Napoleon's Poisoned Chalice

by Dr Martin Howard

  The true state of Napoleon’s health at this time is uncertain as we only have the reports from Longwood and these tend to exaggerate any minor indisposition. He was certainly not acutely unwell. At times, he was cheerful, whistling or singing, but he was also pale and he was becoming increasingly unfit and flabby. O’Meara had previously raised concern as to the prisoner’s sedentary lifestyle. To encourage him to leave his room, Antommarchi and others suggested that he take exercise on horseback but the Emperor was unenthusiastic. The doctor then proposed gardening; this was not a new idea as Montholon had made a plan for enlarging the garden earlier in the year. In large part due to Antommarchi’s persuasion, Napoleon decided to suspend his game of hide and seek with the Orderly Officer and, from early October 1819, he spent much of his time working out of doors. Captain Nicholls was delighted by this turn of events.

  The General was in his morning gown amidst the people at work, directing them. Takes a spade sometimes and begins to potter – sends messages to me for carts, shovels and spades. God send he may always continue in this humour during my residence at Longwood.

  Hudson Lowe and his allies strained to find something sinister in this burst of physical activity. When the Marquis de Montchenu, the only Foreign Commissioner left on the island, was offered some haricot beans from the garden, he had a choice of the green or white varieties and accepted a mixture. Lowe later advised, in all seriousness,

  Whether the haricots blancs and haricots verts bear any reference to the drapeau blanc of the Bourbons and the habit vert of General Bonaparte himself, and the livery of his servants at Longwood, I am unable to say; but the Marquis de Montchenu, it appears to me, would have acted with more propriety if he had declined receiving either, or limited himself to a demand for white alone.

  Whatever the political significance of the vegetables, Napoleon benefited greatly from all the spadework in the fresh air. His morale was boosted by the end result; a well watered and well planted garden on three sides of the house. Although his gardening suggestion was not original and had not required any medical expertise, Antommarchi was keen to take all the credit for the improvement in his charge’s health and mood, writing to Colonna in July 1820.

  It is ten months since I arrived on this island and I can assure you that I have not passed one day or night without providing my famous patient with all the help which my zeal and my knowledge have made possible. I found him affected by chronic hepatitis of a most serious nature; the care that I have given him appears to have been crowned with success.10

  Shortly after Antommarchi sent this exaggerated and self-congratulatory letter, the health of the Emperor did start to cause real concern. The physician felt obliged to write a more pessimistic note to Colonna speaking of a ‘very grave relapse’ and referring to the appearance of symptoms including pain in the liver and the leg.

  Napoleon remained highly sceptical of his doctor’s abilities and was very reluctant to receive any treatment from him. When, in October, Antommarchi proposed the placing of vesicatories, a sort of blistering plaster, on his arms, Napoleon refused, commenting that he was already torturing him enough. Bertrand and Montholon talked him into it and he eventually allowed Antommarchi to apply the plasters, although Marchand describes him as holding out his arms in repugnance. Napoleon’s reservations were fully justified as the doctor botched the procedure, failing to shave the skin and then forming shapeless vesicatories which were uncomfortable and left the patient without the use of his hands. The Emperor’s mood deteriorated as he was first unable to eat his dinner and then was told that the perpetrator could not be found. When Antommarchi belatedly returned to Longwood, Napoleon laid into him, complaining that he had been treated worse than ‘the poorest man in a hospital’. Why had the doctor blistered both arms at once thereby completely disabling him? When Antommarchi tried to interrupt, the Emperor cut him short; ‘Go away. You are an ignoramus and I a greater one for having let you do this.’

  According to Marchand, the vesicatories actually had some good effect, at least restoring his appetite, but the damage had been done. The incident had confirmed Napoleon’s worst suspicions regarding his doctor and it was the start of a deterioration in their relationship well summarised by Saint-Denis.

  During the first phase of his illness, the Emperor frequently sent for Antommarchi. When one of us went to his quarters to tell him that the Emperor wanted him, he was most often away from Longwood or at Madame Bertrand’s. When it was reported to the Emperor that Antommarchi was out, he would show his dissatisfaction. As soon as the doctor was informed that they had been looking for him he would hurry back and the Emperor would not fail to give him a dressing down. He would very often go to Madame Bertrand’s in the evening, and that was precisely the time the Emperor would send for him. Once, the Emperor, very irritated at having to wait for him for a long time, said to him, ‘you come to me as though you were paying a thirty-sous visit. You are here in my service and at my order. If Larrey were here he would not leave the head of my bed; he would sleep there, on the carpet. When I send for you it is because I need you. You ought to be at home, and not somewhere else,’ etc. Antommarchi, after such a scolding, ought to have paid attention to it, but, whether he was bored by remaining in his room or for some other reason, he still continued to go away, which was the case the whole time the Emperor’s illness lasted, and so this conduct, which was wholly unreasonable, increased the Emperor’s ill humour more and more.

  Napoleon’s reference to Dominique Larrey, his senior military surgeon who he once described as ‘the most virtuous man that I have ever known’, is poignant. It must have been incredible to him that he was now being attended to by a recalcitrant young man with virtually no clinical acumen. When Antommarchi’s mind was turned to medical matters, it was usually more with comic than with therapeutic effect. Engelbert Lutyens, the Orderly Officer, recalls the doctor wandering around Jamestown looking for ivory balls. Well aware of Antommarchi’s penchant for play, the British presumed that he wanted billiard balls whereas it later transpired that he required smaller spheres to insert into a wound.11

  At the start of 1821, Napoleon was deeply depressed both by his illness and his doctor. He now walked in his garden leaning on Antommarchi’s arm; ‘Put away your pills. Let us cease to grope our way blindfold, and trust to nature; that is much better … The devil take your medicines. If I can perspire and the wounds in my thigh open anew, I am cured.’ The Emperor still had the scar of the thigh injury he received at Toulon as a young man. He vented much of his frustration on his doctor. When Antommarchi visited him in the early hours of the morning, there was a ‘scene’ lasting two hours. Napoleon informed Bertrand that the surgeon was ‘nothing but a great rogue, a rascal, a good-for-nothing’. The Grand Marshal, he cried, should appoint Antommarchi as ‘first lackey’ to his wife – Napoleon was irritated that the physician was conscientiously attending the Countess, who had a miscarriage around this time.

  Demoralised by this constant stream of invective, Antommarchi approached Thomas Reade at the end of January and announced his desire to return home. He almost certainly took this step without confiding in the Emperor or the other Longwood residents. Lowe communicated the request to Montholon who informed Napoleon. Although he cannot have been much distressed at the prospect of losing his incompetent physician, he was irritated that Antommarchi had grasped the initiative and he immediately dictated a note to Montholon for Lowe’s attention. In it, he complained of Antommarchi’s shortcomings and demanded a doctor from Paris, preferably one of the older experienced army doctors, men such as Desgenettes, Percy or Larrey. He did not want Cardinal Fesch to be involved again – the choice could be left in the hands of the British and French governments.

  On the following morning, Antommarchi formally submitted his resignation to Montholon with an expression of regret that he had been unable to win the confidence of the Emperor. Napoleon dictated the following withering response for the Count to give to the doctor.
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br />   Monsieur, The Emperor, taking into consideration the wish which you have expressed to me [Montholon] in your letter of 31st January, authorises you to present yourself to the English officer commanding at St. Helena so that he can facilitate your departure. If it is possible that he could place you on the same vessel as the Abbé Buonavita, your assistance will be of great help to this disabled elderly man during such a long hard voyage. During the fifteen months that you have been on the island, you have given His Majesty no confidence in your moral character; you can be of no use to him with respect to his illness, and your staying here for a few more months would be without object.

  The priest was returning to Europe because of ill health.12

  Montholon describes Napoleon’s response to Antommarchi as ‘hard’ but there is evidence in Bertrand’s journal that, despite the uncompromising tone of the letter, the Emperor still retained some affection for the young doctor.

  He [Napoleon] told Antommarchi that he could go back with Abbé Buonavita. The doctor replied that he would do whatever the Emperor desired, but that he felt that he had done nothing for which to reproach himself. The Emperor then patted him and gave him a slap on the shoulder.

  Neither the Grand Marshal nor the Count had much faith in Antommarchi but, as there was no immediate prospect of recruiting a new doctor from Europe, they now faced the alarming prospect of the Emperor having no medical assistance at all. They decided to launch a charm offensive on both patient and doctor to ensure Antommarchi’s retention until some other arrangement was in place. This seemed to work as, at the beginning of February, Napoleon had mellowed enough to inform Antommarchi that, although he had asked for another physician, he could stay on if he wanted to; he would have to make up his own mind. The Emperor advised the doctor that he must improve his behaviour, as it was this rather than his potions which had caused the unpleasantness. He gave Antommarchi a few hours to make his decision.

  Montholon and Bertrand coaxed the physician to accept this olive branch by appealing both to his ego and his mercenary instincts. The Count flattered him, telling him that he had actually behaved rather well. The Grand Marshal confided to him that he had behaved ‘honourably’ and pointed out that the sacrifice he was making would bring him great rewards. If the doctor stayed on St. Helena the Emperor would ensure him a brilliant future, all the more so when he returned to private practice.

  Antommarchi was swayed by this intense courtship and Montholon helped him to draft a letter to the Emperor stating that he had resolved to remain in his post until a suitable replacement was found. Although he had achieved the desired result and averted a crisis, Bertrand remained cynical regarding the doctor’s true motivation.

  He will soon be leaving. He will have benefited from the situation. He says that fundamentally one is forced to be a slave here; that he prefers a little more happiness and peace of mind to honours, and that he will write his book in Europe.13

  During March there was another worrying development. The Emperor was becoming progressively weaker. Antommarchi remained elusive and Montholon expressed disgust that the doctor still failed to take his patient’s symptoms seriously.

  Napoleon, the Count wrote to his wife, could not live much longer. ‘I have never seen anybody so much like a corpse as he now is.’ Yet, when the doctor did put in an appearance, he was apparently unperturbed. On 20th March the Emperor had been ill during the night but he only agreed to see Antommarchi with reluctance. The physician felt his pulse and indicated to Montholon, with ‘a smile of incredulity’ that it was normal. The clear implication was that the nocturnal symptoms had been exaggerated and that there was little to worry about.

  In fact, Antommarchi was playing a double part. He fully appreciated the seriousness of the situation but he had decided on a strategy of concealment. This attempt to hide the severity of the disease from the patient and his companions was misguided but it was not a practice unique to Antommarchi. Many doctors of the time advocated this paternalistic approach as the best policy. Antommarchi’s real opinion of the Emperor’s state was contained in a letter to Colonna which he handed to Buonavita. He believed him to have worsening chronic hepatitis.

  In order to exculpate myself from all responsibility, I declare to you, to all the Imperial Family, and to the whole world, that the disease under which the Emperor is labouring is an effect of the nature of the climate, and that the symptoms it exhibits are of the most serious kind.14

  Unfortunately for Antommarchi, it was not so easy for him to evade accountability; he was still Napoleon’s personal physician and he could hardly watch him die without attempting some form of medical treatment. On the other hand, he was impeded not only by his lack of therapeutic experience but also by the awkwardness of his patient and the uselessness of almost all of the drugs in the early nineteenth-century pharmacopoeia. The Emperor was convinced that many drugs, mercury for instance, did more harm than good and we now know that he was right. Antommarchi needed courage to write a prescription.

  Napoleon started to vomit and also developed a fever. His doctor suggested an emetic. It appears strange that the remedy should be designed to make the symptoms worse but emetics were a vital part of the so-called ‘antiphlogistic regimen’ which was purported to rid the body of impurities causing disease. Other commonly used agents included laxatives and drugs designed to increase perspiration. Napoleon remained dubious and he initially refused the medicine before allowing himself to be talked into it by Bertrand and Montholon. On 22nd March, a quarter of a grain of tartar emetic was administered in a glass of lemonade. The patient immediately became violently sick and rolled about on the floor in agony. Antommarchi insisted that it was the correct treatment but that the dose had been too strong. Unsurprisingly, Napoleon refused any repeat performance; instead he resorted to his own favourite cure, liquorice in water. Showing it to Montholon, he commented astutely, ‘If it doesn’t do me any good, it will do me no harm.’ Marchand says that Antommarchi was present and that he smiled at the Emperor’s words, and restated the case for another emetic. ‘Why don’t you go for a long walk and take the emetic yourself!’ Despite this rebuke, the doctor was intent on imposing his treatment on his patient and he later whispered to Marchand that he intended to smuggle the emetic into the Emperor’s drinks. The loyal valet was horrified and refused to take part in the scheme. Napoleon, as usual, was alert to all possibilities and he had ordered his butler, Pierron, to check that his drinks were not doctored. Montholon relates what happened next.

  Confident he had taken adequate precautions, he was going to drink some lemonade, when, stopping with the glass between his lips, he said to me, ‘But there seems to be a strange smell. Are you really sure that nothing has been mixed with this lemonade?’

  – I am sure of it, I responded; but it is better for me to check. Your Majesty must not drink it. I am going to drink it; we will soon see.

  He gave me the glass and I drank. Ten minutes later, I was struck by a feeling like sea-sickness and I only just had time to get to my room.

  Napoleon was furious and he tore a strip off Marchand who was almost certainly innocent. He then called for the real culprit but Antommarchi was not at Longwood. When he returned in the evening, the Emperor had cooled a little but he still called him an assassin. The surgeon tried to redeem himself by saying that by refusing medical help the Emperor was endangering his life.

  Well, Sir, do I owe you an account? Do you not believe that for me death would be a blessing from heaven? I do not fear it, I will do nothing to hasten it but I will not grasp at straws to survive.

  The doctor was curtly dismissed with a threat that he would not be consulted again. In fact, his ostracism lasted only forty-eight hours. Marchand was ordered to throw the remaining drinks out of the window.15

  Napoleon was more disenchanted than ever by Antommarchi’s incompetence and slyness. In a deliberate slight to the Corsican physician, he asked Vignali to feel his pulse. After urgent solicitations from his entourag
e, he agreed to see another British doctor, Archibald Arnott. Antommarchi, who had encouraged this second opinion, met with Arnott on 25th March and discussed Napoleon’s case, giving him details of the symptoms and the treatments used. On 1st April, the Emperor gave his consent for the British surgeon to see him in person – we will return to Arnott.

  Having a more experienced medical colleague at his side must have been a considerable relief to Antommarchi but, as he continued to pay his own visits, he was still in the firing line. A week later, an incident occurred which discredited both doctor and patient. Since Madame Bertrand’s miscarriage, Antommarchi had been seeing her regularly. It is unlikely that there was anything improper in their relationship but Napoleon, whose own advances to the Countess had been rejected, suspected an illicit liaison and he resented it. When Antommarchi attended him at 7.30 in the morning, the Emperor flew into a rage, shouting that he should have been there much earlier and that he should pay less attention to the Grand Marshal’s wife. Whilst Antommarchi was still in the room, Napoleon turned to the newly arrived Bertrand and continued his diatribe against the doctor.