that Napoleon I's death the preceding day was due to extensive cancerous lesions of the stoma.ch. The view that Napoleon died of 'cancer' was not accepted by Francesco Antomrnarohi, the man who actually performed the autopsy, who had been Napoleon's household physician for the last twenty months, and was the only physician on St. Helena with a pathologist's training. He maintained that the hepatitis the Emperor had suffered from for a long time was the cause of death. Furthermore, the Emperor's enlarged, tender liver, jaundiced complexion and yellow conjunctivoo had also been diagnosed as signs of severe hepatitis by Barry O'Meara, Napoleon's household physician during his first three years in exile, and John Stokoe, who had attended Napoleon for a week in January 1819. Consequently, apart from Dr. Arnott, who assisted Antommarchi during the last few weeks when the morbid picture was especially baffling, those medical men who personally had attended Napoleon during his illness refused to admit that he had died from cancer. Many medical writers with doubts about the cancer diagnosis have attempted to identify Napoleon's disease on St. Helena by analysing compilations of his signs and symptoms. This has produced surprisingly disparate results. Thus, when exiled on St. Helena, Napoleon is alleged to have had, or suffered from the sequels of, the following diseases: peptic ulcer, intestinal ulceration, various liver inflammations, undulant fever, malaria, dysentery, rheumatoid arthritis, heart failure, congenital extremely slow blood circulation, epilepsy, tuberculosis, pleurisy, severe hormonal imbalance leading to obesity and impotence (dystrophia adiposogenitalis), syphilis, gonorrhrna, intoxication from defective teeth (socalled focal infection), gout, piles, and a constitutional predisposition to severe constipation which, it is SS1id, wa.s fatal owing to auto-intoxication and poisoning by laxatives. If a suitable selection is made from the variety of signs and symptoms manifested by Napoleon on St. Helena, it is a simple matter to make out a convincing case for every one of these diagnoses in turn. But if what, after all, was a fairly unchanging disease pattern on St. Helena is taken as an entity, and allowance is made for all the signs and symptoms and their interrelations, then one cannot escape the impression that all the pieces form an orderly picture of two highly characteristic syndromes, namely, the chronic and acute types of arsenic poisoning.
