Bedside Rounds

43 - The Cursed


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What killed Charles II of Spain, the inbred monarch whose autopsy famously showed a heart the size of a peppercorn, a head full of water, and a bloodless body? This episode addresses that medical mystery by not only delving deep into Charles’ unfortunate past, but by exploring some of the fundamental assumptions physicians have made about the nature of disease. Along the way we’ll walk about inbreeding coefficients, postmodern philosophy, and two thousand years of anatomy and autopsy. Plus a new #AdamAnswers about whether Vincent van Gogh’s love of the color yellow was caused by digitalis poisoning!

 

Sources:

  • Alvarez G, Ceballos FC, Quinteiro C (2009) The Role of Inbreeding in the Extinction of a European Royal Dynasty. PLoS ONE 4(4): e5174. https://doi.org/10.1371/journal.pone.0005174
  • Burchell HB, Digitalis poisoning: historical and forensic aspects. J Am Coll Cardiol. 1983 Feb;1(2 Pt 1):506-16.
  • Burton JL, A Bite Into the History of the Autopsy: From Ancient Roots to Modern Decay. Forensic Sci. Med. Pathol. 1:4:277.
  • Cerda JL. Charles II of Spain, «the bewitched». Rev. méd. Chile  [Internet]. 2008 Feb [cited 2019 Feb 11] ; 136( 2 ): 267-270.Cullen W, Nosology. Retrieved online at: https://books.google.com/books?id=3IgUAAAAQAAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false
  • Foucault, Michel. The Birth of the Clinic: An Archaeology of Medical Perception. New York: Vintage Books, 1975.
  • Gargantilla Madera P. Enfermedades de los reyes de España, los Austrias : de la locura de Juana a la impotencia de Carlos II el Hechizado. Madrid 2005.Ghosh SK, “Giovanni Battista Morgagni (1682-1771): father of pathologic anatomy and pioneer of Modern Medicine, Anat Sci Int, 6 Sep 2016.
  • Gruener A. Vincent van Gogh's yellow vision. Br J Gen Pract. 2013;63(612):370-1.Hodge GP. A Medical History of the Spanish Habsburgs: As Traced in Portraits. JAMA. 1977;238(11):1169–1174.
  • Lagay F, The Legacy of Humoral Medicine, Virtual Mentor. 2002;4(7):
  • Lee TC. Van Gogh's Vision: Digitalis Intoxication? JAMA. 1981;245(7):727–729. Lesney MS, Flowers for the heart, ACS, March 2002, Vol. 5, No. 3, pp 46, 48
  • López AG et al, Charles II: From Spell to Genitourinary Pathology. Arch. Esp. Urol. 2009; 62 (3): 179-185.
  • Somberg J et al, Digitalis: Historical Development in Clinical Medicine, The Journal of Clinical Pharmacology, Volume 25, Issue 7
  • Starkstein, S., & Berrios, G. (2015). The “Preliminary Discourse” to Methodical Nosology, by François Boissier de Sauvages (1772). History of Psychiatry, 26(4), 477–491. Viale G, The rete mirabile of the cranial base: a millenary legend. Neurosurgery. 2006 Jun;58(6):1198-208.
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Bedside RoundsBy Adam Rodman, MD, MPH, FACP

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