Napoleon III, the last monarch of France, led a life marked by political ambition, exile, and a quest for legitimacy. Born in Paris in 1808 as the nephew of the reining emperor Napoleon Bonaparte, he spent much of his early life in exile and was involved in several unsuccessful attempts to seize power. In 1848, he was elected President of the French Second Republic, and in 1852, he declared himself Emperor. At first he proved himself a strong and decisive leader, but chronic physical and mental issues eventually led to his downfall.

As a young man Napoleon smoked heavily. Following his attempted coup d’etat and imprisonment in the French fortress of Ham in 1840, he developed chronic leg pains. His health began to decline in the early 1860s when he began to suffer from urinary retention and suprapubic pain as well as depression and anxiety.

His symptoms gradually worsened, causing significant discomfort and impacting his ability to rule effectively. In 1869, after consulting several prominent European doctors, he saw Dr. Henry Thompson, a renowned British surgeon, who made a diagnosis of bladder stones and recommended surgery.

His physical state took a dramatic turn for the worse in 1870. Some historians have argued that his declining health led to the disastrous outcome of the Franco-Prussian War of 1870–1871. Chronic pain, fatigue, and reliance on medications impaired his judgment and energy and contributed to bad decisions. At the battle of Sedan in September 1870, he was in such physical agony that he could barely sit on his horse. The French suffered a disastrous defeat, and he was captured by the Prussian forces.

While in captivity at Wilhelmshöhe Castle in Germany, Napoleon III’s health continued to deteriorate. After his release in March 1871, he went into exile in England, where he resided at Chislehurst in Kent. On January 2, 1873, he underwent an operation by Sir Henry Thompson to destroy a large phosphate stone “of no recent formation” and difficult to remove in its entirely.^1,2 A second operation was performed on January 6 to remove the rest of the stone “to get rid of as much of the detritus as possible”¹ but he died three days later, from sepsis or, as some authors have postulated, from “uremia.” He was buried in St. Michael’s Abbey, Farnborough, Hampshire.

Further reading

1. Editorial. The late Emperor Napoleon III. British Medical Journal. January 11, 1873.
2. Friedrich Moll F, Krischel M, and Fangerau H. Napoleon III and his bladder stone—A royal patient and the public debate to popularize modern treatment modalities. J.Urol. April 2011:e416.