Saturday, May 17, 2014

How a spirochete secured the English succession

The year was 1565 and Mary, Queen of Scots was on the hunt for a husband.

 (Mary - Public domain image sourced from Wikipedia)




The young catholic Queen was in a precarious position with a divided protestant Scotland, low on allies and a powerful Elizabeth and England to the south.  She needed an ally. She also needed an heir.

For such a powerful position multiple candidates were considered.  Among the candidates were Don Carlos the heir of spain (although possibly not a good choice given how mentally unstable he was), and the Archduke of Austria.  Elizabeth's choice was Robert Dudley the Earl of Leicester as she hoped to neutralise Mary by marrying her to a protestant Englishman.  Finally up for consideration was Henry Stuart, Lord Darnley, Mary's first cousin.  As both were descendents of Henry VIII's sister Margaret, any children of the union would have a strong claim on the English throne.

Mary had first met Darnley in 1561 whilst in mourning for her first husband Francis the Daupin of France.  His parents had sent him to France precisely in the hopes of encourage a match with the Queen.  Mary, a tall handsome woman herself, had found her cousin particularly tall and attractive but that was about it.  She showed no specific interest in the match at all - other than noting the advantage it would provide in terms of the English succession.

All that was to change.

Darnley presented himself to the Scottish court in Feburary 1565, and Mary enjoyed his company but did not particularly favour it.  However in April, Darnley became ill.

 (Lord Darnley - public domain image sourced from wikipedia)

It began as a cold, and Darnley attempted to sweat it out - this being the standard treatment at the time - which could have been accomplished in several ways, either with the use of herbs such as horehound, exercise, saunas or a combination.  However the cold soon progressed to the measles.

Confined to his sick bed at Stirling Castle, Darnley had an unusually long and severe course of measles infection.  This detail is curious and well worth remembering for later.  Mary was reportedly a sweet and kind young lady and had already nursed one sickly husband, Francis, until his untimely death.  She took it apon herself to attend her cousin at his sick bed, taking many of the duties of nurse.  Often staying past midnight, Mary would visit his private chamber at all hours, refusing to leave Stirling until Darnley was recovered.

Over a month later, when Darnley finally threw off his illness, the die was cast.  Mary was violently in love.  The two were married on the 29th July 1565 and Mary pregnant not long thereafter.

Unfortunately by October the cracks had started to show.  Darnley, it seems, was not the tall, handsome, courtly man Mary had taken him to be on his sickbed.  He was vain, drunk, prone to bouts of violent anger and frequently at the brothel.  Where previously she had showered him with riches and responsbility, Mary began to hold back.  In particular she refused to grant him the Crown Matrimonial - a legal right which would have made Darnley King in the event of Mary's death.

Angered and arrogant, Darnley entered into a secret deal with the Protestant lords recently routed by Mary in rebellion a few months earlier.  On the 9 March 1566, as Darnley held a heavily pregnant Mary and forced her to watch as her private secretary David Rizzio was murdered in front of her using Darnley's dagger. 

The intention was that the shock would cause the Queen to miscarry.  It and the plot to seize control of the throne failed. A humbled and fearful Darnley switched allegience back to the Queen, which she tolerated if only to ensure the legitimacy of her soon to be born child.  As soon as James was born on the 19 June 1566, Mary proceeded to shut Darnley out entirely.

Darnley reverted to what he had always done best, drinking, boasting, frequenting prostitutes and virtually absenting himself from court.  He also became involved in intrigue again -plotting with his father to seize James and rule in his place as Regent.

In November 1567 Mary was involved in a discussion with her nobles about how to deal with the problem that Darnley had become.  Divorce was considered - but difficult - as Mary was catholic and it would throw doubts on the legitimacy of James.  Mary acknowledged to the nobles that Darnley needed to be dealt with - but that there must be no stain on her own honour.  This has been widely interpreted to mean she had some idea of what was to come next.  As part of whatever bargain was struck at this meeting, in December she pardoned the remainder of the Rizzio murderers, and allowed them to return to Scotland. These being the same men Darnley had previously betrayed, he chose to retreat to his father's estates in Glasgow for safety.

However at the very start of the journey he suddenly became very unwell, with an ongoing fever and eventually developing pox marks that disfigured his face.  He remained unwell for quite some time. Supposedly he had smallpox.

In late January Mary went to Glasgow to convince her husband to return to Edinburgh for his convalescence. In this, some have argued, she was complicit in the later plot, as Darnley needed to be in Edinburgh for it to be carried out. However, equally it can be said that Mary had seen what Darnley got up to when left to his own devices, and preferred him to be under her watchful eye. Whatever the reason, Darnley was eager to return with her, begging Mary for a resumption. Of cordiality within their marriage.

However he refused Mary's request to reside with her in the castle of Craigmillar. Instead he chose to reside in a house outside Edinburgh's city walls - known as Kirk o'the Field. This was probably mostly out of shame. Darnley was still requiring daily baths for his condition and was shrouding his pock marked face with taffeta. 

This marked the start of a relatively calm period in the marriage of Mary and Darnley.  Perhaps because, once again, she was able to act as a nursemaid.  He took up residence on the 1st of Feburary, she visited daily, even staying the night once or twice in the chamber below his.

A week later, however, on the 9th of Febuary 1567, there was an explosion that destroyed Kirk o'Field.  Interestingly, however, the bodies of Darnley and servant William Taylor were not found inside the property but outside in the orchard, half naked, lying beside a cloak, a dagger, a rope and a chair.

It remains one of the most intriguing unsolved murder mysteries of all time.  What is certain however is that the blame was firmly laid at the feet of the Earl of Bothwell and the woman he went on to marry, Darnley's widow, Mary Queen of Scots.  It would prove to be her downfall. 

However, this is a blog about medical history and it is Darnley's illness, rather than his death, which is of interest today. 

It is certainly possible that Darnley was unlucky enough to suffer bouts of both measles and smallpox.  However another diagnosis fits both illness discriptions better along with what is known about his debauched lifestyle.  Syphilis. 

Syphilis is caused by a sphirochete named Treponema pallidum.  A spirochete is a form of bacteria with corkscrew shaped cells and flagella (tails) that allow the cells to move about.  Syphilis is primarily sexually transmitted although it can also be passed from mother to child during pregnancy.  Syphilis is known in medicine as a great mimic - in that it can commonly present in a wide variety of different ways. 

Classically, however, syphilis presents in four stages.  After initial contact with an infected individual three days to three months following the unlucky individual will develop a chancre.  This is a painless skin ulcer, usually, but not always on the genitals.  However, syphilis being syphilis, anywhere between 40-60% of people may never have this symptom and will proceed directly to secondary syphilis.

Secondary syphilis occurs four to ten weeks after the first infection.  Patients can get a rash, a fever, sore throat, and headache.  The rash can be reddish pink and look very similar to a measles rash.  However unlike the measles, which usually has a course of about a week, secondary syphilis can take at least three, up to six weeks to resolve.  

As you can probably guess, my conjecture is that Darnley was not suffering the measles in April 1565, but had in fact contracted syphilis.  The first written records of syphilis in Europe date from 1494 and by 1565 it was quite well described.  Given Darnley's penchant for prostitutes - he could easily have been exposed. 

Further evidence comes in his second bout of illness 18 months later.  Up to a quarter of people will have a recurrence of secondary syphilis and it seems that this occurred to Darnley, only more severely this time. 

Again he was affected for over a month. Even at its worst, smallpox rarely lasts longer than 20 days.  Smallpox is also more severe, killing 20-60% of sufferers.  Again he was affected with fever and malaise.  This time, however, it seems that the skin manifestations were worse.  Based on the fact that he needed to shroud his face it sounds like the rash this time was pustular, or possibly warty - both known side effects of syphilis. 

Did Mary contract syphilis?  It is possible, although based on the historical records it appears that she has been lucky enough to escape that fate.  Although she had sexual contact with Darnley - that was only for a few months - and not while his disease was active. 

That contact, however, was enough to create a son, James, who went onto become James I of England and James VI of Scotland.

Thanks to that wily little sphirochete - a United Kingdom was born. 

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