Did Claudius die accidentally of poison mushrooms or marital treachery?

A history resource article by Mary Harrsch © 2015

Bust of the Roman Emperor Claudius
Photographed at the Museo Archaeologico
Nazionale di Napoli in Naples, Italy
by Mary Harrsch © 2007

Note: This is a crosspost of an article originally posted to my other historical blog "History's Medical Mysteries".

"He ate and drank in excess regularly, rarely leaving his dining room until he was "stuffed and soaked". This caused him to gain considerable weight in later years and produced heartburn so severe that it is reported that he contemplated suicide as his only means of relief."

Thus begins a study to determine what may have caused the Roman Emperor Claudius' death as a clinical exercise at a 2001 clinical pathologists' conference at the University of Maryland School of Medicine. Each year, a team of practicing pathologists and historical consultants select a famous individual from the past whose manner of death remains speculative and attempts to derive a definitive cause of death.

Claudius' case is examined by Drs. William A. Balente, MD, Richard J. A. Talbert, PhD, Judith P. Hallett, PhD and Philip K. Mackowiak, MD.

The researchers continue:

"Born prematurely after only 7 months of gestation, he suffered from a succession of disorders including milk allergy, malaria, measles, deafness, and colitis. He suffered from weakness in both legs to the extent that he noticeably limped and could not walk more than a short distance without assistance. He had longstanding tics and jerks of his head and hands, as well as a stammer and drooling, which were most pronounced when he was excited. He was also prone to fits of inappropriate laughter."

Claudius cowers behind a curtain after the murder of his younger brother,  the
Roman emperor Gaius (Caligula) Caesar.  He is astonished when the Praetorian
Guard declare him Emperor instead of murdering him as well.  "A Roman
Emperor AD 41" by Sir Lawrence Alma-Tadema courtesy of Wikimedia.

"A physical examination revealed that his temperature was normal butt his abdomen was mildly tender throughout."

"An attending physician induced additional vomiting by placing a feather in the back of the patient's throat. Shortly thereafter, the emperor became confused and exhibited signs of unremitting abdominal pain and fecal incontinence. He died 12 hours later."

Was it a case of the "cure" being worse than the disease? (PDF of original article reprinted with permission)

Although the team ends up suspecting that a particular variant of mushroom was a contributor to Claudius' death, surprisingly, the researchers point to Claudius' existing physical disabilities as the reason the episode is ultimately fatal.  In fact, the researchers suspect if Claudius had not be otherwise impaired, the assassination attempt probably would have failed.

I found Dr. Valente's  discussion of possible causes of Claudius' long list of physical defects to be most interesting.  He eventually arrives at a conclusion that Claudius suffered from congenital dystonia caused by abnormal basal ganglia - brain cells interconnected with the cerebral cortex, thalamus, and brainstem - the result of an extremely premature birth. Typical of this disorder, Claudius suffered from a twisting of the foot, involuntary cranial and cervical muscle contractions, an inability to control salivation at times and hypertrophy of the neck muscles as seen in some of his portrait sculptures.  Claudius' excellent cognitive function, however, enabled the researchers to eliminate a number of other conditions.

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Fluorosis a problem in ancient Palmyra and Herculaneum

A history resource article by Mary Harrsch © 2015

The great archway leading to the grand collonade in Roman Palmyra.  Image
courtesy of Wikimedia Commons.

Note: This is a crosspost from my blog "History's Medical Mysteries".

A 2006 study by researchers at Kyushu University suggests residents of ancient Palmyra may have suffered from fluorosis, a chronic condition caused by excessive intake of fluorine compounds, marked by mottling of the teeth and, if severe, calcification of the ligaments.

Palmyra, today, is a World Heritage Site, a designation bestowed by the United Nation Educational, Scientific and Cultural Organization (UNESCO) in 1998. About 140 miles southeast of Damascus, the trading town once known as Tadmor (also spelled Tadmur) to the ancients, had been a center of trading since around 2000 B.C.E. But the town really bustled during the Roman Empire, and was filled with magnificent buildings throughout the 1st and 2nd century, beginning with the reign of Roman emperor Hadrian in 129 A.D. Hadrian renamed the oasis town "Palmyra Hadriana." But, the city's wealth faded with the decline of Roman influence in ancient Syria.

Starting in 1990, Japanese archaeologists began excavating the southeast necropolis of Palmyra and examined remains from the Roman era dating to the 2nd and 3rd centuries CE. Despite Palmyra's prosperity, "skeletal remains uncovered from the underground tombs of Palmyra have been found to retain an arthropathy of the joints, especially in the knee joint, bone fracture, marked bone lipping, spur formation, and eburnation (smoothed bone cavities)," reports the team led by Kiyohide Saito of the Archaeological Institute of Kashihara in the Journal of Archaeological Science. "A brown discoloration was also observed in the teeth."

Funerary Portrait of Yarkhai, Son of Ogga and Balya his Daughter
from Palmyra in Roman Syria 150-200 CE Limestone.  Photographed at the
Portland (Oregon) Art Museum by Mary Harrsch © 2012.

Fluoride in small concentrations is thought to deter microbes that cause tooth decay, the reason why about 66% of public water supplies in the United States are now fluoridated, according to the federal Centers for Disease Control and Prevention. But the Palmyrans' skeletal pathology, along with their discolored teeth, point to "fluorosis," a skeletal and enamel-damaging syndrome caused by ingesting too much fluoride over a long time, the researchers note. Looking at two large tombs for example, 25 of 33 individuals (76%) had discolored teeth in one, and 45 out of 65 (69%) had discolored teeth in the other.

Palmyrans drank, and still drink, water from wells tapped from ground water by long tunnels called "qanats" (an excellent Scrabble word). The area's geology and water table has been stable for about 7000 years, meaning water conditions now aren't greatly different from those during Roman times. In a bid to estimate the fluoride burden suffered by the town's ancient inhabitants, the researchers analyzed the water from these wells. Fluoride levels were as high as three parts per million in the water, a level that a National Academy of Sciences report in March warned could lead to fluorosis.

Archaeologists also ground up seven discolored teeth from tomb inhabitants, and compared them to seven others without discoloration, to reveal their fluoride concentration. In a chemical reaction, fluoride tends to replace some calcium in tooth enamel, making overexposure to fluoride particularly worrisome for children with growing teeth and bones. The ground-up teeth revealed that in the most discolored ones, about 22% of the calcium had been replaced by fluoride. "Thus, it was possible to directly verify that the ancient inhabitants of Palmyra did suffer from fluorosis," they conclude.

Vesuvius still hovers threateningly over the remains
of Herculaneum near Naples, Italy.
Photo by Mary Harrsch © 2007.

But, ancient Romans in Palmyra were not the only ancients to suffer from fluorosis. In 1981, when skeletal remains of victims of the Vesuvius eruption were found in the boat chambers on the shore of Herculaneum, researchers were provided with another opportunity to study dental conditions of Roman residents in a different ancient setting. In The Lancet, researchers Gino Fornaciari, M. Rognini and M. Torino reported finding only 3.8% of teeth recovered from 41 adults and 12 children damaged from tooth decay.

"This percentage is very low for both modern and ancient populations, in which values were between 8.5%, as in classic Magna Graecia and 11.4%, as in Roman Britain," the researchers stated.

However, the researchers also discovered a high percentage of individuals with calcium-deficient tooth enamel - a condition often resulting from starvation at an early age but also found in well-nourished individuals suffering from fluorosis.

"To elucidate this hypothesis, we examined thin sections of permanent teeth enamel (first molar) from 8 individuals found in the Herculaneum arches site and from a present-day patient from Pisa without evidence of fluorosis, as control," the researchers explained, "Enamel was analysed by energy dispersion system (EDS) with an SEM (Jeol) 6400 connected to a microanalysis system (EDS) (Noran-Tracor) with a detection of Z-MAX 30. Enamel fluorine concentrations were greater than 10-fold higher than normal (1500-3600 parts per million [ppm]) were recorded in 6 individuals."

Skeletal remains of 32 victims awaiting evacuation in the boat chambers of
Herculaneum.  Image courtesy of Tom Huesing via Flickr.

However, the condition was not found uniformly throughout all individuals in the sample and no fluorine was found in soil samples. But, researchers did find a strong concentration of fluorine in the water-bearing stratum of Herculaneum (3-8 mg/mL), with a calculated intake of 11.4-19.0 mg a day per person at the time of the volcanic eruption.

Researchers concluded that some of the sampled remains may have been visitors to the area, since the Roman aristocracy maintained vacation villas in the area.

References:

Torino, M., Rognini, M., & Fornaciari, G. (1995). Dental fluorosis in ancient Herculaneum. The Lancet, 345(8960), 1306. doi:10.1016/s0140-6736(95)90952-4

Yoshimura, K., Nakahashi, T., & Saito, K. (2006). Why did the ancient inhabitants of Palmyra suffer fluorosis? Journal of Archaeological Science, 33(10), 1411-1418. doi:https://doi.org/10.1016/j.jas.2006.01.016

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Review: Hero of Rome by Douglas Jackson

A historical fiction review by Mary Harrsch © 2015

When I first met Gaius Valerius Verrens in the opening chapters of "Hero of Rome" by Scottish author Douglas Jackson, he was leading his cohort into a Silurian hill fort bristling with Celtic spears on a hilltop in Nero's Roman Britain.  In this first novel of a new series, Jackson skillfully fleshed out his new protagonist with a backstory that included tutelage by the famous philosopher Seneca, a deep sense of honor instilled by his patrician father and a warrior's courage developed over his course of service with the XXth Legion.  It was also quickly apparent that Valerius was respected by his men because he, in turn, respected them - all except a particularly nasty centurion named Crespo, who would eventually create the flashpoint for Boudicca's famous revolt.

I had not read any summaries of the novel before I started listening to this tale (this review is based on an unabridged performance recorded for Audible.com) but I immediately knew what was going to happen to Valerius when he is sent with his cohort to winter in Colonia - Camulodunum - the scene of the first massacre of the Boudiccan Revolt.  Knowing this was a first novel in a new series, however, I just wasn't sure how Jackson would extract Valerius so he could fight another day, as the Celtic destruction of Camulodunum was quite complete according to the ancient sources and evidenced by the destruction layer found by archaeologists.

When Valerius arrives in Colonia, he finds the thriving town, then capital of Roman Britain, protected by rather aged and grizzled Roman veterans from the original invasion of the island by the emperor Claudius, equipped with rusty swords and disintegrating armor.  Falco, the veteran centurion, quickly demonstrates how tough his men can be, however, when he challenges Valerius' men to a shoving match.  Valerius also meets the local Trinovantes chieftain, Lucillus, who is trying so hard to be accepted as an equal to the other Roman residents.  Then, Valerius is instantly captivated by the chieftain's auburn-haired daughter, Mave, and begins a subtle campaign to win her heart.

Again, Jackson carefully sculpts these characters to bring them to life for the reader.  I especially liked Ciaran, an Iceni nobleman who already realized there was little hope of actually defeating the Romans so was trying his best to develop a peaceful relationship with them.

But these first attempts at reconciliation are thwarted when the greedy Roman procurator, Catus Decianus, attempts to seize all of the Iceni land when the Iceni King, Prasutagus, dies.  Leading Romans, including Seneca, had also suddenly recalled loans to the British elite resulting in brutal property seizures, just as portrayed in the novel.

Seneca by Joseph Wilton.  Photographed at the
J. Paul Getty Museum by Mary Harrsch © 2005.

Decianus, the provincial procurator of Roman Britain,  is said to have been based in Colonia at the time of the revolt but the ancient sources said he "sent" only 200 men when he received the town's plea for help, so scholars assume he must have been in Londinium at the time.  This is reflected in the novel as well. The depth of Douglas' research is obvious from the narrative's detail.

Although Decianus is villified as greedy, both in the novel and in the ancient sources, his failure to recognize any claim by Boudicca was not unusual. Both H. H. Scullard, in his 1982 work "From the Gracchi to Nero", and John Morris, in his 1982 work "Londinium: London in the Roman Empire", point out that it was normal Roman practice to allow allied kingdoms their independence only for the lifetime of their client king, who would then agree to leave his kingdom to Rome in his will. This occured in the eastern provinces of Bithynia and Galatia.  Roman law also allowed inheritance only through the male line, so Rome would not normally have allowed the ascension of a client queen.  Boudicca may have thought otherwise, however, due to the Roman support of the Brigantes queen, Cartimandua.  Of course the flogging of Boudicca and the subsequent alleged rape of her daughters was obviously over the top.

Statue of Boudicca near Westminster Pier as commissioned by Prince Albert and
executed by Thomas Thornycroft in 1905. Image by Mary Harrsch © 2006

Jackson handles this brutal event with sufficient detail to dismay the reader but does not appall the reader with excessive gore. Likewise, Jackson's battle scenes are absolutely taut with tension.  At times I felt as emotionally spent afterwards as Valerius must have been.

By the climax of the battle at Colonia where Valerius struggles shoulder to shoulder with his comrades to prevent the wildly shrieking Britons from storming the temple of Claudius, I felt such a bond with Valerius that I feared the inevitable - after all, I had read the history!

The Temple of Claudius in Camulodunum was beseiged by the Britons for
two days before it fell and defenders were massacred.

Ultimately, though, Jackson succeeds at believably extracting Valerius from the jaws of death, but at a terrible price, both physically and emotionally, leaving an imprint on his character that will obviously affect his behavior in subsequent novels.

I highly recommend this novel and have become so captivated by Valerius I have already started the second book, "Defender of Rome."

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