Gout, Gangrene, and other Gross (and Royal!) Ways to Die

Throughout history, it might have been good to be King, but that didn’t necessarily spare you from suffering the maladies of the day. As part of my research in historical fiction, I’ve encountered illnesses in my principal historical figures which were messy, malodorous, and often impossible to work around. But if these illnesses made my life difficult as a historical fiction KHVIIIauthor, imagine how challenging they made life for the monarch in question—or, much more so, for their servants and retainers.

Below I share just a few of these crown culprits:


Known for centuries (somewhat incorrectly) as the “disease of kings”, gout is a particularly painful type of arthritis caused by a buildup of uric acid crystals in the joints. This buildup results in inflammation, usually in the feet (though it can also appear in elbows, fingers, etc.), and can be mind-bogglingly painful. Flare-ups can last for several days, during which time the slightest touch of a bedsheet against your big toe can make you want to chop off someone’s head. Considering that King Henry VIII, one of history’s most famous figures, suffered this disease, which can be caused/made worse by the consumption of alcohol, shellfish and organ meats, no wonder beheading was his execution style of choice.

Other famous figures who suffered from gout: Charles V, Queen Anne of England, Louis XIV of France, Leonardo Da Vinci, Benjamin Franklin, and Sir Isaac Newton.


victoriaHemophilia is a blood disorder characterized by the inability to properly form blood clots. As a result, any small cut or internal hemorrhaging after even a minor bruise can be fatal. The disorder became known as the royal disease after several of Queen Victoria’s descendants were diagnosed with hemophilia. One of Queen Victoria’s sons, Leopold, died from a cerebral hemorrhage after a fall; and, while the Queen’s daughters, Anne and Beatrice, did not show evidence of the blood disorder themselves, they carried the disease into many of the royal families of Europe.

Through Queen Victoria’s descendents, other royal victims of this disease included: Alexei Nikolaevich-Tsarevich of Russia, Prince Friedrich of Hesse and by Rhine, Prince Waldemar of Prussia, Lord Leopold Mountbatten, Prince Heinrich of Prussia, and Prince Alfonso of Spain.


When blood can’t flow freely throughout the body, your cells don’t receive the oxygen and nutrients they need to survive. As a result, those cells and the body tissue they make up can die. This process of healthy live tissue sickening and dying is known as gangrene, and it’s a condition that was a real problem for even the royal classes.bourbon-2 Usually the result of an injury that becomes infected, gangrene can also accompany other damaging conditions just to make them even more uncomfortable. King Louis XVIII of France, for example, suffered not only from gout (there it is again!) and obesity, but also both wet and dry gangrene. That’s right. Gangrene is so nasty that it has sub-categories of misery.

Other famous monarchs who suffered from gangrene include: King Herod, King Tut, and Louis XIV. Considering that the infection turns healthy tissue into a “liquid viscous mass”, it’s not a good way to go.

These are just a few lowlights of the illnesses that beset the royal houses. Other all-too-common ailments included: hemorrhoids, stomach infections, severe tooth decay, syphilis, kidney disease, liver disease, malaria, leprosy (though this is somewhat disputed) or other skin maladies like severe eczema, depression, and mental illness. And that’s not even including the physical trials faced by children born into royal families whose passion for pure bloodlines resulted in inbreeding. (Note: it’s not just the Europeans who dealt with inbreeding. According to recent scientific testing, King Tut’s parents were likely brother and sister, resulting in the young king suffering clubfoot and other genetic disorders.)

So it would seem that all the riches and power in the world couldn’t guarantee a monarch a healthy body and spirit. For that, they needed to pray they didn’t inherit something unsavory from their parents, exercise regularly, try not to get injured in battle… and lay off the lampreys (yes, Henry I of England apparently died of eating too many of these jawless, sucker-mouthed fish. Gross.)





11 thoughts on “Gout, Gangrene, and other Gross (and Royal!) Ways to Die

  1. pattimoed says:

    Hi. Interesting post! I knew that hemophilia ran in the royal families, but didn’t know about gout and gangrene. I’m sure there were also the indiscrete illnesses like syphillis…Patti

  2. jennmcgowan says:

    Thanks for posting, Patti! And yes, the royal houses were rife with illnesses. Monarchs may have been able to endure sickness with more comfort, but that didn’t make their prognosis any better. Royal Physicians routinely soft-pedaled diagnoses for fear of being punished by a monarch in no mood for a sick day. Dangerous work indeed!

  3. Ah, syphilis! I’ve marked that for further research while working on my NaNo novel (no time for it now) because it comes up in my source material. One of those situations where the cure could be as awful as the disease, and the end result was never good.

    As a lover of history, it’s always fascinating to watch historians try to figure out what a monarch might have been suffering from when there was so little medical knowledge and so few records were kept at the time. Was Mary I really pregnant or was it in her mind or was it a tumor or fibroids? What kind of mental illness incapacitated Henry VI? What was the cause of death of Edward IV (this historical novelist would sure like to know)? We’ll never know, but it is fun to sift through the clues.

    • jennmcgowan says:

      Maryanne, hello! And YES on the constantly shifting ideas of what *really* caused a given death. In some cases, allegations of “madness” became much easier to understand given the underlying diseases suffered by the royal victim. Fascinating stuff!

  4. Abby Murphy says:

    Super interesting! I knew about Queen Victoria’s hemophilic legacy, but only vaguely about gout and not at all about gangrene. It’s also fascinating to read about how physicians diagnosed and treated diseases they only sort of understood. For my previous historical YA, I read a lot about hysteria and neurasthenia, which were Victorian catch-all terms for depression and anxiety, usually in women (the heroine Charlotte Perkins Gilman’s “The Yellow Wallpaper” suffers from this). Treatment ranged from weeks of bed rest, to forcing women to consume the fattiest foods available, to primitive electro-shock treatments. It was fascinating and horrifying to read.

  5. catemorgan says:

    There’s so much mystery surrounding Henry VIII’s various illnesses, and how he went from a hale and hearty young man considered quite handsome during that time period, to the condition he was in (both physically and mentally) during his later years. Fascinating!

    • jennmcgowan says:

      Cate, I definitely agree. In 1536, he suffered from an injury while on horseback riding that simply would not heal, which really sidelined him, and he pretty much went downhill after that. Thank you for posting! 🙂

  6. When I was a kid my best friend and I played “Olden Days” for hours nearly every day, pretending we lived in all sorts of time periods. It was romantic and fantastical, but as a grown up I sure do like modern medicine and cleanliness! 🙂

    • jennmcgowan says:

      Kimberley, your comment made me laugh! Folks are always asking “so, what historical time period would you really want to live in?” And I hesitate EVERY time, because I have read so much about the standards and challenges of the day. Whatever timeline I choose, I always say “and I have BAGS OF MONEY to roll around in.” 🙂

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