The Black Prince may have died of malaria or even inflammatory bowel disease rather than chronic dysentery as is commonly believed, according to a new study.
The death of Edward of Woodstock, known as the Black Prince, at the age of 45 in 1376, is said to have changed the course of English history.
He was the eldest son of King Edward III of England, and heir apparent to the throne.
Edward, who earned distinction as one of the most successful English commanders during the Hundred Years’ War and was heralded as the greatest English soldier ever to have lived, died before his father and so his son, Richard II, succeeded to the throne at just 10 years of age.
Young King Richard II was later deposed and murdered, sparking over a century of instability, including the Wars of the Roses and the rise of the Tudors.
Now a military expert says it is unlikely that the Black Prince died as a result of chronic dysentery, as previously believed.
Dr James Robert Anderson, of 21 Engineer Regiment, believes it may have been malaria or brucellosis, caused by eating unpasteurised dairy products and raw meat.
He also thinks it might have been inflammatory bowel disease (IBD) or complications arising from a single bout of dysentery.
He says that what happened to the Prince, who pretty much continuously fought wars and was exposed to violence from the age of 16, has been endlessly repeated throughout history, with disease, rather than battle injury, taking the heaviest toll on life during warfare.
The Black Prince was never seriously injured despite the number of military campaigns he led.
But Dr Anderson says he suffered chronic illness that waxed and waned for almost nine years, to which he finally succumbed in June 1376.
Writing in BMJ Military Health, formerly the Journal of the Royal Army Medical Corps, Dr Anderson says the Black Prince’s illness is thought to have started after his victory at the Battle of Nájera in Spain in 1367.
A chronicle suggested that up to 80 per cent of his army may have died from “dysentery and other diseases.”
And most later accounts of the Black Prince’s death suggest that he died from chronic dysentery, possibly the amoebic form, which was common in medieval Europe.
Dr Anderson explained that amoebic dysentery can cause long term complications, including internal scarring, intestinal inflammation and ulceration (colitis), and extreme inflammation and distension of the bowel.
But Dr Anderson questions that if the Black Prince really did have amoebic dysentery - with its symptoms of chronic diarrhoea - would he really have been well enough, or even welcomed aboard, a ship with a cargo of soldiers heading for battle in France in 1372?
He said complications from surviving a single bout of dysentery are a possibility, particularly as historical records indicate that paratyphoid - similar to typhoid, but caused by a different bug - and a recently discovered cause of dysentery, was in circulation in 1367.
Dr Anderson suggests that complications from that could have included long term health issues, such as anaemia, kidney damage, liver abscess and/or reactive arthritis.
He says dehydration due to lack of water during the hot Spanish campaign is another possibility. That could have caused kidney stones which would fit with a fluctuating illness lasting several years.
Dr Anderson says that IBD is another possibility as it might have accounted for relapsing-remitting symptoms and gradual deterioration.
He said brucellosis was also common in medieval Europe, and its sources - dairy products and raw meat - were often kept aside for the nobility on military campaigns.
Dr Anderson said: “It can produce chronic symptoms of fatigue, recurrent fever, and joint and heart inflammation.
“Another common disease in medieval Europe was malaria, the symptoms of which include fever, headache, myalgia - muscle aches and pains, gut problems, fatigue, chronic anaemia and susceptibility to acute infections, such as pneumonia or gastroenteritis, leading to multiorgan failure and death.
“This would fit the fluctuating nature of his illness and the decline towards the end of his life. Any anaemia would not have been helped by the purging and venesection [blood letting] treatments of the time.
“There are several diverse infections or inflammatory conditions that may have led to the Black Prince’s demise. However, chronic dysentery is probably unlikely.”
He added :“Even in modern conflicts and war zones, disease has caused enormous morbidity and loss of life, something that has remained consistent for centuries.
“Efforts to protect and treat deployed forces are as important now as in the 1370s.”
The Black Prince was buried in Canterbury Cathedral, Kent, where his surcoat, helmet, shield, and gauntlets are still preserved.
