Hektoen International

A Journal of Medical Humanities

King Henry III of Castile, the Suffering

Nicolas Robles
Badajoz, Spain

The tomb of Henry III of Castile. Chapel of the New Monarchs of Toledo Cathedral. Via Wikimedia. CC BY-SA 4.0.

Henry III of Castile was called “the Suffering” (in Spanish, Enrique III el Doliente) because of his ill health. He was the son of John I and Eleanor of Aragon, born in 1379 in Burgos. Henry was the first person to hold the title of Prince of Asturias as heir to the throne. At age nine, he was married to his cousin, Catherine of Lancaster, who was fifteen years old. She was the daughter of John of Gaunt, Duke of Lancaster, and Constance of Castile, the second daughter of Peter I “the Cruel,” who had been killed by his half-brother, Henry II of Castile, grandfather of Henry III. This marriage solved the dynastic conflict created after the death of Peter the Cruel, strengthened the House of Trastámara, and established peace between England and Castile. He assumed power on August 2,1393 when he was thirteen years old. Despite his nickname, he maintained a vigorous foreign policy during the first few years of the fifteenth century. He pacified the nobility and restored royal power. In 1402, he began the colonization of the Canary Islands, sending the French explorer Jean de Béthencourt on this mission.

One chronicler described Henry’s ill health in the first months of his life as arising from poor feeding, resulting in pallid skin.1 In 1395, when he was seventeen, he had several diseases that weakened his body and disfigured his face. During this time, he temporarily handed over the reins of government to his brother, the Infante Don Fernando (later King Fernando I de Aragon). Henry recovered from this crisis, but his health progressively declined. His poor health may also have caused him to be distrustful and suspicious.2

There is not enough data to diagnose the king’s disease. Tuberculosis has been suggested, but no clear symptoms of this illness are described by the chroniclers, and TB is not associated with facial lesions. Leprosy is a possibility, but that would likely have been recorded by the chroniclers. Syphilis, another consideration, did not reach Europe for another century.

At least six physicians treated the king: Alfonso Chirino, Master Mateo, Juan Toledano, Pietro da Tossignano, Mosseh Aben-Zarzal, and Mayr Alguadex.3 The rather unbelievable treatment received by the king in 1398 included an electuary from which was diluted a purple ruby and a fragment of gray amber. There is also evidence of at least one other electuary with jewels as the active substance, described by the royal physician Alfonso Chirino as a “rich electuary with ground emeralds, which cost twenty pesos of gold each.” These jewel-based treatments produced nothing more than pain and severe nausea.4

King Henry III died in Toledo in 1406 while preparing a campaign against the sultan of Granada. He was buried in a tomb in the Chapel of the New Monarchs of the Cathedral of Toledo, where he remains today.

Four years after the king died, the Jewish doctor Mayr Alguadex was arrested under suspicion of desecrating a consecrated host. Under torture, he confessed to that crime and also to having poisoned Henry III. For this, he was hanged, and his body was quartered and burned. No Jewish doctor was allowed to be the king’s physician from that moment on. However, there is no evidence that the poisoning happened. The story does serve to demonstrate the power of torture to elicit false confessions.5


  1. Gutierre Díez de Games. El Victorial. Madrid: Ed. Carriazo, 1940.
  2. Fernan Perez de Guzmán. Generaciones y semblanzas. Ed. de R.B. Tate. Londres 1965.
  3. Emilio Mitre Fernández. “Lo real, lo mítico y lo edificante en la precaria salud de un monarca medieval: Enrique III de Castilla como paradigma (1390-1406).” Hispania Sacra 2004; 16 (113): 7-28.
  4. David Nogales Rincón. “Un año en la corte de Enrique III de Castilla (1397-1398).” En la España Medieval. 2014; 37: 85-130.
  5. Gil González Dávila. Historia de la vida y hechos del Rey Don Henrique Tercero de Castilla. https://play.google.com/books/reader?id=jTGFSnCgqs4C&pg=GBS.PA204&hl=esa Accessed June 16, 2024.

NICOLAS ROBERTO ROBLES is a full professor of Nephrology at the University of Extremadura (Badajoz) and member of the Academy of Medicine of Extremadura.

Spring 2024



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