Autopsy on Sir George Douglas
Ambassador to Poland and sweden
Medical History, 1978, 22: 431437.
AUTOPSY ON SIR GEORGE
DOUGLAS, A.D. 1636
by
CHARLES H. TALBOT*
ON 12 March
1636, the inhabitants of the town of Demmin in Pomerania were
astonished to hear the bells of Saint Bartholomew's Church ringing
out. Their astonishment was due to the fact that it was not a Sunday
when the church services took place
but a Saturday and the time
was eight-thirty in the evening when most good people
were abed.
As the bells continued to ring loud and strong, the governor of the
town
Colonel Cunningham, summoned the three burgomasters to find
out from them the
cause of this unusual occurrence, and when they
could offer no explanation, he
suspected that a traitor was
giving a signal to enemies outside the town. He immediately ordered
the guard to be increased and sent men with lights to climb up
to
the belfry of the church and find out if someone was hidden there.
To their surprise,
the soldiers found the bells hanging
motionless in the steeple and giving out no
sound, yet for more
than one hour and a half the people in the town continued to
hear
the peals of bells until they stopped suddenly at the third stroke
of ten o'clock.
This unusual occurrence impressed the citizens
and authorities so much that on
28th of the same month, the
Burgomaster and Council drew up a declaration describing all the
details of the incident and signed it with their seal. By that time,
another
incident (which will now be described), had happened in
their town, and they realized
that it was a portent of the death
of a man in high position.
Whilst the bells were ringing at
Demmin, Sir George Douglas, Charles I's ambassador to the court of
Poland,2 was staying with Francis Rithwein, the governor of
Anklam, a few miles distant. Sir George had been, for some years, a
most successful
diplomat in Poland, and among his many
achievements he had managed to secure
cessation of the war
between Sweden and Poland. As a result, he stood in high favour
with Sigismund III, the Polish king, whose interests he had
fostered. Suddenly,
however, and for no apparent reason,
Sigismund, who had previously described
Douglas as his closest
friend amongst the ambassadors, attributed all the credit for
the
truce to the French ambassador, and shortly afterwards for some
offence not
specified, caused Douglas to be recalled to his own
country.
At the very time the bells were ringing at Demmin, Sir
George Douglas, "somewhat
staggered in his confidence"3 was on
his way home with a retinue of sixteen men.
When he called on
Rithwein at Anklam, he was suffering from a bout of diarrhoea,
but little attention was paid to his sickness and next day he set
out for Demmin.
He reached it in the evening and was received in
solemn state by Robert Cunningham,
the governor. He spent the
evening happily with his relative, Robert Douglas, who
was also
there, and after a light meal went to bed.
On the following
morning he was taken round the ramparts of the town to see the
view and appeared to be in good spirits, but at lunchtime he
complained of feeling
unwell and got up from the table to go to
his room. At four in the afternoon he felt
rather worse, so he
called in Dr. Matthew Sacchus, a physician and a senator of the
town, to ask for his advice. When the doctor learned that Douglas
was leaving next
day, he considered it unnecessary to suggest any
thorough treatment, and merely
prescribed an enema, to which
Douglas agreed. Shortly afterwards, Douglas changed
his mind, for
he had heard in the meantime that Johann Sch6ner was staying in the
vicinity with a certain baron, and he gave orders to the soldiers to
fetch him. Johann
Schoner had just been appointed Professor of
Medicine at Greifswald. He was the
son of Martin Schoner, a
former physician to Queen Anne of Denmark, wife of
James I.4 He
had been born in Edinburgh on 2 July 1597, and had studied there,
but after the death of his parents, he returned to Germany. It may
have been his
connexion with Scotland that caused Douglas to call
him to his bedside.
The local doctor, Matthew Sacchus, had
noticed that though Douglas had no fever,
he complained of great
thirst and a feeling of heat in his stomach. He gave him
several
measures of cool fountain-water to drink, but these were vomited
almost
immediately. At ten o'clock that evening Douglas went to
bed and slept quietly until
next morning when he confessed that
he felt better. However, as soon as he tried to
rise and dress
himself, he found that he was unable to walk, and a kind of
paralysis
had seized his legs and feet so that even when holding
on to a table, it was impossible
for him to stand. So he returned
to bed: the windows were closed, the doors locked,
and no one was
admitted to see him except a nurse and a companion who sat at his
bedside. He appeared to go to sleep quietly, but about eleven
o'clock, he became restless and sighed and groaned. The nurse tried
to quieten him and asked him how he
felt; she could get no
intelligible reply. The servants were therefore summoned and
told
to fetch the other guests in the house, and Dr. Sacchus was sent
for. When he
arrived, he administered a cordial, Bezoardicum
medicamentum, but Douglas could
swallow only a little of this.
Dr. Sacchus then applied an embrocation or liniment
to the
patient's elbows, but it had no effect, and his condition gradually
deteriorated.
Between two and three o'clock in the afternoon of
14 March 1636, he died. Shortly
after, when it was too late, Dr.
Schoner arrived on the scene. He was of the opinion
that, had he
come in time, he could have saved Douglas's life by trying various
remedies, particularly that of opening a vein, but on the evidence
before us it seems
extremely doubtful.
Robert Douglas, Sir
George's relative, asked Schoner to undertake an autopsy,
and
embalm the body. Schoner was loth to do this, both because of his
fear of fevers,
malignant and petechial, and of encephalic
epidemics which were rife at the time.
But because of his
devotion to the king of England and to his ministers, he agreed to
carry out Robert Douglas's wishes. He therefore brought from
Greifswald everything
necessary to carry out the procedure. He
called in Dr. Matthew Sacchus, and employed
two other surgeons to
assist him. He then invited the governor, Robert Cunningham,
and
other noblemen in the town to be present at the autopsy, as well as
Sir George
Douglas's servants; the former excused themselves on
the plea of grief, though a
number of the deceased's retinue
came, among them being his secretary and his
chamberlain, (aulae
suae Magister).
After lunch then on 17 March 1636, Sch6ner
offered a prayer for Divine help
and exhorted all present to
watch every step in the operation attentively, and to write
it
down in the notebooks they carried with them. First they examined
the body from
head to foot to convince them what a wonder of
wonders the human body is; the sum
total of all nature; the
greatest work of God's creation; the norm and exemplar of
all
bodies. They admired the wonderful integration of parts, the
aptitude of various
members for the tasks imposed on them and so
on. Then they noted the colour
which, though ordinarily white or
creamy, had already changed in parts, particularly
on the back,
where it seemed suffused with blood-a characteristic, as Sch6ner
pointed out to them, of people who had died of apoplexy, as he had
often observed
before. It was now the third day after the death
of Douglas, so it was not surprising
that part of the scrotum was
decomposed, though earlier, like the rest of the body,
it had
been perfectly healthy.
A cut across the abdomen showed that
there was copious fat beneath the skin;
the peritoneum was strong
and thick. After separating the parts, he came to the
intestines.
He showed them the omentum [epiplaos] stretching almost to the
navel,
covered with fat: then putting it on one side, he showed
the stomach, liver, and
intestines, the stomach lying in its
natural place in the abdominal cavity [epigastrio],
rather white
in colour and not quite normal in size, the intestines also in their
proper
place and covered on the outside with fat, though they had
all, together with the
stomach, collapsed somewhat more than
usual, except the colon which was inflated
with gas. On opening
the stomach, nothing but mucus was present, yellow in colour
and
thin and watery; there was little faecal matter in the intestines,
and that rather
yellow, thin, and like serum. Sch6ner thought
that this arose from the diarrhoea
and from the copious draughts
of water taken by the deceased before his death, for
the stomach
and intestines looked as if they had been washed.
Before he took
these parts away, he showed the bystanders the liver to examine.
It was rather large and healthy, dark red, and without any blemish
on the convex
side but carrying signs of inflammation on the
concave side. The colour here was not
so much yellow as black, as
if it had been burned, and this, Schoner thought, was
an
indication that Douglas had already caught a fever in the early days
of his journey.
The substance of the liver was soft and bloody
but rathei dark. The small branches
entering the liver were
flaccid and empty and contained no "chyle" or chyme but a
kind of
serum of greenish hue. He found blood in the vena cava but it was
thick
and slimy. He then showed them the gall-bladder to the
right of the liver, and noticed,
with some astonishment, the
enormous size of it, the largest he had ever seen in any
of his
previous anatomical dissections or autopsies. The bottom of it, like
a pillar of
palm, ended in a neck which was much greater than it
would naturally be, and was
swollen out, possibly because of the
amount of bile; it was not so much yellow in
colour as blackish,
or black with a yellow tint. The biliary canal and pores were also
larger than usual and were full of bile. As soon as he saw the size
of these two vessels,
he pointed them out to the physician,
Matthew Sacchus; to the two surgeons, and to
the other assistants
present. The spleen, lying towards the back of the body on the
left side, was seen, after a certain portion of the intestines had
been taken away, to
be rather large-larger in fact than was
normal, blackish in colour, and of medium
consistency. Schoner
thought that its size had nothing to do with Douglas's illness,
but was its natural size, perhaps because of Douglas's melancholic
temperament
and the preponderance of melancholic humour in the
body.
He then separated the intestines, looked at the mesentery,
and in the middle near
the navel found a glandulous body covered
with fat. But he found no notable collection of humours there. In
the pancreas there was nothing unnatural to be seen.
Having taken
out the intestines, he looked closely at the kidneys because one of
the
secretaries had told him that a large amount of gravel had
been observed in the
ambassador's urine. Schoner therefore cut
open both the bladder and the kidneys,
but could find nothing to
substantiate this observation.
He next separated the spermatic
vessels and the testicles, all of which, in size,
number, and
position, conformed to their natural disposition. From the belly he
proceeded to the midriff, taking note of the diaphragm before he
closed it up. He
then opened up the chest, cut through the
mediastinum and showed the two lungs,
the lobes of which he
examined. They were yellowish in colour, loose and thin in
texture. On the surface of the right lobes could be seen various
pustules full of a
watery substance, which, had the ambassador
lived, would have caused him much
trouble in later life, probably
from coughs and asthma, at least so thought Schoner.
Schoner then
showed through these lungs the arterial vein (vena cava) running
from the right side of the heart; the venous artery (pulmonary
artery) from the left;
the branches of the aorta; and the rough
artery (trachea), from which it is, as it were,
suspended with
many other branches, and he pointed out that it is from these and
its own parenchyma or tenuous membrane which they take from the
pleura, that
the lungs are constituted.
After the lungs, he
came to the noblest member of the internal organs, the heart,
which is the hearth, the centre, the fount of life-giving heat. He
would have examined
all the elements of this organ, but time
would not allow him to give ocular demonstration of all its details.
He therefore restricted himself to noting a few things. Having
dissected the hard and thick membrane of the pericardium, he found
there a little
watery substance which he had found in greater
quantities in other dissections he
had performed. But when he
came to examine the heart itself, he was not a little
astonished
to see its unusual conformation. Not only was it smaller than usual,
but
it was full of wrinkles, and formed as it were out of pleats.
These wrinkles or pleats
were lined with fat from top to bottom.
In the middle part of the heart these wrinkles
were deeper and
more pronounced, but near the lower point they were thinner,
four
or five in number, with a great many more which were hardly visible.
He pointed
434Texts and Documents
these out to the bystanders,
and then, when he had opened up the vessels of the
heart, he took
it out and gave it to the assistants to examine. These wrinkles made
the heart dry and flabby to the touch. Schoner excused himself from
inquiring into
the reasons for this condition of the heart, but
he averred that these unusual wrinkles
were either natural or
adventitious; if natural, then because of their singular rarity
they should be carefully noted, but if adventitious (which he
considered the more
likely opinion), he could give no snap
judgment on their cause, other than that they
followed the
peculiar conformation of the left ventricle, which was the seat of
the
vital spirits. These vital spirits had been suppressed or
suffocated by some occult or
malign agency, either violently and
suddenly or slowly and by degrees, with the result
that the left
ventricle had collapsed, and with its collapse, the thick walls had
fallen
in.
However, Schoner did not wish to press his opinion
on others, and he left the
final judgment on the matter to the
most noble and Royal College of Physicians of
London, his friends
and patrons, who were by far the most learned and experienced
body to consider such a problem.
Nevertheless, in order to find
some cause for these wrinkles, Schoner made an
incision in the
left side of the heart, where the walls of the cavity seemed to come
together. In the cavity, he found a few drops of blood, bright red
in colour. He then
showed the valves and opened up the other side
of the heart, but could find nothing
that would afford a
reasonable explanation for the unusual collapse of the septum.
As
regards the shape of the heart, its substance, and all the other
parts of it, he could
find nothing out of the ordinary, and so,
as the evening was approaching and there
was little time, he cut
short this part of his inquiry.
Having put the heart on one side,
he opened up the chin inside the lower jaw,
extracted the larynx,
the oesophagus, and the tongue, and handed them to the assistants
for examination. At this point he seems to have forgotten the
purpose of his
dissection and appears to have treated the whole
affair like a lesson in anatomy for
his students. For immediately
he began to show and explain to the bystanders how
the larynx is
used to produce the voice, to explain the Adam's apple, and to
demonstrate the work of the intercostal muscles.
Finally he came
to the head, "the dwelling place of the mind, the senses, the
animal faculties", which, because of the sudden death of Douglas
with its suspicion
of apoplexy, he would have examined first if
the great and heavy stench of the lower
members had allowed it.
Having cut away the skin, the two assistant surgeons opened
the
skull with a saw. They found the skull very thick. The calvarium of
the skull was
put on one side and an examination was made of the
meninges, the dura and pia mater.
The former was found to be
strong and robust, the latter was ruddy with all the ducts
and
cuniculi turgid with blood. Having put aside the meninges, Sch6ner
then showed
the people present all the parts contained in the
brain, dealing with them (as far as
time would allow) in the
order used in anatomical demonstrations, namely the
choroid
plexus, the corpus callosum, the external venous sinuses (in which
he found
serum mixed with blood), the corpus arcuatum or fornix,
the third sinus with its
different glands, the pineal gland, the
cerebellum, the four orbicular prominences,
corpora quadrigemina
called the nates et testes, the ventricle which is called the
fourth,
435Texts and Documents
the pituitary gland, and the
rete mirabile. Then he showed them the optic nerves,
and (carried
away once more by his enthusiasm beyond the limits of his immediate
work), he took out the eyes and showed those present the various
humours of these
organs; the aqueous, the vitreous, and the
crystalline [lens] (taking care to give
ocular demonstration of
how small letters are enlarged by this latter); then the different
membranes, the pupil, the iris, the most important muscles which
open, close, and
move the eyes, and many other things, though he
thought it frivolous to give an
account of these in writing on
this present occasion.
Furthermore, he found not only a quantity
of thick humours, as has already been
said, in the first sinus of
the meninges, but also in the third sinus he found a liquid
mixed
with blood which had already begun to flow through the nostrils.
Indeed,
near the conjunction of the sinuses in the hinder part of
the brain, where the third
sinus joins up with the others and
makes what is called the fourth, or near the torcular,
he found
not a little thick liquid mixed with blood, as also round the
choroides
plexus and retiformes, a thing which he had never
experienced before in all the
anatomical dissections he had made
at Greifswald in his position as Professor of
Medicine.
His
opinion was that this thick, viscous matter round the torcular and
the plexus
had prevented the access to the brain of the vital
spirits, and so, in a very short time,
had destroyed all sense
and movement, and all animal actions through the deprivation
and
interception of these vital spirits. This also increased and
confirmed his earlier
suspicion that Douglas had died of
apoplexy. All the same, he was far from asserting
that this was
the primary and immediate cause of the sudden death. All that he
intended to do was to describe, in simple and homely style, the
facts that had come
before him during the post mortem and which
had been seen not by himself alone,
but also by the physician
Matthew Sacchus, the two surgeons, and their assistants.
He
therefore left it to the judgment of others to reason and decide
what the cause
of death may have been.
When, with the help of
God, the whole task of eviscerating the body had been
completed,
all the viscera (with the exception of the heart and the tongue,
which,
after being lightly dried, were put aside in a metal
container), together with the
brain (the greater members, the
great arteries and venae cavae having been separated
from the
spine), were placed in an oaken chest lined with pitch. Some salt
and aromatic
powders were sprinkled on them, The box was closed
and sealed and then despatched
to the church of St. Bartholomew
at Demmin to await the union of soul and body on
the day of the
Resurrection.
In preparing the body for embalming, first, all the
cavities of the body were washed
with tepid water, then with
strong wine-vinegar, then with wine-spirit, and finally
rinsed
several times in wine of aloes and myrrh. Next, all the internal
fleshy and
muscular parts were sprinkled and rubbed with salt and
aromatic powders which
dried them and made them resistant to
putrefaction. Finally all the cavities of the
body, the mouth,
throat, nostrils, and so on were filled with these and other
aromatic
powders, no expense being spared, and then all were
carefully sewn up. In the places
where sewing had taken place,
liquid balsam and sweet-smelling ointments were
poured and rubbed
so that every portion was closed up. In the same way, the cranium
436Texts and Documents
was also filled up, then put in place and
fixed, the skin sewn up and the whole covered
and anointed with
balsam, with the addition of a few pills which kept out worms. At
length, the whole body was anointed with the spirit of wine
compounded with aloes
and myrrh, and the hands and face washed
with Damascene water. It was then that
very fine linen
impregnated with terebinth, resin, and aromatic gums, was swathed
round the whole body and round each limb, on which sweet-smelling
spices were
scattered whilst this was being done, and then all
was tightly sewn up.
Afterwards, the body was clothed first in a
garment of fine linen and then in purest
Damascene silk. A cap
made of silk, was fitted on the head, a collar put round the
neck, sleeves and gloves over the arms and hands, and everything
else disposed in as
decent a manner as possible. It was then
placed in an oaken coffin, lined with pitch
and covered with fine
taffeta, with cushions made of taffeta and filled with lavender
and other aromatic herbs supporting the body at the head, feet, and
sides. The heart
and tongue of the deceased man, enclosed in a
metal casket, were placed beneath
his head. And thus adorned, tbe
corpse of Douglas was left in the coffin for a whole
day so that
the governor, the colonel, and all others who wished to pay their
last
respects, might see him.
"So", concluded Sch6ner, "did I
carry out my task without any noticeable nausea
or disgust; with
how much diligence and industry it is not for me to say. Those who
were present, the physician, the surgeons and their assistants, to
whose testimony I
willingly submit, will be better witnesses of
this. For the rest, this my judgment
about the constitution of
the parts and viscera of the body, and about the reason
and cause
of the sudden, too sudden death, because it is off the cuff and made
during
the process of the dissection, I impose on no one." But he
hopes that his labours and
his examination of the deceased will
be acceptable to his friends and patrons, all
of which he piously
offers to God.
So ends Sch6ner's account of his dissection or
post mortem on Sir George Douglas.
There is just one more
document concerning Schoner and this case which is worth
mentioning. George Ewin, one of the ambassador's men, had to draw up
a list of his
expenses after the funeral was over. This account
which is headed-"Account of the
money disbursed by George Ewin
for embalming the body, the mourning and entertainment of his
servants for 18 days and for transporting the body from Demmin to
Hamburg"-has as its first item, the following:
To Dr. John
Schoner for embalming the body.. .. .. .. .. 205 Rigs dollars
To
another Dr. and two surgeons chosen as assistants. .. .. .. 34
To
their servants .. .. .. .. .. .. .. .. .. 4
For the coffin and
for burying the entrails in the Church .. .. .. 9
I think the
comparative amounts of money received by the various partners in the
job are very enlightening. Schdner received six times as much as the
local physician
and two surgeons put together, and, counting the
dollar roughly at five shillings, his
fee was about fifty pounds.
*Charles H. Talbot, B.D., Ph.D., F.S.A., F.R.Hist.S., Wellcome
Institute for the History of Medicine,
183 Euston Road, London
NW1 2BP.
1 The documents translated here are to be found in
Public Record Office, London, State Papers
Foreign, 88/89, fos.
238-256. The description of the actual autopsy occurs fos. 241-250r
with
the following title: ETr1Toxspl De Subitanea et
Repentina/sed pia ac placida Morte/Viri
Generosissimi,
Nobilissimi, summe Strenui et Consultissimi/Dni Georgii Douglasii
... Johanne
Schonero, Phil. et Med. D./Academiae Gryphiswaldensis
Professore Publico. Demmini, Anno
Christi 1636, 22 Martii. It was
addressed to the College of Physicians in London.
'Calendar of
State Papers, Domestic series, Charles I, 1635-36, p. 147.
'Calendar of State Papers, Domestic series, James I, 1603-1610, pp.
99, 205, 233.
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