Friday, February 1, 2013

NAPOLEON’S MOUTH


Set of Dentistry Instruments, Early 19th Century


Dr. Xavier Riaud
Doctor in Dental Surgery
Winner of the National Academy of Dental Surgery
Director of a Harmattan publishing house Collection
Preparation of a PhD in History of Sciences and Techniques


Is it useful to recall the story of a man with an extraordinary destiny? I do not think so. Moreover, some have done it better than I would ever do.

On August 7 th 1815, the Emperor(1) and his supporters boardedtheNorthumberland heading to Saint Helena where it shored on October 14 th. In 1821, between the nights of May 4 th and 5 th, Napoleon died around 4 o’clock.
On December 15 th 1840, the Emperor’s mortal remains were placed in the Church of the Invalides in Paris.

What do we know on Napoleon’s mouth and teeth(2) ?
He was born with teeth(3).
Witnesses maintained that Bonaparte had met a lady from Toulon who had fallen in love with him “simply because of his teeth”. Constant(4), Bonaparte’s servant, mentioned his master’s nice teeth when he returned from Egypt.
Does not Alexandre Dumas(5) think the same when speaking of Bonaparte in the days following Brumaire 18 th: “He had the same pretension for his teeth; indeed, his teeth were nice, but they were not as splendid as his hands. ”

Napoleon’s personal hygiene was highly methodical and meticulous. Brushing his teeth was a step that he particularly valued. In this respect, the Emperor disposed of a “Necessary to teeth”. Moreover, from 1806 to 1813, he had Jean-Joseph Dubois-Foucou(6) (1747-1830) at his service to take care of his teeth. According to F. Masson(7), one of Napoleon’s greatest historiographers, the care that the latter was giving to his teeth was such that “all his teeth were beautiful, strong, and well-arranged”. He added: “He was carefully picking his teeth with a toothpick made of boxwood, then was brushing them for a long time with a brush soaked in opiate, flossed them with thin coral, and was rinsing his mouth with a mixture of brandy and fresh water . Finally he was clearing his tongue with a silver scraper of silver gilt or tortoiseshell.” In 1806, Chardin, “perfumer of Their Imperial and Royal Majesties”, delivered 52 boxes of opiate toothpaste worth 306 francs, 15 dozen of toothpicks made of boxwood and ivory. In October 1808, he delivered 24 dozen of these toothpicks, 6 boxes of thin dental coral worth 36 francs and 28 boxes of opiate of superior quality valued at 168 francs.
It seemed that during his reign the monarch never had to ask Dubois-Foucou for his service, apart from personal cleanings.

In 1815, while he was embarking for the island of Saint Helena, a British officer, named Maitland(8), noticed: “His eyes are light grey, his teeth are in good condition.” Another officer, present at that very moment, said: “pale blue eyes, and unpleasant teeth”. As for Lady Malcolm, she described Napoleon with “pale or grey eyes, white teeth in good condition and equal, but small”. As for Bunbury, he maintained: “he has grey eyes, his teeth are unpleasant anddirty”. Lord Rosebery declared that: “The Emperor’s teeth are bad and dirty, and barely shows them.” Lastly, Augustin Cabanès (1928) related that: “Napoleon ate liquorice which eventually blackened his teeth.” He added that “this assertion would need to be confirmed.”

During his exile, the Emperor(9) suffered from dental abscesses which seemed to come from his right upper wisdom teeth. The tooth was extremely unsteady. In the memorial of Saint-Helena, Las Cases(10) dated the first episode of dental inflammation on October 26 th 1816. “I found him with his face wrapped up with a handkerchief;… “What is the most terrible ache? What is the sharpest pain?” he asked. I answered that it was always the most instantaneous one that was the worse. “Well, then it must be the toothache!”, he replied. Indeed, he had a fierce inflammation; his right cheek was swollen and extremely red… Alternatively, I started to alternately warm a flannel and a cloth that he would apply in turns on his sore cheek, and he said that was making him feel better.” On Sunday 27 th, “…His headaches and toothaches were extremely intense. The inflammation had not diminished at all...” On the 30 th, “Today, the Emperor was not feeling better. That night, the doctor came; he was saying that he had brought harmless gargles; but he had great difficulty using them. The Emperor’s lips, throat and mouth were covered with spots. He said he could barely swallow or speak”. On Thursday 31 st, “…He was suffering a lot, especially from the spots that were covering his lips.” On November 2 nd 1816, “…the inflammation was even more decisive…” On Tuesday 5 th, “…his mouth was on the way to recovery but his teeth remained extremely sensitive.” On Saturday 9 th, “…When having his dinner, the Emperor was feeling much better, was very happy and even lively; he was congratulating himself on having gotten over his last illness without taking medicine, without paying tribute to a doctor…
At that time, Baron Sturmer, sent from Austria to Saint-Helena, wrote to Metternich: “He is in good health, and threatens to live for a long time.” Further, he added: “He has a gumboil”.
On that occasion, Barry O’Meara(11), his Irish doctor, reported symptoms of scurvy. In 1817, either the Emperor had swollen legs, either the scurvy was spreadingover his gums. In July, he suffered once again from an inflammation of the face due to his bad teeth. The doctor wanted to extract one of them which was unsteady. Napoleon refused the operation. In November, O’Meara noted: “He complained about a pain in the right cheek which came from his bad tooth. His gums were spongy and were bleeding from the slightest touch of his hand. Few days later, he wrote: “the Emperor’s gums are extremely sore. They are spongy.”, then “the right part of his jaws is significantly swollen.” Despite everything, Napoleon ended up accepting the extraction. The doctor executed the extraction after having made the Emperor sit on the ground. Lieutenant-colonel Gorregner(12), Sir Hugues Lowe(13)’s secretary in Saint Helena related: “He (General Bonaparte) recently lost a tooth (wisdom tooth). It was his very first surgical operation, and under such circumstances, his behaviour was far from brave. In order to be able to extract his bad tooth, Doctor O’Meara was forced to make him be held on the ground. From then on, he complains a lot and keeps to his bedroom where he demands that a fire be lit despite the hot season. So he remains roasting for hours...” It was the very first teeth extracted from Napoleon’s mouth. Until then, he had never really suffered from his teeth. According to the Frenchman, “this tooth was barely rotten and could have been filled” (this is taken from Baron Sturmer’s account). On the occasion of this operation, Betsy Balcombe(14) apparently exclaimed: “I beg you pardon! You are complaining about the pain caused by an operation of such little importance! You, who assisted at countless battles, and escaped a shower of bullets, you, who got injured so many times! I am ashamed of you. But anyway, give me that tooth!” Montholon(15) dated this operation on November 16 th 1817. To combat scurvy, O’Meara used antiscorbutic plants (fumitory, cochlearia, etc…) and opiate toothpaste containing the same plants triturated with canned roses. In a report dated to July 9 th 1818, O’Meara(16) related that “…the gums (of the Emperor) appeared spongy, scorbutic;…Three molars were affected. Given the circumstances, I considered that they must have been caused by the inflammatory affections of the muscles and the membranes of the jaw. Besides, I thought that catarrh had been caused by those affections. I extracted them at appropriate intervals…To destroy the scorbutic aspect that the gums had, I recommended the use of vegetables, acids. I was successful. It disappeared, then reappeared again and was cleared up by the same means. The tongue was almost constantly white.” According to Marshal Bertrand, Napoleon suffered from other dental problems after January 1818, but remained vague on the dates.
Derobert and Hadengue(17) gave more details about Napoleon’s oral symptoms during his exile: “Within chronic arsenical intoxication, the ulcerous stomatitis of variable levels always takes the aspect of dental pyorrhoea.” The prescription based on mercury and calomel certainly did not help the recovery of Napoleon.

My final words will be on Jean-Joseph Dubois-Foucou(18) (1747-1830). He was successively a dental surgeon under Louis XVI (1754-1793), Napoleon 1 st (1769-1821), Louis XVIII (1755-1824) and Charles X (1757-1836). As a matter of fact, his name was simply Dubois, but he added to it the name of Foucou, taken from one of his relatives, who was an artist. In 1775, he upheld his thesis entitled: “De dentis vitiose positorum curatione” and became the member of the Royal Academy of Surgery. He succeeded to Etienne Bourdet when he became Louis XVI’s personal dentist from 1790. He was mentioned in the “Chronological Chart of dentists serving the Court of France”. In 1808, he published: “Presentation of new methods for the making of teeth, known as composition”.
As soon as he entered the Temple (in August 1792), Louis XVI asked him for a sponge for his teeth. Then, in December 1792, Louis Capet, as he was then called, asked for citizen Dubois-Foucou’s help because of dental inflammation which had been affecting him for a while. On December 22 nd 1792, this was not allowed after a deliberation from the Council who refused to give a decision on solicitation.
During the time he spent around the Emperor, he earned 6000 francs of annual salaries.
He only stopped practicing when he died in 1830.
* Dr Xavier Riaud, 145, route de Vannes, 44800 Saint Herblain, France, e-mail : xavier.riaud@wanadoo.fr
(1)  Roy-Henry Bruno, Napoléon repose-t-il aux Invalides?, in Historia, 2000 ; 638 : 42-48.
(2)  Riaud Xavier, Les dentistes détectives de l’histoire, L’Harmattan (éd.), Collection Médecine à travers les siècles, Paris, 2007, p. 53-57.
(3)  Lamendin Henri, Petites histoires de l’art dentaire d’hier et d’aujourd’hui (Anecdodontes), L’Harmattan (éd.), Collection Ethique médicale, Paris, 2006, p. 11-12.
(4)  Lamendin Henri, Napoléon, des dentistes et l’Histoire..., in Le Chirurgien-Dentiste de France, 6-13/01/2000 ; 966/967 :66-71.
(5)  Dumas Alexandre, Les compagnons de Jéhu, Phoebus (éd.), Paris, 2006, p. 426.
(6)  Société Odontologique de Paris, Les daviers de Napoléonhttp://www.sop.asso.fr, 2006, p. 4.
(7) Lamendin Henri, 6-13/01/2000, pp. 66-71.
(8) Lamendin Henri, Anecdodontes, Aventis (éd.), 2002, p. 49-50.
(9)  Balcombe Betsy, Napoléon à Sainte-Hélène, Plon (éd.), Paris, 1898, p. 22-23.
(10)  De Las Cases Emmanuel, Mémorial de Sainte-Hélène, Le Grand Livre du Mois (éd.), Tome IV, Paris, 1999, p. 64-119 (republishing of the first version of 1822).
Las Cases gave meticulous details on Napoleon’s toilette. After shaving his beard, and cleaning his face, last of all: « …Then comes the story of his teeth ». Las Cases was banned from Saint Helena in December 1816. He also alluded to “scorbutic symptoms” from which Napoleon suffered during his exile in Saint Helena.
(11) Lamendin Henri, 6-13/01/2000, pp. 66-71.
One of Napoleon’s teeth, extracted from O’Meara is exhibited at Madame Tussaud’s Museum, in London. The relic is supposed to be a third upper molar.
(12)  Société Odontologique de Paris, Les daviers de Napoléonhttp://www.sop.asso.fr, 2006, p. 4.
(13)  Rousseau Claude, Histoire de l’aménagement opératoire du cabinet dentaire – Le coffret d’instruments de chirurgie dentaire de Napoléon, l’énigme de son testament, Actes de la SFHAD, http://www.bium.univ-paris5.fr, pp. 1-8.
(14)  Société Odontologique de Paris, Les daviers de Napoléonhttp://www.sop.asso.fr, 2006, p. 4.
(15)  Bastien Jacques & Jeandel Roland, Napoléon à Sainte Hélène – Etude critique de ses pathologies et des causes de son décès, Le Publieur (éd.), 2005, p. 26-29, 48, 53.
(16)  Lamendin Henri, 6-13/01/2000, pp. 66-71.
Later, O’Meara commercialised «toothpaste from O’Meara, Napoleon’s former doctor in Saint Helena. »
(17) Derobert L. & Hadengue A., Intoxications et maladies professionnelles, Flammarion (éd.), Paris, 1984.
A stomatitis is the inflammation of mucous tissues in the mouth and a pyorrhoea is an infectious destruction of the tissues.
(18)  Lamendin Henri, Praticiens de l’Art dentaire du XIV ème au XX ème siècle, L’Harmattan (éd.), Collection Médecine à travers les siècles, Paris, 2006, p. 51.

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