Tuesday, 15 September 2020

The blood of Marat


 
I can't believe I managed to miss this story!!! 

Here is yet another quest in historical anthropology from "France's most famous forensic sleuth", Philippe Charlier. This time the object of his attention was the blood-soaked pages of the journal annotated by Marat on 17th July 1793 at the moment when Charlotte Corday plunged her fatal knife into his heart.  The aim was to isolate Marat's DNA from the stains and, potentially, to throw light on his medical condition

As with the gourd containing the blood of Louis XVI, the work was carried out in conjunction with the Spanish paleo-geneticist Carles Lalueza-Fox in Barcelona.  The final report was published in January this year. The investigation claimed a couple of firsts: "the oldest successful retrieval of genetic material from cellulose paper.", and, more portentiously, "the first retrospective medical diagnosis to include the genetic analysis of a historical figure".



The evidence

The object of under scrutiny is one of the iconic "treasures of the Bibliothèque Richelieu":



These bloody sheets from  l’Ami du Peuple (numbers 506 and 678 from 30th June 1791 and 13 August 1792)  were said to have been preserved by Marat's sister Charlotte Albertine. They came into the possession of  the collector François-Nicolas Maurin  in 1837 and  subsequently passed to the baron Carl de Vinck, whence in 1906 to the national collection.  The BN has welcomed the opportunity to have the claims authenticated.  In December 2019 Philippe Charlier  presented his findings at an INHA Trésors de Richelieu conference.



The DNA of Marat

The first goal was to identify a sample of the genetic material of Marat.

Charlier explains that pattern on the paper is characteristic of blood stains, with a combination of  greasy spots, thinning out more liquid in the surrounding areas.  The stains soaked through several pages, consistent with a large amount of blood; we know that Marat bled out rapidly - witnesses record that the gore splashed out into the room and into the water of the bath.

The laboratory in Barcelona was able successfully to isolate human genetic material from the bloodstain, which is identified as that of Marat on the following grounds: 

1. It is old DNA, which is highly fragmented and consistent with a date at the end of the 18th century.  The experts are confident that it does not represent material introduced by subsequent handling.
2. The subject is male.
3. Comparison with the laboratory's extensive database of historical samples from different locations, suggests that the DNA belonged to someone with a Franco-Italian geographical pedigree
4. There is associated evidence of an extremely severe skin disease.

According to Charlier, these factors, taken together, represent a "concordance of objective arguments" in favour of this being the blood of Marat.  The bloodstained paper is genuine; a forgery created before 1837, even a sophisticated one, could not have yielded this result.

More precise analysis of the DNA is impossible due to lack of comparative data - the body of Marat is no longer extant;  the sample is too degraded and the potential for error too great to enable comparison with living relatives.



Marat's Medical Condition

The investigation discovered traces of several pathogens which could have been responsible for Marat's debilitating skin complaint.  The most likely culprit was the fungus Malessezia restricta, which causes the opportunistic skin infection seborrhoeic dermatitis.  Also present were two bacteria, staphylococcus aureus and, in more substantial quantities, cutibacterium acnes, which causes acneThese latter would have created secondary infections which compounded Marat's misery.  There was no evidence of other conditions - syphilis, leprosy, thrush and scabies -  which have been suggested and which may now be ruled out.
According to the National Eczema Society, seborrhoeic dermatitis is form of eczema, which primarily affects the face, scalp and chest, where there are large numbers of grease-producing sebaceous glands.  It is an inflammatory reaction to species of Malassezia yeasts, which are present on normal skin, but  can trigger symptoms in susceptible individuals.  The condition is not contagious or related to diet, but can be aggravated by illness, psychological stress, fatigue and general poor health.  It presents as red inflamed areas of skin with greasy-looking white or yellow scale, particularly on exposed areas.  These can be itchy and, in extreme cases (and Marat's was certainly that) sore.




Ho


How does this square with existing medical opinion?

There  has been a lot written about Marat's skin condition, much of it in subscription-only medical journals.  One of the few accessible article (Lipman & Lipman, 1958) does indeed come down in favour of  seborrhoeic dermatitis.  More recent experts have favoured a  rarer condition, dermatitis herpetica, but everyone agrees that diagnosis remains speculative.

The historical record offers some confirmation for the new findings, though I think seborrhoeic dermatitis, even compounded by bacterial infections, may not be the whole story :


1. The origins of Marat's illness

 The date for the onset of Marat's illness is not certain. 1788 or 1790 is usually stated.  It is clear that he suffered poor health from an earlier date. In the 1770s he found himself in a state of debilitating exhaustion;  in 1782 he wrote to Brissot that he has been laid low by "a long and cruel illness", the nature of which is not specified; constant relapses made it difficulty for him to work.

 However, Marat later specified that in the Revolutionary years he suffered a new "inflammatory malady" which he traced to his time hiding from the authorities in cellars and  sewers, that is in 1790 and 1791. This claim has to be approached with caution,  since the patriotic sacrifice of his health soon became a component in Marat's self-dramatisation as Friend of the People.  However, crisis in his health are clearly documented: 

In 1791, a fortnight after the flight of the king, Marat was obliged to take to his bed.  A second, more severe bout of illness occurred immediately prior to his assassination, in June-July 1793.

At the INHA conference Philippe Charlier was asked whether Marat could really have contracted seborrhoeic dermatitis in the sewers.  He replied that so severe a case was likely to have been more longstanding in origin.  Seborrhoeic dermatitis is also not particularly associated with unhygienic conditions.   Perhaps Marat suffered an unusually severe "flare-up" of a chronic condition?  According to Charlier the associated bacterial infection may well have originated in the sewers, and perhaps resulted in more acute symptoms.

Marat by Jean Garneray, Musée Lambinet


2. Pattern and Nature of his Skin Complaint

The presentation of Marat's skin complaint is broadly consistent with seborrhoeic dermatitis, which affects the greasy areas of the body, such as genital folds, the chest and face.  The primary symptom is inflammation and itching, rather than a rash or visible sores. 

The physician Joseph Souberbielle informed Augustin Cabanès that Marat had been tormented by an incessant itching which had begun in the genital region, indeed that the Friend of the People was "being devoured by a horrible impetiginous affection of the perineo-scrotal region" (Marat inconnu, p.178; Secret Cabinet, p.149).  Other witnesses talk about an inflammation which  particularly afflicted his left side. 
 
Marat's face was also badly affected. (For this reason  Cabanès discounted "scabies" which does not normally affect the face; he diagnosed quite accurately, a form of eczema. Secret Cabinet, p.149).   At one point during his period of hiding, he was afflicted with swollen eyelids (blepharitis), which he blamed on a poorly ventilated oil stove; this is common in seborrhoeic dermatitis sufferers.  In 1791 it was reported that his whole head was swollen.

Souberbielle described Marat's condition as a "dartre". This is a vague term, but implies a dry scaly skin condition, such as herpes or ezcema.

On the other hand, there are no explicit references to spots, acne, rashes or unsightly sores in descriptions of Marat, even by his enemies.  Portraits, like the one by Jean Garneray in the Lambinet, show a complexion which is free from obvious blemish, though it is easy to imagine that this might be a man prone to eczema.   Fabre d'Eglantine in his funeral eulogy described Marat tellingly as having the "thick complexion and withered skin" of a typical eczema sufferer.

In Marat's final months, however, the swelling, inflammation and blotching of his skin clearly became visible and disfiguring.  Marat was suspected, with some malice, of suffering from leprosy.  Chabot testified to the aversion felt by his colleagues in the Assembly who would move away and shrink from his touch. (reference?).  The artist David, who was part of a delegation sent from the Jacobins on 12th July 1793 also stated that Marat suffered from a "leprosy".


3. Was his complaint of  nervous origins?

Much ink has been wasted on discussion of whether Marat's violent disposition caused his skin complaint or was merely exacerbated by it.  The most that can be said is that seborrhoeic dermatitis is known to be triggered by psychological stress.  Marat obviously did himself no favours with long hours, sleep deprivation and a predilection for coffee.  


3. Other complications?

Marat's symptoms, particularly in the final crisis, do suggest he may have suffered bouts of illness more acute than just the flare-up of a skin complaint.  He is described in 1791 as "tormented by an appalling migraine and devoured by a burning fever".  In June 1793 he described himself as "burning up inside", his stomach "would support only liquids"; he suffered a chronic thirst which he attempted to sooth by water "mixed with almond paste and clay".  David reported not only that  "leprosy" covered the body of the Friend of the People, but that his blood was burning (Moniteur, session of 15 July).  After the assassination, Marat's blood decomposed so rapidly that it was feared the corpse would disintegrate before it could be displayed.  I don't know what this implies - maybe some sort of blood poisoning or sepsis? Perhaps the result of the bacteria present in his system?  Just how dangerous Marat's condition really was, remains difficult to assess  (see below).


4. Treatments

Marat soothed his skin by soaking in a bathtub.  This is consistent with seborrhoeic dermatitis - wet compresses and baths have been standard treatments for eczema.  According to Brissot, during his time as a doctor Marat had developed his own "eau pour dartres".



How ill was Marat?

This is a question worth asking.  It is easy to assume, with Marat's 19th-century biographer Alfred Bourgeart, that Charlotte Corday's knife only hastened his inevitable demise. In contrast Marat's modern political editor Jacques De Cock, thinks he was not so very ill; certainly he was not so sick as to abandon all political action.   

A detailed look at the timing provides some illumination. Marat fell ill in 1793 almost immediately after his triumphal acquittal on 24th  April.  At this time he ceased to provide original copy for his journal and attended the Convention on only two occasions, for the crucial accusation of the Girondins.  After their exclusion on 2nd June, he took to his bed and his journal became "a veritable bulletin on the health of Marat" (Bourgeart, Marat,  vol. 2 p. 254) 

 Marat characterised his condition as an "inflammatory malady". If it was painful and necessitated treatment at home, but it did not disrupt his editorial work, his contacts or his correspondence.  His withdrawal from the Convention may have been partly tactical.  Nor was he entirely confined to bed: on 9th June he attended a meeting of the  Bon Conseil section.  Speculation on his state of health oscillated wildly but at the end of June the journal La Quotidienne, gave regular bulletins, mostly signalling his recovery.

 Marat's condition now seems to have entered a crisis.  He was too ill to attend  sessions of the Cordeliers on 20th June and 5th July.  In a letter to Thuriot, president of the Convention, dated 4th July, he threatened to have himself brought to the Assembly in his bed.  Nonetheless he still received visitors.  On 9th July he was with several activists from the Marseille section, when Jacques Roux burst into his lodgings to demand the retraction of Marat's accusations against him.  (So vituperative was his outburst that, following Marat's assassination, he was questioned by the Committee of General Security  as a suspect.)

On 11th-13th July several journals were again speculating that Marat was seriously ill and close to death.  However,  it would seem the danger had passed. On 12th July a deputation from the Jacobins was pleased to find Marat up, working from his bath, as later in the day did Hébert.  Maure reported, perhaps a little optimistically, that the Friend of the People suffered only an "indisposition" not a true sickness.  There was no question that he was about to die of natural causes.



Further projects?

Having taken the analysis of Marat's blood sample as far as possible, Philippe Charlier mentions a couple of other possible projects for the future:

1. Analysis of the residue in Marat's bath in the musée Grévin to establish its authenticity and investigate the remedy that Marat was using.
2. Creation of  an authentic portrait of Marat which takes into account his medical condition (remembering  that horrible virtual Robespierre, I'm not looking forward to this .....).



References

Report:  "Metagenomic analysis of a blood stain from the French revolutionary Jean-Paul Marat (1743-1793)
Toni de-Dios et al. Final version, posted 27.01.2020.
https://doi.org/10.1101/825034

 

 INHA Trésors de Richelieu: "Le Sang de Marat", conference of 17.12.2019  [With Corinne Le  Bitouzé and Philippe Charlier]
https://www.bnf.fr/fr/agenda/les-tresors-de-richelieu-le-sang-de-marat
https://youtu.be/8YJWbvea6ag


Marc Gozlan, "Des biologistes moléculaires font parler le sang du révolutionnaire Marat", Le Monde, 08.11.2019.
https://www.lemonde.fr/blog/realitesbiomedicales/2019/11/08/des-biologistes-moleculaires-font-parler-le-sang-du-revolutionnaire-marat/

Erin Blakemore, "What can 200-year-old DNA tell us about a murdered French revolutionary?" National Geography, 22.11.2019.
https://www.nationalgeographic.co.uk/history-and-civilisation/2019/11/what-can-200-year-old-dna-tell-us-about-murdered-french



General sources on Marat's health

Summary list of articles on Marat - PubMed
https://pubmed.ncbi.nlm.nih.gov/396805/

J. H. Lipman Cohen and E. Lipman Cohen, "Doctor Marat and his skin", . 1958 Oct; 2(4): 281–286.
https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC1034419&blobtype=pdf

Augustin Cabanès, "La maladie de Marat" in Marat inconnu (1891), p.196-206
https://archive.org/details/maratinconnulho00caba/page/196/mode/2up
The Secret Cabinet of History (English translation, 1897), p.147-153.
https://archive.org/details/secretcabinetofh00caba/page/148/mode/2up

Jacques De Cock, Action politique de Marat pendant la Révolution: (1789-1793), 2003. p.442-444: Illness of 1791; p.885-892  :3rd to 13th July 1793.



Readings:

Marat's physical appearance: 

Marat was  45-50 years of age when he died, short of stature, scarcely five feet high ... a firm, thick-set figure, without being stout.... Upon a rather short neck he carried a head of a very pronounced character. He had a large and bony face, aquiline nose, flat and slightly depressed, the under part of the nose prominent; the mouth medium-sized and curled at one corner by a frequent contraction; the lips were thin, the forehead large, the eyes of a yellowish grey colour, spirited, animated, piercing, clear, naturally soft and ever gracious and with a confident look; the eyebrows thin, the complexion thick and skin withered, chin unshaven, hair brown and neglected
Fabre d'Églantine, Portrait de Marat, (1793), p.6-7.


Marat's period in hiding:

Most often he hid in cellars to avoid the domiciliary visits authorised by the virtuous Bailly.  There, working all day by the little small amount of light which penetrated the basement window, his eyelids became inflamed;  he almost lost his sight; the infected odour of oil from a lamp almost continually alight; lack of air; humidity; privations of all sorts; the fatigue of endless work, almost continuous insomnia, moral anxieties, so many burdens imposed on a man whose health was already fragile, of nervous temperament, gave him a dartre from which he suffered unheard of torments; which grew worse and worse each day, and  invaded his whole body, and finally made him repulsive to look at, which led to great sufferings, and resulted in outrages.  One can read what Roland said about him, in the ministerial council surrounded by his platonic admirers.  The Counter-Revolutionaries took pleasure in the rumours, often exaggerated, of the terrible state of health of their common enemy; they congratulated themselves on their murderous triumph:  "If we cannot finish him off, they said, then death will".
 Alfred Bougeart Marat, ami du peuple, 1865. Vol. 1, p.287
https://books.google.co.uk/books?id=425UxvKEke4C&pg=PA287#v=onepage&q&f=false

Marat could find no hiding place; he looked underground, and took refuge in the quarries of Montmartre...More wretched than Diogenes in his barrel, he was deprived of light.  Often, in those humid places, he had nowhere to lie down to sleep. Racked by extreme poverty, he covered his body with a simple blue coat, and his head with a handkerchief - a handkerchief which alas was almost always soaked in vinegar in order to calm the fever of his brain, which could not bear the torpore of the friends of liberty.  , A writing box in his hand, a few sheets of paper, on his knees, which were were his only table....
Guiraut, Oraison funèbre de Marat, p.7


Illness of July 1791

Letter of Blondel, citizen of the section of Mauconseil
Arrogant men who claim that the Fatherland is not a passion...would soon change their tune if they were at the bedside of the Friend of the People;  if they could see him on his bed of pain. He is tormented by an appalling migraine and devoured by a burning fever; his head is swollen up and his whole left side is inflamed. Vesicatories [ie.heated plasters - a form of treatment?] cover his thighs, and he has been unable to change position for days.  His only complaint is the damage to his vigilance over public safety; in his dreams he talks only of affairs of state; he profits from the slightest respite to dictate to a friend articles for his paper.
L'Orateur du peuple, July 1791. Quoted, De Cock, p.443.  Marat remained discreet about this episode; the worst of the crisis seems to have been on the 8th to 9th July.  On the 9th he describes himself as "tormented by a violent migraine"  For 9th the Orateur du peuple carried a speech by Robespierre and on the 10th it did not appear. On 11th July, Marat  reported that he had risen from his"bed of pain".



Marat's last illness

We believe that he was mortally sick, for his blood was boiling, his body was covered with scabs ("dartres") as a result of this internal inflammation; he was literally devoured by fever. To relieve his burning head, he covered it with vinegar water compresses; his stomach would only take liquids, and to muster strength, to gain a day, to write one more page, he drank strong coffee, so adding to the inextinguishable fire that invaded all his organs.
Bourgeart, Marat, vol. 2, p.259


Comments by Marat: 
I was only able to attend the sessions of the Convention on two days;  an inflammatory illness, the result of the torments to which I have exposed myself ceaselessly for four year in defence of the cause of liberty, has afflicted me for five months and confines me at  present to my bed. 
Marat in Le publiciste de la République, June 1793, quoted by Bourgeart, vol. 1 p.258-9. 

Perhaps they come to see the dictator Marat, but they find a poor devil in his bed, who would give all the honours of the world for a few days health; yet he is still a hundred times more occupied by the troubles of the people than by his own illness.  Marat, quoted in De Cock, p.887


Report by Maure to the Jacobins, on behalf of the deputation of 12th July.
We have just visited, on your behalf, our brother Marat; we found him in the bath, a table, an inkwell, papers, books beside him, busy as usual with public affairs.

It is not an illness, it is an indisposition that never affects his limbs on the right side; there is a huge amount of patriotism compressed inside that little body.  The efforts that he makes on its behalf are killing him.
Journal de la Montagne, 15th July 1793. Reproduced  De Cock, p.891

Testimony of Hébert
Yesterday I spoke for the first time with Marat.  I saw him in the bath, weighed down by a grave illness.  Exhausted by sickness, Marat was working for the people;  he was putting in order authentic proofs of a conspiracy which had been denounced to him, and it was probably this work that cost him his life.  Reproduced De Cock, p.892

Testimony of David
I found him in a striking position.  He had by him a block of wood, on which he had placed paper and ink, and with his right hand out of the bath, he was writing his latest thoughts for the safety of the People.. Yesterday the surgeon who embalmed his body,  asked how it should be arranged for public viewing in the church of the Cordeliers.  No part of his body can be uncovered; for he had a leprosy, and his blood was totally inflamed; but I thought it interesting to present him in the attitude with which I found him, writing for the happiness of the people.   Reproduced De Cock, p.891