March 12, 2018History of Medicine
Graphic credit: John Michael Wright - National Portrait Gallery: NPG 531, While Commons policy accepts the use of this media, See Commons: Licensing for more information., Public Domain, https://commons.wikimedia.org/w/index.php?curid=6373274
Charles II (29 May 1630-6 February 1685) was king of England, Scotland and Ireland. He was king of Scotland from 1649 until his deposition in 1651, and king of England, Scotland and Ireland from the restoration of the monarchy in 1660 until his death. Charles II was one of the most popular and beloved kings of England, known as the Merry Monarch, in reference to both the liveliness and hedonism of his court and the general relief at the return to normality after over a decade of rule by Cromwell and the Puritans. Charles's wife, Catherine of Braganza, bore no live children, but Charles acknowledged at least twelve illegitimate children by various mistresses. He was succeeded by his brother James.
Charles II's father, Charles I, was executed at Whitehall on 30 January 1649, at the climax of the English Civil War. Although the Parliament of Scotland proclaimed Charles II King on 5 February 1649, England entered the period known as the English Interregnum or the English Commonwealth, and the country was a de facto republic, led by Oliver Cromwell. Cromwell defeated Charles II at the Battle of Worcester on 3 September 1651, and Charles fled to mainland Europe. Cromwell became virtual dictator of England, Scotland and Ireland, and Charles spent the next nine years in exile in France, the Dutch Republic and the Spanish Netherlands. A political crisis that followed the death of Cromwell in 1658 resulted in the restoration of the monarchy, and Charles was invited to return to Britain. On 29 May 1660, his 30th birthday, he was received in London to public acclaim. After 1660, all legal documents were dated as if he had succeeded his father as king in 1649.
Charles's English parliament enacted laws known as the Clarendon Code, designed to shore up the position of the re-established Church of England. Charles acquiesced to the Clarendon Code even though he favored a policy of religious tolerance. The major foreign policy issue of his early reign was the Second Anglo-Dutch War. In 1670, he entered into the Treaty of Dover, an alliance with his first cousin King Louis XIV of France. Louis agreed to aid him in the Third Anglo-Dutch War and pay him a pension, and Charles secretly promised to convert to Catholicism at an unspecified future date. Charles attempted to introduce religious freedom for Catholics and Protestant dissenters with his 1672 Royal Declaration of Indulgence, but the English Parliament forced him to withdraw it. In 1679, Titus Oates's revelations of a supposed Popish Plot sparked the Exclusion Crisis when it was revealed that Charles's brother and heir (James, Duke of York) was a Catholic. The crisis saw the birth of the pro-exclusion Whig and anti-exclusion Tory parties. Charles sided with the Tories, and, following the discovery of the Rye House Plot to murder Charles and James in 1683, some Whig leaders were executed or forced into exile. Charles dissolved the English Parliament in 1681 and ruled alone until his death on 6 February 1685. Ironically, he was received into the Roman Catholic Church on his deathbed.
He died in his bed, surrounded by his spaniels, friends, and family, in the early hours of 6 February 1685. His death was torture, due to a complete lack of medical knowledge. Hence, in Charles II case, the torturers/killers were his doctors. It was not the intention of the doctors to cause the death of the king. But through their total medical ignorance, their actions, led the already ailing Charles, a speedier and agonizing death. Because the daily accounts of Charles II demise are so detailed and vivid, we include the next few passages as a stark contrast to the 21st century hospice and palliative care we are now accustomed to.
DAY 1: On the morning of 2nd February 1685, things seemed to be going normally for Charles. As he was preparing to shave, he suddenly cried out to pain, fell to the floor and suffered from a series of fits. Six royal physicians rushed into the Royal Bedchamber to help Charles. Their good intentions, however, paved the path to Charles' undoubtedly excruciating end. Once the seizure had passed, the first thing that the doctors did was bleed him of 16 ounces of blood. Next, they applied heated cups to the king's skin, to form blisters. This treatment, which is still practiced in parts of the world today, was believed to ?stimulate' his system, and once the blister was lanced, the disease would go away with its contents. After the cupping procedure was completed, Charles' doctors drained him of 8 more ounces of blood. After this second bleeding session was completed, they gave the king a drug to induce vomiting, an enema to purify his bowels, and a purgative to clean out his intestines. The doctors believed that the bad consequences of the disease was not only in the blood, but also in the bowels. The next treatment was to force-feed a syrup, containing blackthorn and rock salt, followed by shaving his head and blistered his scalp, which caused the king to wake from a nap. None of the physicians understood the healing nature of sleep. They administered yet another enema to the ailing king, put an irritant powder up his nostrils, blistered his skin again with cupping, and applied cow-slip flowers to his stomach. At the end of the day they applied pigeon droppings to his feet. The torturous treatment of the first day, lasted for 12 hours. After the ?care' was done, the king was put to bed.
DAY 2: When the king awoke, he seemed greatly improved. This should have been a sign that something had worked, however, as soon as Charles II woke, his doctors began to bleed the king again, this time, opening both of Charles' jugular veins bleeding out 10 ounces. At this point, the king had lost 34 ounces of blood. The physicians then proceeded to feed him a potion containing black cherries, peony, lavender, sugar, and crushed pearls. After he ingested the liquid, he slept through the day and night soundly.
DAY 3: When Charles awoke on the third morning, he suffered another seizure. His doctors bled him again, after feeding him first sienna pods in spring water, and white wine with nutmeg; next a force-fed drink made of ?40 drops of extract of human skull', taken from a man who met a very violent demise, as well as a gallstone (the Bezoar Stone) from an East Indian goat. The physicians proudly announced that the king was going to survive.
DAY 4: The king was near death on this day. Seeing his pitiful state of health, the doctors applied the hot cups to his skin again to form blisters, gave him another enema and emetic, and was bled yet again. He was then given Jesuit's Powder; a quinine remedy, laced with opium and wine. Perhaps this potion helped as a pain killer and a soporific.
DAY 5: Dr. Scarborough, one of the royal doctors, wrote on the morning of 5th February 1685: Alas! After an ill-fated night, His Serene Majesty's strength seemed exhausted to such a degree that the whole assembly of physicians became despondent and lost hope. On this day, in an attempt to revive the king, he was bled until the doctors gave up this technique and turned to creating a new stronger potion. The physicians gathered an antidote containing ?extracts of all the herbs and animals of the Kingdom' by scouring the palace grounds. These ingredients were then mixed with ammonia and poured down his throat.
DAY 6: 6th February 1685 was the final day for the popular monarch. The scene around his deathbed was one that still draws some emotion 300 years or more later. Charles, although incredibly weak and in great pain, wished to see each of his surviving children and mistresses for one last time. At one point, the king asked for the curtains of his room to be drawn back, so that he could view the sun over the Thames for one last time. As he took in the view, he said: I have suffered much more than you can imagine. You must pardon me, gentlemen, for being a most unconscionable time a-dying. He converted to Catholicism shortly before he died. At 11:15 am, on 6th February 1685, at the age of 54 years, King Charles II died.
It's said that Charles was suffering from a variety of ailments at this time; uremia, malaria, mercury poisoning, chronic nephritis, and quite possibly some form of an STD. We know that he was ill, but the exact illness was not known. Could today's physicians have kept the king alive? We'll never know; however, we do know that his death would have been peaceful and would have lacked all the suffering Charles II endured.