logo
episode-header-image
Feb 2019
43m 5s

43 - The Cursed

Adam Rodman, MD, MPH, FACP
About this episode

What killed Charles II of Spain, the inbred monarch whose autopsy famously showed a heart the size of a peppercorn, a head full of water, and a bloodless body? This episode addresses that medical mystery by not only delving deep into Charles’ unfortunate past, but by exploring some of the fundamental assumptions physicians have made about the nature of disease. Along the way we’ll walk about inbreeding coefficients, postmodern philosophy, and two thousand years of anatomy and autopsy. Plus a new #AdamAnswers about whether Vincent van Gogh’s love of the color yellow was caused by digitalis poisoning!

 

Sources:

  • Alvarez G, Ceballos FC, Quinteiro C (2009) The Role of Inbreeding in the Extinction of a European Royal Dynasty. PLoS ONE 4(4): e5174. https://doi.org/10.1371/journal.pone.0005174
  • Burchell HB, Digitalis poisoning: historical and forensic aspects. J Am Coll Cardiol. 1983 Feb;1(2 Pt 1):506-16.
  • Burton JL, A Bite Into the History of the Autopsy: From Ancient Roots to Modern Decay. Forensic Sci. Med. Pathol. 1:4:277.
  • Cerda JL. Charles II of Spain, «the bewitched». Rev. méd. Chile  [Internet]. 2008 Feb [cited 2019 Feb 11] ; 136( 2 ): 267-270.Cullen W, Nosology. Retrieved online at: https://books.google.com/books?id=3IgUAAAAQAAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false
  • Foucault, Michel. The Birth of the Clinic: An Archaeology of Medical Perception. New York: Vintage Books, 1975.
  • Gargantilla Madera P. Enfermedades de los reyes de España, los Austrias : de la locura de Juana a la impotencia de Carlos II el Hechizado. Madrid 2005.Ghosh SK, “Giovanni Battista Morgagni (1682-1771): father of pathologic anatomy and pioneer of Modern Medicine, Anat Sci Int, 6 Sep 2016.
  • Gruener A. Vincent van Gogh's yellow vision. Br J Gen Pract. 2013;63(612):370-1.Hodge GP. A Medical History of the Spanish Habsburgs: As Traced in Portraits. JAMA. 1977;238(11):1169–1174.
  • Lagay F, The Legacy of Humoral Medicine, Virtual Mentor. 2002;4(7):
  • Lee TC. Van Gogh's Vision: Digitalis Intoxication? JAMA. 1981;245(7):727–729. Lesney MS, Flowers for the heart, ACS, March 2002, Vol. 5, No. 3, pp 46, 48
  • López AG et al, Charles II: From Spell to Genitourinary Pathology. Arch. Esp. Urol. 2009; 62 (3): 179-185.
  • Somberg J et al, Digitalis: Historical Development in Clinical Medicine, The Journal of Clinical Pharmacology, Volume 25, Issue 7
  • Starkstein, S., & Berrios, G. (2015). The “Preliminary Discourse” to Methodical Nosology, by François Boissier de Sauvages (1772). History of Psychiatry, 26(4), 477–491. Viale G, The rete mirabile of the cranial base: a millenary legend. Neurosurgery. 2006 Jun;58(6):1198-208.
Up next
Sep 2023
74 - R2D2
What does it mean when a computer can make better medical decisions than a human? The progress in large language models, and in particular the popularity of ChatGPT, has brought these questions to the forefront in 2023, but we’ve been discussing this for over 50 years. In this ep ... Show More
33m 22s
Jun 2023
73 - Seadragon
What happens when a patient far from surgical care – say, at the bottom of the Pacific ocean on a submarine, or at a research base in Antarctica in the middle of the winter – develops a surgical abdomen? This dilemma was the impetus to build the first truly effective clinical dec ... Show More
27m 57s
Mar 2023
72 - Problems
American doctors spend the majority of their time during the day on the computer, either writing or reading notes about their patients; only a small fraction is spent with the human beings in their care. Technology itself – especially the electronic medical record – has often bee ... Show More
52m 3s
Recommended Episodes
Jun 26
A Ridiculous History of Brain Science, with Jorge Cham
Today, we all generally understand that the brain is responsible for what we call personality and thought -- yet this wasn't always the case. Once humans figured out the brain was more than a weird lump in the skull, it took centuries of trial and error, along with quack science, ... Show More
56m 6s
Nov 2024
Case #21: Scott
In peak health, Scott's life took a drastic turn when a rare disease nearly claimed it all. Initially misdiagnosed and dismissed, his symptoms escalated into a near-fatal episode, revealing the true extent of his condition. Forced to confront challenges affecting his heart, lungs ... Show More
38m 46s
Nov 2024
Douglas J. Engelman, "A Boy Broken: A Father's Journey Through His Son's Mental Illness, Loss, and a Search for Meaning" (2023)
In A Boy Broken: A Father’s Journey Through His Son’s Mental Ilness, Loss, and a Search for Meaning (2023), Dr. Douglas J. Engelman takes us through an often painful, sometimes uplifting story, where he recalls and describes the moment his relationship with his son changed foreve ... Show More
44m 57s
Jun 13
Double-Blasted
We first aired this episode in 2012, but at the show we’ve been thinking a lot about resilience and repair so we wanted to play it for you again today. It’s about a man who experienced maybe one of the most chilling traumas… twice. But then, it leads us to a story of generational ... Show More
20m 54s
Dec 2024
Who was the "Elephant Man"? Joseph Merrick's True Story
The life of Joseph Merrick, the man they dared to call "The Elephant Man", will fill you with pain and anger. He was treated so cruelly by society that he found becoming a freak show exhibit preferably to the life available to him elsewhere. Yet alongside darkness there is light ... Show More
47m 14s
Mar 2025
BIG T Trauma Series Ep. 21: All Things TXA
Join Patrick Georgoff as he welcomes Dr. Gene Moore and Dr. Ian Roberts, two giants in trauma surgery and epidemiology, to discuss tranexamic acid (TXA) in trauma care. Dr. Moore, a legendary trauma surgeon and researcher, and Dr. Roberts, the architect of the CRASH trials, break ... Show More
49m 21s
Oct 2024
14. Gabor Maté
Kirsty Young asks physician and trauma specialist Gabor Maté what advice he would give his younger self.Maté was born to Jewish parents in terrible circumstances in Hungary in 1943. His grandparents were killed in the Auschwitz concentration camp, his father was in forced labour ... Show More
40m 15s
May 2019
"The Happiness of All Mankind" Season 1 Episode 4 'Chernobyl' Review
Christian, Jeremy and Julana break down episode 4. Think you have a bad job? Try getting animal control or roof clean-up duty post-Chernobyl. Plus, a horrifying parent-child dynamic rounds out yet another episode of It’s Always Sunny in Pripyat. HBO brings Chernobyl to the screen ... Show More
52m 17s
Oct 2016
Episode 29 - Halloween Edition
In this episode, we take on the controversial and strange subject of cephalosomatic anastomosis, better known as a head transplant. Although never done before in humans, there is both a surgeon and a patient willing to try this in the near future! We'll take a look at the surpris ... Show More
13m 53s
Apr 2025
Final Days of 'Mad' George III
How did George III die? Was it raving in a straightjacket? Who stayed with him at the end of his long illness? Today we uncover the truth about George III, the man unfairly remembered as the mad King who lost America. Produced by Freddy Chick. Edited by Tomos Delargy. Senior Prod ... Show More
55m 25s