Robespierre's Illness: a Deep Dive
For the most part, details of Robespierre’s ailments are scarce. I am writing this in order to compile the information that is known, along with other proposed diagnoses and try to make the most sense of his illnesses. A disclaimer before I begin: I am not a medical professional nor do I claim to be one, therefore I am not in a position to diagnose any disorders. However, I hope my discussion of various disorders can help provide a framework to “fill in the gaps” in recorded information and allow a clearer view as to what his illnesses may have been like.
Robespierre seems to have been riddled by numerous bouts of nondescript illness, ranging from weeks to days long, which kept him at home for much of the day. These bouts prevented him from attending meetings with the National Convention, although he still seemed to attend meetings with the Committee of Public Safety and the Jacobin Club during these periods. His weakened state still allowed him to write speeches and remain involved in politics to the best of his ability. It may be very likely that he suffered from multiple issues.
Known Ailments:
“Varicose Ulcer” on his leg, which was dressed each morning by his doctor
Illness lasted for weeks at a time, often coincided with stressful political events
Blood loss
“Nearly every night Robespierre bathed his pillow in blood”
Unhealthy complexion: “bilious,” “green-veined,” “pale,” etc.
A phrase commonly repeated in Thermidorian depictions of Robespierre
Tiredness, Exhaustion, Lack of physical strength, physical collapse
Intense headaches
Unusual body movement
twitching eyes and mouth, clenching fists, stiff gait, moving shoulders left to right
Poor mental health, mental collapse
Anxious tendencies
Intense stress, paranoia, tics
General unhappiness
“For my conscience, I should be the unhappiest man alive”
Popular Diagnoses (and Misdiagnoses)
Several theories about the nature and reason for Robespierre’s illness have appeared over the years, many of which seem rather questionable in nature.
Some suggest symptoms are caused by a variety of dubious causes, ranging from narcissism, homosexuality, infatuation with female sexuality, and constipation. Peter McPhee dismisses these ideas, saying “the likely cause of Robespierre’s increasingly frequent periods of illness is far more important than these unfounded speculations” [1] While I agree that his illnesses’ effects are certainly more crucial to understanding Robespierre as a person, I cannot help but wonder what actually caused these ailments. I understand why no respected historian or scientist may attempt to determine what Robespierre had, as there is simply so little information available. Thankfully, I am neither of these, and will thus attempt what they cannot.
Sarcoidosis (and my argument against it)
The most common claim about Robespierre's illness is that of Sarcoidosis. While this diagnosis does not explain Robespierre’s long absences, I believe it is still beneficial to examine how his symptoms are assessed in this scenario.
Robespierre’s Sarcoidosis diagnosis was popularized by Philippe Charlier, a TV forensic anthropologist who helped create the infamous 3D reconstruction of Robespierre’s face. [3] The reconstruction itself was dubious— it was based on a death mask that many historians doubt was ever Robespierre’s at all (where is the broken jaw?), [8, 10] and portrayed Robespierre in a way that hardly resembled any portraits of him. Could the figure they portrayed really be the man who attracted crowds of women? Based on the questionable nature of the reconstruction, one may suspect a similarly suspicious quality of scientific research to support the reconstructed spectacle.
Firstly, Sarcoidosis is an autoimmune disorder generally marked by tender, red, swollen lumps throughout the body, caused by the body’s immune system attacking itself. [4] While Robespierre was described as having a pockmarked face due to a childhood infection of smallpox, I have no recollection of him ever being described as having inflamed and bulbous patches of skin. Even the researchers proposing this idea have no source to support this idea, as it is not mentioned in their paper. While not every individual with Sarcoidosis experiences every symptom (meaning it is possible Robespierre could have had sarcoidosis while lacking the inflamed patches of skin), these inflamed areas appear in his facial reconstruction.
Despite our subject lacking the defining trait of his supposed disorder, Charlier & Froesch, the anthropologists arguing this idea, state that Robespierre has a number of symptoms of this disorder, including:
Poor eyesight
Nose bleeds (taken from the claim that he “bathes his pillow in blood”)
Jaundice (yellow colored skin and eyes)
Asthenia (continued tiredness)
Recurrent leg ulcers
Frequent facial skin disease associated with scars of a previous smallpox infection
Permanent eye and mouth twitching
I am not a doctor or professional in the medical field, so I will not argue whether these traits adequately represent a person suffering from sarcoidosis.
I will give the researchers credit where credit is due— they also included an exhaustive list of other possible disorders and why they felt Robespierre did or did not fit the description. Their research appears to be thorough, although not without issue. I understand that this study was done retrospectively, and thus is finding the disorder which best matches his symptoms, but I cannot help but feel that this study was created in order to find any disorder to diagnose him with, rather than determine whether he had one to begin with. The study appears to take claims steeped in Thermidorian bias at face-value without understanding the possible distortion behind them.
I personally feel that while many of these symptoms may be inter-related, they can often be explained away through a basic understanding of Robespierre’s lifestyle and habits.
Firstly, I do not think I need to address his poor eyesight being a symptom of anything in particular. We all know that sometimes people just have poor vision.
The authors also claim that Robespierre had nosebleeds based on the claim that he “bathed his pillow in blood each night” — it is important to note the exaggerative language present here (and the negative tone present throughout the larger quote this is a part of). Furthermore, as far as I am aware, this is the only such claim of this kind. While nosebleeds are more common at night (which would explain why there’s no documentation of his nose bleeding in public), usually they are the result of irritation, infection, or allergies. [5] These are often shorter-term maladies, meaning we have no evidence that this continued to ail him past that brief period in time. On the other hand, historian Ruth Scurr states that “perhaps Robespierre had nosebleeds (people with high blood pressure and fiery tempers often do). These certainly would have left him anemic and contributed to the unusual pallor of his skin that many contemporaries noticed.” [9]
Robespierre was also described as having Asthenia (a medical term used to describe weakness and a lack of energy). This description, at least, seems faithful. Robespierre was certainly tired, often returning home after midnight and rising early the next morning, a routine which he would repeat day after day. Robespierre himself even alluded to his own lack of wellbeing, saying “Would to God that my physical powers were equal to my moral powers,” and “my strength and my health are not great enough.” [1]
Next the authors claim Robespierre had jaundice, due to his appearance of “yellow skin and eyes.” While many sources describe Robespierre as having a “pale, bilious complexion” and “green veins,” a select few individuals (including Fréron) did describe his complexion as yellow, but I have yet to find any that directly imply his eyes also being yellow. Yellow scleras (whites of the eyes) are a signature symptom of jaundice, but considering descriptions of Robespierre’s eyes typically are “round” and “green,” I would be surprised if his enemies collectively chose to spare him the embarrassment of vividly yellow eyes. At times, Robespierre has been compared to a cat, and since I cannot access the source the anthropologists cited, I would not be surprised if the original quote was written to make his appearance more cat-like, perhaps exaggerating an element of hazel present in his light eyes.
With regards to his yellow skin, I stand to believe this may have more basis in reality. It is well known that Robespierre was pale, and considering his consistent illness, I would venture to reason this would reference a lack of rosiness in the skin rather than just commenting on his light-colored complexion. Furthermore, considering Robespierre’s well-documented love of oranges, it is also possible that his high consumption of the fruit led to a change in his skin tone. Beta-carotene is the pigment present in oranges that gives them their signature color, and having an excess of beta-carotene in the blood can lead to carotenemia, a yellow tint in the skin. Carotenemia is harmless, but is often misdiagnosed as jaundice. [6] This tint can be subtle and fluctuates directly as a result of the amount of beta-carotene consumed, meaning it may have been especially obvious at some points and less at others. If it was present at all, it may have been just noticeable enough to draw a few negative comments, but otherwise subtle enough to fly under the radar.
Then, Robespierre’s recurrent leg ulcers are addressed. Venous ulcers (often caused by varicose veins) are caused by poor circulation of blood in the legs. Instead of being properly pumped back to the heart, the blood pools in the legs, causing skin damage and thus, the open wound. [2] These are well-documented as an issue of his, so I am not arguing their assessment.
The authors then claim that Robespierre had a “frequent facial skin disease associated with scars of a previous smallpox infection.” Regrettably, this is also from the same source I was unable to access. Robespierre’s smallpox scars and subsequent pockmarks are well documented, but I cannot speak to any knowledge of a “frequent facial skin disease.” I suppose this is what aligns most with the red, irritated patches signature to Sarcoidosis, and perhaps matches some additional markings found on the death mask. However, I have no sources I have personally read that even reference any other disfigurements or issues with his skin like what is described, so I will just leave this here.
Finally, the authors cite his eye and mouth twitching. These are also well documented, however, I personally find it easier to believe these to be the results of tics. Basic examples of common simple motor tics include eye blinking, facial grimacing, and shrugging/jerking of the shoulders, [7] all of which are symptoms Robespierre exhibited, although the latter is not addressed in the paper. Tics are also more likely to occur in individuals with anxiety disorders. Knowing Robespierre’s anxious tendencies, I do not think it is a stretch to think that these traits may have made him more prone to these behaviours.
It is also important to note that McPhee’s work was a key citation on the facial reconstruction & sarcoidosis diagnosis project. Since its publication, McPhee has spoken out against the misleading information, and how the researchers neglected to assess the reliability of the sources they cited, among other things. [8, 10]
My Thoughts on the Matter
Now that I have established some of my thoughts on Robespierre’s key symptoms (and established a case against the diagnosis of Sarcoidosis), I hope I will be able to weave them together to create a better picture of what his illness may have entailed.
Psychosomatic Nature
This is established well in McPhee’s article [1] that details the ways in which external stressors in his political life typically correlate with his bouts of illness. While McPhee does not venture to give these tendencies a label, they seem to be a prime example of a psychosomatic disorder, where mental stress can create— or worsen— physical illness. Other historians, including Ruth Scurr, have openly labeled Robespierre's variety of illness as psychosomatic. [9] Robespierre certainly experienced an inordinate amount of stress, anxiety, and paranoia, so it makes sense that his health was greatly impacted by this.
Physical Collapse
For the most part, the best description I can find of Robespierre’s long-term periods of illness is that they were caused or accompanied by physical, and sometimes mental collapse. [1, 9] This term seems rather vague; at a surface level, it would suggest Robespierre literally collapsed to the ground and lost all his strength. However, there are no records suggesting him falling or fainting in public that I can recall. Although, these literal collapses may have happened out of the public eye. Or, it could simply mean he lost much of his physical strength (in a less sudden way) and felt physically incapable of his usual long hours of work.
However, after a reassessment of his other known symptoms, I think it seems fair to suggest that Robespierre may have literally been losing consciousness and fainting.
Certain individuals are more prone to fainting in general, but certain habits can accentuate likelihood of fainting. These include (but are not limited to) not eating and drinking enough, lack of sleep, illness, migraines, and anemia, to name a few.
Knowing that his ulcer was indicative of poor blood flow in his legs, I would not be surprised if Robespierre had poor blood flow in general. When one sits or stands up, the body must adjust its blood pressure and pump more blood from lower regions like the legs to the head. Because of this, individuals with poor circulation (especially those with POTS or similar syndromes) are more prone to lightheadedness and in extreme cases, loss of vision, passing out, etc.
Robespierre was also known to eat abstemiously, and seemed to have little variety in his diet, including a potential lack of protein due to his distaste for eating meat. Furthermore, he consistently was low on sleep. As mentioned before, his anxious nature likely lowered his immune system and made him more prone to succumbing to viral infections and colds. He was also documented as complaining of violent headaches, and wrapping his head in a tight handkerchief in order to ease the pain. Ruth Scurr also speculated that Robespierre’s intense nosebleeds may have caused enough blood loss to leave him anemic. [9] All of these factors increase the body’s likelihood to fainting, which is often accompanied by physical weakness, and brain fog.
I expect these bouts of illnesses may have been marked by a collapse at the beginning and sustained physical weakness throughout the weeks, perhaps accompanied by other fainting spells. Physical collapse, if it is assumed to be fainting (syncopy), does not usually create adverse effects for more than a few hours: as soon as one recovers, they generally return to normal. However, I suspect Robespierre’s many issues interacted and worsened each other in positive feedback loops: his stress (combined with the symptoms listed above) likely induced fainting, which then created additional stress by being unable to leave his home as much to engage in politics. Perhaps he felt faint, dazed, nauseous, or in pain (especially if he did truly have migraines). In addition, his mind may not have been very clear, especially if he continued his habits of minimalistic eating during these periods.
Evidently he was not entirely bedbound, as he was still able to go out for shorter periods of the day (rather than the 12+ hours he would often work when healthy). Weakness doesn’t always keep you in bed or at home, but oftentimes it’s wise to remain there if overexertion could lead to greater problems. In Robespierre’s case, this could mean an increase in all his symptoms, and thus a greater inability to work. Furthermore, if he was still physically vulnerable, the last thing he would want would be to place himself in a situation in which he could lose consciousness publicly. Physical harm of collapse aside, being so vulnerable in a public place would not only be dangerous to him, but even more damaging to his reputation.
These symptoms would naturally add to Robespierre’s state of mental collapse. As stated previously, these collapses typically happened after making extremely stressful and difficult decisions. Now, add the stress of being unable to properly exert his influence in the convention and the loss of control he must have felt over his own country as well as his own health. He was fed news and updates by those closest to him, who selected the most relevant (and seemingly, the most stressful) news for him to hear. He also worked and existed alone for much of the day, allowing him to mull over the news and his own ideas in his personal echo chamber, making exaggeration of ideas and fears very easy.
In short, I hope this has provided an insightful look into what Robespierre’s bouts of illness may have entailed. I am still learning a lot myself, so if you have any information to add to (or contradict from) my claims, please let me know. I would be happy to hear any arguments for or against my proposals, as I want to ensure that myself (and others) understand this topic as fully as possible.
Sources
My Strength and My Health are not Great Enough: Political Crises and Medical Crises in the Life of Maximilien Robespierre, Peter McPhee
Venous Ulcer, Cleveland Clinic
Charlier & Froesch
Sarcoidosis, NHS
Nose Bleeds at Night, Healthline
Carotenemia, MedScape
Tics, Cleveland Clinic
McPhee & the Reconstruction Debacle, The Guardian
Robespierre: Fatal Purity, Ruth Scurr
McPhee’s & Faure’s responses to Charlier & Fresh, The Lancet
The Debate on Robespierre’s health - not truly a source, but a great blog post unpacking the issues with the Sarcoidosis diagnosis
