Hektoen International

A Journal of Medical Humanities

Robert the Bruce

Crop of Robert the Bruce statue, Bannockburn. kim traynor on geograph.org.uk via Wikimedia. CC BY-SA 2.0.

Robert the Bruce and leprosy

King Robert I of the Scots (1274–1329), better known as Robert the Bruce, is revered in Scotland as a national hero. He is principally remembered for defeating the English at Bannockburn in 1314 and thereby restoring the independence of Scotland for several centuries. He presents a medical as well as a historical interest because of the supposition that he may have suffered from leprosy.

Leprosy or Hansen’s disease

Leprosy is mentioned throughout the Bible, but many patients described as suffering from it undoubtedly had other diseases that had not yet been identified. It is clear, however, that between the 12th and 14th centuries, leprosy was rampant in Europe, perhaps spread by crusaders and religious pilgrims. Its unexplained decline in the 16th century may be due to the rise of tuberculosis as people began to crowd into cities. As leprosy and tuberculosis are caused by related mycobacteria, it has been suggested that tuberculosis being more deadly and affecting young people helped eliminate leprosy by killing off many of its sufferers, so that there were fewer subjects available to spread it.

In the past, leprosy was greatly feared as a devastating disease. It is now mainly confined to tropical Africa and Asia, affecting some two million people worldwide. It involves the skin, mucous membranes, and nerves, causing discoloration and lumps on the skin and in severe cases deformities, disfigurement, crippling lesions of the hands and feet, paralysis, and blindness. It was so feared and stigmatized that even its name has become unmentionable and often changed to Hansen’s disease after the man who described its causative mycobacterium. Throughout history people suffering from it were grossly stigmatized, persecuted, herded together, and isolated in leprosaria, from which they could not leave.

Historical note

Relevant to this article is the history of Scotland, inhabited in antiquity by a variety of different people. The Greeks called it Albion, the Romans Caledonia. The Romans partially subdued it but left around 410 AD. Some 400 years later, local tribes of Picts, Gaelic Scoti, and Romanized Britons united to form a kingdom, but dynastic squabbles and disputes over succession eventually led the English under Edward I to attempt to subdue it. A feudal lord, Robert the Bruce, defeated other aspirants to the crown. He (or his supporters) apparently murdered his competitor and was excommunicated by the Pope, but as king, he took on the English and fought several battles against Edward I. He defeated a large but incompetent army led by his successor Edward II, establishing Scotland’s independence for several centuries.

Plaster cast of skull of Robert the Bruce in the Abbey Church, Dunfermline Abbey, Fife, Scotland. Otter on Wikimedia. CC BY-SA 3.0.

Interment and exhumation

Robert the Bruce died in 1329. According to his instructions, his heart was removed, placed in a silver box, and taken on a crusade. It was returned to England after the nobleman charged to take it to the Holy Land was killed in Spain by the Moors, and it was at buried Melrose Abbey near the English border. The internal organs were embalmed and placed in the medieval church of St. Serf in Dumbarton. The body was buried in Dumferline. There in 1818, workers laying the foundation for a new cathedral came across a lead coffin containing what appeared to be a royal tomb. It contained the remains of a man enclosed in two lead sheets, with an embroidered linen cloth interwoven with gold and the remains of a crown. Further evidence established that these indeed were the remains of King Robert the Bruce and later a smaller tomb was found containing the skeleton of a female believed to have been his queen.1,2 Subsequent investigations were carried out by Dr. Alexander Monro Tertius, professor of surgery at the University of Edinburgh; several other authorities; and also by the famous surgeon Robert Liston.

Findings

Examination showed much damage to the king’s upper mandible, from which four or five teeth were missing. There was also a fracture of the upper jaw, perhaps caused by a blow received in war. Several casts made of the king’s head can be seen in various places in Scotland, and more recently reconstructions of his face have also been made. Contemporary surviving documents indicate that the king indeed had suffered from severe incapacitating pain, perhaps from trauma to his face, but do not suggest that he had leprosy. Even documents from his enemies, the English and the Pope, do not infer leprosy. Unfortunately no tissue specimens are available for DNA analysis, so that the cause of the king’s injuries remains an unsolved mystery.

References

  1. “Robert the Bruce.” Wikipedia.
  2. Kaufman MH and MacLennan WJ. Proc R Coll Physicians Edinb 2000;30:75-80.

GEORGE DUNEA, MD, Editor-in-Chief

Highlighted in Frontispiece Volume 14, Issue 4 – Fall 2022

Spring 2022

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