emperor's hair samples, ICP-MS revealed massive concentrations consistent with chronic intoxication by highly toxic inorganic arsenic. We are unambiguously on the trail of criminal intoxication".
More recently, in his article Trois séries d'analyse des cheveux de Napoléon confirm une exposition chronique à l'arsenic (24/01/2008), he adds: “Given these scientific data, we can conclude that Napoleon was indeed the victim of chronic intoxication by the mineral arsenic, and therefore by rat poison”.
These conclusions were supported by the International Museum of Surgical Sciences and the International College of Surgeons of Chicago.
On February 11, 2008, the Italian Institute of Nuclear Physics (INFN) of the Universities of Milan and Pavia concluded on the basis of hair samples conserved in Napoleonic museums in France and Italy (Musée Glauco-Lombardide Parme, Musée Napoléonien de Rome and Musée du Château de Malmaison), and measured by the Italian center's nuclear research reactor, that arsenic levels were abnormally high, but comparable to those found in the hair of his youth, and not exceptional compared to the levels found in samples from Josephine de Beauharnais and her son the King of Rome. The institute noted that the quantity of arsenic observed in these samples was a hundred times higher than the level measured today, and observed that “the environment in which people lived at the beginning of the nineteenth century obviously led to the ingestion of quantities of arsenic that we would consider dangerous today”.

### In purely medical terms

The diagnosis of arsenic poisoning in Napoleon is unconvincing, as massive acute poisoning causes death, while proponents argue for chronic poisoning over months or years. Sten Forshufvud identified 31 suggestive signs, including a mix of acute and chronic symptoms, but many are nonspecific. Additionally, chemical poisons typically target specific molecules, leading to a logical progression of symptoms and tissue damage, which does not align with Napoleon's symptoms, such as gingivitis.

### Kidney failure and poisoning

In his book Napoleons nyrer (Napoleon's kidneys), Danish physician Arne Soerensen suggested that Napoleon died of urinary and kidney problems.

## Commemorations of Napoleon's death
### Ceremonies

Every May 5 on St. Helena, a public ceremony is held around the tomb of the French Emperor to mark the anniversary of his death.
At Les Invalides in Paris, ceremonies including wreath-laying and religious ceremonies are organized every year jointly by the Military Governor of Paris, the Governor of Les Invalides, the imperial family and the Fondation Napoléon.

### Bicentenary

To mark the bicentenary of Napoleon's death on May 5, 2021, 200 years to the day, commemorative ceremonies were held in France and on St. Helena.
Various ceremonies are also planned on the island of St. Helena. On May 5, a ceremony was held at Longwood House. On May 6, a mass will be held in the Emperor's chapel. Finally, a ceremony will be held on May 9 for the burial of the Emperor. These events will be broadcast live over the Internet.
Numerous events (exhibitions, conferences, concerts, etc.) are also planned around the world in 2021. Due to the COVID-19 epidemic, a number of events are likely to be adapted or postponed to a later date.

## Cinema

* Monsieur N., a French film by Antoine de Caunes, released in 2003
* L'Otage de l'Europe, a Franco-Polish historical film directed by Jerzy Kawalerowicz, released in 1989