- Enter Cangrande della
Scala, Lord of Verona (1291-
1329): On 18 July, 1328, the
Lord of Verona made a trium-
phant entrance into the city of
Treviso. This was the crown-
ing achievement in his long
struggle to conquer the entire
region of Veneto (Northern
Italy).
However, soon after his en-
trance he became seriously ill
and contemporary accounts
describe fever, vomiting and
diarrhea after drinking pollut-
ed water from a local spring.
He took to his bed on the 22
of July and five days later died.
Rumors of poisoning soon
arose.
In 2004, 700 years later,
Congrande’s tomb, in the
church of Santa Maria Anti-
gua in Verona, was opened to
allow complete examination.
The very heavy stone lid of the
sarcophagus was raised and a
well preserved body appeared. The autopsy showed him wrapped in
precious silk textiles and still wearing some clothes. His legs were
extended and he was on his back with his arms folded across his
chest and in the tomb was his sword.
He was extensively studied by digital radiography and CT. Food
was found in his esophagus and gut. Other diagnoses included:
Chronic sinusitis, mild diffuse arthritis, emphysematous bullae in
his lungs. The autopsy was performed by opening the abdomen
from sternum to the pubis. Several organs remained well preserved.
He had a small amount of atheromatous plaque on his aorta. The
analysis showed that the contents of his stomach and feces were filled
with chamomile and black mulberry as well as digitalis purpura
(Foxglove). Chamomile was used as a sedative and an antispasmodic
and black mulberry as an astringent. Foxglove was the poisonous
plant. The digitalis leaves were very high in his gut and his feces.
The conclusion was the Lord of Verona was poisoned and his
symptoms were classic of digitalis intoxication. The chamomile
and black mulberry were suggested to have covered up the taste
of the digitalis. The perpetrators of this crime remain to this day
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LOUISVILLE MEDICINE
unknown; some perhaps have accused rival Italian rulers, his own
heirs, or even his personal physician, who was executed shortly after
Congrande’s death: the ultimate price for having your patient die.
The 19 other herbs Mother Hutton added to her tea probably
eased the bitter taste of digitalis.
Thus, 400 years before Withering, the toxic effects of Foxglove were
well known. An interesting example of “nothing new under the sun.”
Ed. Note: The one thing they drilled into every new medical intern
at Grady Hospital (then and now):
“Never, ever, stop an old lady’s digitalis.” They said nothing of
Lords.
Dr. Weiss practices Cardiovascular Diseases with Medical Center
Cardiologists.