The Death of Napoleon, Cancer or Arsenic?

Abstract

Napoleon Bonaparte died on May 5, 1821, at the age of 51 on the island of Saint Helena, his prison for 5 years. Four autopsy reports, including 2 from the French contingent, revealed the cause of death to be an extensive carcinoma of the stomach complicated by terminal bleeding, the same disease that took his father and several close relatives, including a purported illegitimate son (1). Napoleon was reasonably well until the autumn of 1820, when he developed recurrent abdominal pain, weakness, and stubborn constipation, and toward the end intractable vomiting, hiccupping, and possibly thrombophlebitis-migrans. In the 1960s, when neutron and other activation techniques became available to measure trace elements in individual hairs, a series of articles appeared reporting that increased arsenic concentrations had been found in Napoleon’s hair, leading to claims that he had been deliberately poisoned while on Saint Helena (2)(3). However, the increased concentrations were measured in hair samples dating back to 1805, including samples taken while he was on Elba in 1814. Indeed, an Italian group has recently reported concentrations of 8 ppm (μg/g) and 6 ppm (modern normal concentration <1 ppm) from 1770 when Napoleon was a baby on Corsica (4). Also, samples of equal provenance have shown both normal and increased arsenic concentrations from hair samples culled on the same day as samples with increased concentrations (5)(6). This confusing situation exemplifies the unreliability of trace-element values measured in individual hair samples; concentrations vary enormously from hair to hair on the same head. Thus, to improve reliability it is necessary …