Robespierre suffered from rare immune disease

Sarcoidosis: Revolutionary Robespierre suffered from a rare immune disease

22/12/2013

The French revolutionary Maximilien de Robespierre probably suffered from the rare immune disease sarcoidosis. Researchers came to this conclusion after evaluating his death mask and historical documents relating to his medical history.

Disfigured by hatred?
The French historian François Furet wrote in his book „The French revolution“: „Rarely has a man been so disfigured by hatred as Maximilien de Robespierre. This hatred has made the cabinet politician a demagogue, the man of moderation as a bloodthirsty beast, the agile parliamentarian a dictator, the uncompromising devotee of God the despiser of religion.“ But it was probably not the hatred that disfigured the face of the revolutionary who was executed in 1794. Scientists at the University of Versailles are much more convinced that Robespierre suffered from a rare immune disease.

Dead mask Robespierres evaluated
Forensic scientists Philippe Charlier and Philippe Froesch write in the British journal „The Lancet“, that it was probably sarcoidosis (Boeck's disease), a disease in which the immune system is directed against one's own body. The researchers had evaluated both Robespierre's death mask, which was made shortly after his beheading by Marie Tussaud, as well as historical documents on his medical history. Eyewitnesses have described numerous symptoms including nosebleeds, blurred vision, jaundice, persistent fatigue, and recurrent leg ulcers. In addition, the revolutionary suffered from a constant twitching of his eyes and mouth. It is said that the disease symptoms have occurred more in his last four years of life.

Small knots in the organs
The very rare sarcoidosis is an inflammatory disease in which small nodules, so-called granulomas, can occur in virtually all organs. The most commonly affected are the lungs, skin and lymph nodes. In the days of Robespierre a diagnosis of the disease was unthinkable, it was first described in 1877 by the British physician Sir Jonathan Hutchinson scientifically. Even today, the diagnosis of sarcoidosis is often difficult. Due to the often symptomless running lymph node swelling, the disease is not infrequently detected by chance in the chest X-ray.

Cause of the disease unknown
To date, the exact cause of the disease is considered unknown. However, it is clear that the cause of the typical nodule formation is a malfunction in the immune system. So far, however, it is not yet understood in detail how this erroneous control comes about. Hereditary factors as well as environmental influences could play a role. Mostly, sarcoidosis occurs between the ages of 20 and 40, and women are more affected than men. The symptoms disappear in many patients even without treatment, in others they increase in batches or chronically. Sarcoidosis patients are treated with cortisone supplements that suppress the immune system to relieve the symptoms. About five percent of those affected die as a result of the disease.

Diagnosis not sure
The French forensic scientists admit that their diagnosis today is not certain. Robespierre's well-known symptoms would also fit various other conditions, but not as well as sarcoidosis. Also conceivable, for example, are tuberculosis without the typical cough or fever or another immune disease in which the vessels are inflamed. Due to the skin problems described, the two researchers also do not rule out scleroderma, in which the skin and internal organs harden. It was not known how Robespierre's personal doctor treated the patient. Since he ate a lot of oranges, there was evidence of a fruit therapy. In addition, Charlier and Froesch go out of baths and the then common bloodletting. (Ad)