Fourteen physicians, a bucket of blood, hot irons and pigeon droppings on the royal feet: the Merry Monarch's last week was no laughing matter
WHITEHALL, 6 February 1685 - Charles II, the Merry Monarch, died after four days of the most ambitious medical care ever inflicted on an English king. He had survived exile, civil war, plague and the Great Fire of London. He did not survive his doctors. As deathbed apologies go, his was the best in royal history: he is said to have begged pardon of those around him for being "an unconscionable time a-dying".
What Happened to Charles II?
On the morning of 2 February, as he was being shaved, the king let out a strange cry and collapsed in a fit. He lost the power of speech for a time and was put to bed. Most modern writers believe he suffered a stroke, perhaps brought on by kidney failure, though others have blamed mercury from his hobby of chemistry. The article on Charles II of England sets out the basics. What isn't in doubt is the speed at which his physicians swarmed. Within hours, around fourteen of them were arguing over the royal body.
The Treatments, in Full
Brace yourself. First they bled him, taking about sixteen ounces from a vein in his arm. Then they cupped his shoulders, cutting the skin and drawing out more blood. They gave him an emetic to make him vomit, a purgative to clear his bowels, and a series of enemas, one of which contained, among other things, antimony and rock salt. They shaved his head and applied red-hot irons to his scalp, and put plasters of pigeon droppings on the soles of his feet. Finally they gave him a potion called "spirit of human skull", an expensive tincture made from the powdered bone of a dead man. If you wanted to design a regime to finish off a stroke victim, you would struggle to improve on it.
What a Modern Stroke Unit Would Do
Today the first rule is speed. The NHS campaign for recognising a stroke asks you to look at the face, arms and speech, and to call 999 at once. The ambulance takes the patient to a specialist unit where a brain scan establishes whether the cause is a clot or a bleed. If it's a clot, drugs can dissolve it within hours, and a surgeon can remove it by threading a tiny device through an artery. The patient then spends a few days on the ward, starts rehabilitation, and goes home with advice about blood pressure. The king would have survived, and he would have been furious at the paperwork.
Imagine Charles in a Modern Stroke Ward
Picture the scene. A consultant in a lanyard approaches the royal bed. "Your Majesty, we're going to avoid the cupping and the hot irons." Charles, still half-paralysed, raises an eyebrow. The nurse takes his blood pressure, which is sky-high, and pops a tablet under his tongue. A junior doctor arrives with an iPad. "He's allergic to pigeons, I presume?" "He's the king." "I'll put that on the form." Charles, who spent his life dodging responsibility, would have loved a hospital. Nobody expects the patient to do anything but lie still, and the food is brought to you.
Why the Doctors Were So Determined
It would be unfair to say the royal physicians were wicked. They were doing exactly what the best medical theory of their age told them to do, and they were terrified. A king dying under your care was a career-ending embarrassment at best and a charge of treason at worst. So they threw everything at him, in the belief that doing more was always better than doing less. The age of "first, do no harm" hadn't yet arrived, and the fashion for bleeding patients lasted until well into the nineteenth century. You can find a good account of the era in the Britannica biography of Charles II.
The Succession Problem
Charles died without a legitimate child, though he had at least a dozen illegitimate ones, and the throne passed to his brother James, a Catholic and a man of rather less charm. Within three years James had managed to throw away the kingdom, and the Glorious Revolution of 1688 brought in William and Mary. A longer-lived Charles might have kept the peace for another decade, and England might have avoided the Revolution altogether. He had a talent for ducking trouble that his brother entirely lacked. It's an uncomfortable thought, but the doctors who bled him may have changed the course of British history.
The Verdict: Saved by Dull Modern Medicine, Killed by Exciting Old Medicine
Any modern stroke unit would have given Charles a decent chance of survival, and certainly a better chance than the fourteen men who crowded round his bed. The moral is a curious one. When you're sick, you want a calm, evidence-based doctor who does the minimum necessary. You don't want fourteen of them fighting over your head. Charles had a famously dry wit, and one suspects he'd have appreciated the irony of being killed by the people paid to keep him alive.
Humorous Observations
- Fourteen physicians is the largest number of doctors ever to agree on a treatment and be wrong about all of it.
- Pigeon droppings on the soles of the feet is the nearest the seventeenth century got to reflexology.
- "Spirit of human skull" sounds like a rejected rock band, but cost a fortune.
- The king apologised for dying too slowly, which makes him the politest patient in English history.
- Red-hot irons on the scalp have never once been recommended by the NHS.
- In 1685, getting ill was cheaper than getting treated.
- If Charles had been a commoner, he'd have survived a week longer simply because nobody could afford so many doctors.
- The best medicine at the royal bedside would have been a chair, a cup of tea and a closed door. https://prat.uk/?p=51082
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