Channelling the Emperor: what really killed Napoleon?
Mari F, Bertol E, Fineschi V, Karch SB.
Department of Forensic Toxicology, University of Florence, Italy.
J R Soc Med. 2004 Aug;97(8):397-9.
Arsenic was present in Napoleon's hair before he arrived on Saint Helena and the findings at necropsy are consistent only with the diagnosis of ulcerating, regionally invasive, gastric carcinoma. The question of whether Napoleon died of, or merely with, arsenic poisoning is illuminated by developments in the treatment of promyelocytic leukaemia. Arsenic trioxide induces remission in many, but treatment can be complicated by QT prolongation, torsades de pointes and sudden death. At clinically relevant concentrations, arsenic blocks both I(Kr) and I(ks) channels and, at the same time, activates I(K-ATP) channels. The balance of these forces is easily disrupted, and QT prolongation is worsened by hypokalaemia. Napoleon was chronically treated with tartar emetic for gastrointestinal symptoms, and the day before he died he was given a huge dose of calomel (mercurous chloride) as a purgative. Both treatments would have caused potassium wastage. In addition, the Emperor was being treated with a decoction containing 'bark'-presumably 'Jesuit's bark'. The quinine in Jesuit's bark is another cause of QT prolongation. It is likely that the immediate cause of the Emperor's death was torsades de pointes, brought on by chronic exposure to arsenic and a medication error.
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Related: Chemical Compounds
mercury (I) chloride, or calomel, chemical compound, Hg 2 Cl 2 , a white crystalline powder, very slightly soluble in water. It was once used medicinally as a purgative, cathartic, liver stimulant, and to eliminate parasitic worms, but is rarely so used today because it is readily decomposed into metallic mercury and the very poisonous mercuric chloride on exposure to sunlight or if heated in the presence of moisture. Mercurous chloride is a less dangerous poison than mercuric chloride chiefly because it is much less soluble; it is highly toxic if retained in the body. Mercurous chloride is prepared by sublimation from a mixture of mercury and mercuric chloride or by precipitation from a mercurous chloride solution on adding chloride ion. It is also found in nature as horn quicksilver. The calomel electrode, often used as a reference in determining electric potentials and for measuring the p H of solutions, contains mercurous chloride, mercury metal, and potassium chloride solution.
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