The Last Days of Henry VIII

by Hutchinson, Robert

  The concoction would be poisonous and is certainly not one to be tried at home. Henry sent his own recipe for curing ‘the sweat’ to the courtier Sir Bryan Tuke, Treasurer of the Privy Chamber and Henry’s secretary, during the great epidemic of 1517–18, which involved drinking a little wine ‘with the pills of Rasis’ – probably Rhases, an Arabian physician. But following his normal cautious, if not neurotic, practice, Henry himself fled diseased London to the safety of the countryside, moving from palace to palace ahead of the spread of the scourge. Henry also had his own patent recipe for curing bubonic plague. His ingredients were exotic in the extreme:

  Take one handful of marigolds, a handful of sorrel and a handful of burnet,19 a handful of feverfew,20 half a handful of rue21 and a quantity of dragons22 of the top or else the root and wash them clean in running water and put them in a pot with a potel23 of running water and let them seethe easily. From a potel on to a quart of liquor and then set it back till it be almost cold and strain it with a fine clothe and drink it. If it be bitter, put thereto sugar. And if it be taken before the purpulls [buboes, swelling in the glands of the armpit or groin] do appear, it will heal the sick person with God’s grace.24

  Divine intervention therefore remained essential.

  The royal staff of doctors, surgeons and apothecaries was extensive and frequently consulted, but their advice not always obeyed due to Henry’s obstinacy and relentless, restless energy. The king was, in all senses, a difficult patient,25 ignoring pleas to rest and the protests of his doctors. But he was also very generous in his gifts and rewards to his medical team, possibly a sign of his growing concern over his declining health.

  Henry began his reign with three doctors on the Privy Purse payroll – Thomas Linacre, who had been tutor to his sickly brother, Prince Arthur; John Chambre; and the Spaniard Fernando de Victoria or Vittoria, who had arrived in England with Catherine of Aragon’s entourage in 1501. The king granted letters patent in 1518 to all three to set up

  a college in perpetuity of learned and wise men who make any practice of medicine in our City of London and suburbs and within seven miles thereof.26

  However, this college was not established until 1523 because Parliament had to override the Bishop of London’s traditional right to grant licences to practise medicine in the city. What became the Royal College of Physicians was granted its own, very appropriate arms in 1546, displaying ‘an ermine cuff with a hand feeling the pulse of an arm’27 as a heraldic pun.

  In addition, in 1540, Henry approved a parliamentary Act28 that merged two city companies, the Mystery of Barbers and the Company of Pure Surgeons, into one incorporated body, creating a powerful regulatory authority that, like the physicians’ college, strove to take the magic out of medicine.

  Despite these attempts to put medical science on a more rational footing, religion and ancient dogma continued to play important roles in the careers of the leading doctors of the time. Medicine was still rooted in the ideas of the classical anatomists and physicians of centuries before, such as Galen, the Greek who became doctor to the Roman Emperor Marcus Aurelius in AD 163. New ideas were now emerging, some bizarre, such as the requirement for ‘lusty singing’ recommended in 1537 by the diplomat and scholar Sir Thomas Elyot as an exercise for those confined to the sick bed,29 but others more familiar such as the belated recognition that an irregular pulse could be a sign of ill health. The patient’s room could have been a noisy place. The colour and appearance of urine also figured strongly in diagnosis, samples being taken in straw-covered bottles from midnight to midday, with physicians sternly urged not to shake the specimens.

  Sixteenth-century medical treatment, to modern eyes, was crude, if not downright cruel. Enemas, to which Henry was subjected increasingly in his last years for frequent bouts of stubborn constipation, were firmly applied to a patient’s anus by means of a pig’s bladder to which a greased metal tube was fixed. The bladder normally contained more than a pint of a weak solution of salt and infused herbs that had to be retained by the patient for between one and two hours. Another favourite mixture was soothing honey and ‘pap’ – cow’s milk30 – used particularly for the treatment of haemorrhoids, a common affliction particularly prevalent in those who spent long hours in the saddle in all weathers, perhaps wearing armour.

  Medical care of ‘humours’ or ulcers – the chief amongst Henry’s painful afflictions – was based on the principle of counter-irritation: draining them by means of a chronic inflammatory reaction, maintained, if necessary, as a running sore. This involved the so-called ‘seton’, a horsehair or silk filament threaded through a loose fold of skin around the ulcer, tightened and left to suppurate. The wound, of course, stank. With what seems a surprising nod to modern ideas of hygiene, the needle used in this process would be first heated red hot and then handled by the doctor with forceps. At other times, an ‘issue’ was deployed: a bulky object such as a small gold or silver ball would be inserted below a flap of skin, previously cut open with a lancet,31 to achieve the same efficacious effect.

  Who comprised this diagnosis of doctors responsible for the increasingly difficult, if not dangerous, task of maintaining Henry’s health and wellbeing in the face of his numerous temper tantrums and irascibility?

  Linacre, born in 1460, translated a number of Greek and Latin treatises on medicine and was the first president of the College of Physicians, with their meetings held at his house in Knightrider Street in the City of London. He was appointed tutor to the seven-year-old Princess Mary in 1523 but died the following year ‘from the [gall] stone’32 and was buried, as a mark of his status, in St Paul’s Cathedral, where his fulsome Latin epitaph was recorded more than a century later, just before the Great Fire of London destroyed the medieval cathedral33 and all the grand tombs within it.

  Chambre, or Chamber (1470–1549), fellow and later warden of Merton College, Oxford, became a doctor to the king after studying medicine at the University of Padua and was promoted to chief physician on Linacre’s death in 1524. He also collected a number of lucrative ecclesiastical appointments such as Canon of St George’s, Windsor, and Dean of St Stephen’s, Westminster. He supervised the confinement of Queen Anne Boleyn and safely delivered Princess Elizabeth on 7 September 1533. Chambre also probably attended (with two other royal doctors – William Butts and George Owen) the prolonged labour of Jane Seymour in 1537 and her subsequent infection, from which she died soon afterwards.

  Fernando de Victoria, who qualified at a Spanish university, inevitably fell from royal favour when he was dispatched by Catherine of Aragon to inform Charles V of Henry’s attempts to divorce his aunt. He died in 152934 and was succeeded by Edward Wotton, born around 1492, the son of the beadle of Oxford University and a natural historian of some repute. His studies included the use of insects as a source of medicinal drugs. Wotton died in 1555 and was buried in St Alban’s, Wood Street, in London’s Cheapside.

  We have already met Augustine de Augustinis who, when working for Wolsey, famously asked Cromwell for leeches for bloodletting – ‘hungry ones’ – to be procured for his master, then lying ill at Esher, Surrey. They were to be applied by another Italian, Balthasar Guersie, surgeon to Catherine of Aragon. After Wolsey’s disgrace and death, Augustine was employed on diplomatic service overseas for the Duke of Norfolk and Cromwell, as well as suffering a spell of imprisonment in the Tower,35 before being appointed a physician to the royal household around 1537 at £50 a year, receiving a good brooch from the jewel collection of the recently deceased Jane Seymour36 for his pains. In addition to his royal medical duties, he was also engaged in shadowy, if not sinister, diplomatic espionage on behalf of the king. For example, the Spanish ambassador Chapuys wrote to the emperor on 31 October 1540:

  Last week, an Italian physician attached to this King’s household and very familiar with the Lord Privy Seal37 came to dine at this embassy on four different days.

  He is the king’s spy and has come, as I have reason to think, for no other pur
pose than to learn what I am about and persuade me to intercede with your majesty for a closer and particular friendship and alliance to be made with him …

  The Italian at first dissembled as much as he could, trying to make me believe the suggestions came from him, not from anyone else; yet I had no difficulty in guessing, by various loose remarks he made, who had sent him onto me. For in the course of conversation he alluded to various facts which could not be known to him except through the channel of the Lord Privy Seal.38

  Augustine may have also liaised with the French ambassador Charles de Marillac, perhaps in furtherance of the Howard faction’s interests.39 Later, as the king’s health deteriorated, Augustine, long personally and irretrievably linked to the Duke of Norfolk, probably decided that public affairs at court were becoming unhealthy for him, too, and he applied for and was granted a passport to leave England in early July 1546, with £50 as a reward from Henry in his purse. He went to Venice and died in the walled city of Lucca in Tuscany on 14 September 1551.40

  William Butts (?1485–1545) was Henry’s favourite and most trusted physician, with a handsome salary to match and, later, a knighthood. He attended two of Henry’s queens – Anne Boleyn and Jane Seymour, the king’s bastard son Henry Fitzroy and Princess Mary, as well as Prince Edward. A strong intellectual, he was a supporter of religious reform and a friend and ally of both Queen Katherine Parr and Archbishop Cranmer. He died of malaria and was buried beneath a monumental brass depicting him in armour, now sadly lost, in Fulham Church41 in West London, then a fashionable country parish in Middlesex. His personal loss as friend and confidant to the king is difficult to overestimate.

  Thomas Wendy, born about 1500, succeeded Butts as chief physician and was one of the witnesses to Henry’s will, together with fellow royal doctors George Owen and Robert Huicke, who each received a legacy of £100 from Henry. Wendy, who took his MD at Ferrara in north-east Italy, was reappointed physician to Edward VI and Mary, the latter granting him the lordship and manor of Chatteras, Cambridge, in 1558, just before she died.42 He witnessed her will and died at Hasingfield, Cambridgeshire, in 1560.43

  Other physicians in the royal medical team included George Owen, who died in 1558 from ‘an epidemic of intermittent fever’ and was buried in St Stephen Walbrook, London;44 Walter Cromer, ‘the Scot’, who was dead by 1547; and Robert Huicke, whose relative William fell foul of Bishop Gardiner over his unorthodox religious beliefs, particularly his denial of the transubstantiation of bread and wine during holy communion, but escaped unscathed after a personal appeal to the king. The doctor was not an attractive character, however, and was involved in a very messy divorce from his wife, Elizabeth, in 1546. After hearing his appeal at Greenwich against a legal finding in favour of his wife, the Privy Council wrote that

  we never in all our lives heard matter that more pitied us: so much cruelty and circumvention appeared; the man, so little cause ministered by the woman.45

  Huicke again survived the scandal and was appointed physician extraordinary to Edward VI at £50 a year and witnessed Katherine Parr’s will. He became physician to Elizabeth when she ascended the throne in 1558. He is believed to have died in 1581 and was buried in the chancel of Harlington Church, Middlesex.

  If these levels of medical knowledge were not sufficient, special medical advice was also called in from time to time from a variety of sources, notably Andrew Boorde – ‘merry Andrew’ – who had been recommended by Norfolk. This former Carthusian monk examined Henry in 1542 and reported, in the terse manner of most doctors, that the king was ‘fleshy’ with large arteries, ruddy cheeks and pale skin, with his ‘hair plenty and red, pulse great and full digestion perfect, anger short [and] sweat abundant’.46 But Boorde was alarmed by Henry’s overeating and obesity, a concern shared by his household doctors who feared that the royal constitution did not augur well for long life. Following a colourful career, Boorde died in the Fleet Prison in 1549 after being accused, almost inevitably given his lusty, spirited character, of maintaining prostitutes in his home in Winchester.

  The king also employed surgeons, notably Sir John Ayliffe, Master of the Barbers’ Company, in 1538,47 who successfully treated Henry for a fistula – a narrow-mouthed ulcer – at Brinkworth, Wiltshire, ‘for which the king bestowed on him great estate in gratitude’ and later bequeathed him £100 in his will.48 Others included John Monforde, or Mumford, and Richard Ferris, who is believed to have attended the king during his last illness in 1546–7. A ‘nurse-surgeon’, William Bullein, author of a book on pleurisy and the sweating sickness, was also a member of the royal household’s medical team.

  Three barbers also worked for Henry during his time on the throne – these were privileged players in the closed, regimented world of the court. The king’s barber was one of just fifteen courtiers allowed access to the monarch’s secret apartments for the early-morning ritual of the trimming of the regal beard.49 Henry’s ordinances for the organisation of the Privy Chamber prohibited them from consorting with ‘vile persons or misguided women’, warned them not to disclose anything they heard while in the king’s company and ordered them to keep themselves and their clothing clean.50

  This was a formidable array of medical talent, probably unrivalled in its corpus of expertise anywhere in the courts of Europe of the day. Their regular duties included frequent and profound examination of the royal stools, sputum and urine, as well as bleeding and cupping, in line with the changing lunar phases, to maintain the balance of Henry’s bodily humours, as suggested by the classical philosophers.51 Such procedures must have been purely routine in the halcyon healthy days of the king’s youth. Then came the first of many emergencies.

  Henry’s real medical problems began on 24 January 1536, when he was forty-four. He had taken a carefully orchestrated starring role in a dazzling display of jousting at Greenwich, on the eve of the conversion of St Paul.

  The king, mounted on a great horse to run at the lists, both fell so heavily that everyone thought it a miracle that he was not killed, but he sustained no injury.52

  Due to his showy enthusiasm and braggart recklessness, Henry had suffered accidents in the lists before. In 1524, whilst tilting with lances with his old friend the Duke of Suffolk, the king had been injured above the right brow after he unwisely rode out with his helmet visor raised. Although he was lucky not to lose an eye and, daredevil-like, ran six more courses at the lists that day, he suffered frequent migraine headaches afterwards.53

  This latest jousting incident was far more serious even than it seemed at the time. His armoured horse reportedly fell on top of him as he was unseated by his opponent’s blunted lance. Five days later, Anne Boleyn miscarried of a male foetus aged about three and a half months after her uncle, the Duke of Norfolk, told her of the accident. More indicatively, two months later, a report from Rome quoting the French king said that Henry, having fallen from his horse, ‘had been for two hours without speech’, possibly through severe concussion or, worse, bruising of the cerebral cortex.54 Although Cromwell wrote to Bishop Gardiner in February that the ‘king is merry and in perfect health’, one can smell deceit in that devious minister’s reassuring weasel words, which were probably only intended for outside consumption. Then, in March, Lord Montague unwisely and famously blurted out his premonition of the king’s death and paid with his life for his hasty words, for it was high treason to presage the king’s death. But they were patently true: the next month, Henry was said to ‘go seldom abroad because his leg is something sore’.55 The fall almost certainly broke open the varicose ulcer he was treated for in 1527–8 and thus it became chronic, discharging freely. No doubt the royal doctors tightly bandaged up the wound.

  This was the beginning of all the king’s debilitating medical problems that constantly and painfully afflicted him until his death. On 14 May 1538, one of the fistulas on his leg closed up and

  for ten or twelve days, the humours which had no outlet were like to have stifled him so that he was some time wit
hout speaking, black in the face and in great danger.56

  In today’s modern medical terms, the king was suffering from a thrombosed vein in his leg and, dangerously, a clot may have detached from this vein. He was lucky to escape with his life: even with the benefits of twenty-first-century medicine, the condition still remains hazardous. In November that year, Sir Geoffrey Pole reported that Henry had

  a sore leg that no poor man would be glad of and that he should not live long for all his authority next to God.57

  By Good Friday 1539, the king’s legs must have improved, as he was able to take part in that strange pre-Reformation liturgical rite of ‘crawling to the cross’. This ritual involved veneration of the crucifixion scene, temporarily positioned in the Easter Sepulchre on the north side of the chancel of a church, by reverently shuffling forward on the knees from the chapel door during Mass.58

  But in September, he was clearly suffering from acute constipation. This recurrent and very intimate problem would not come as a surprise to today’s dietitians, given the menus of the huge, unhealthy meals daily consumed by the court and other wealthy households in the Tudor period. The English were famous for being big meat eaters (remember the ‘roast beef of old England’) with plenty of game, hoofed and feathered, heaved on to the groaning banqueting tables. The slaughter of birds for food was both prodigious and catholic in choice: larks, stork, gannets (and other gulls), heron, snipe, bustard, quail, partridge, capons, teal, cranes and pheasants all regularly appear on menus that would send horrified shivers down the corporate spine of today’s Royal Society for the Protection of Birds. One of the court’s favourites was stewed sparrows. The king was said to be fond of galantines,59 game pies and haggis – a sheep’s stomach stuffed with minced offal and oats. Today, it is a traditional Scottish dish.60 Impressive quantities of salted and smoked cod, plus herrings, fresh salmon and eels were also consumed after the hot meat course. Most meats and fish, if not downright unpalatable, were heavily flavoured with spices to disguise their lack of freshness. Little roughage appeared on the dinner table: fresh fruit was widely shunned as it was believed to cause diarrhoea and fever. Green vegetables, as well as turnips, carrots and parsnips, were also avoided because ‘they engender wind and melancholy’61 but cucumbers, lettuces and the succulent herb purslane62 were eaten in more healthy salads as a first course. Butter was usually rancid and used mainly in cooking. One writer has ingeniously suggested that most of Henry’s ailments were attributable to scorbutic disease, or scurvy, caused by a chronic lack of vitamins supplied in our modern diet by fresh vegetables and fruit.63 Whatever, his food bingeing aggravated his medical condition and regularly blocked the healthy movement of his bowels.