The Case of the Doctor Whose Brain Was Stronger Than His Heart

Albert B. Lowenfels, MD


December 07, 2012

The Diagnosis

Hunter's brother-in-law performed the autopsy, which revealed that the heart was small and the coronary arteries were ossified, as were both the internal carotid and the vertebral arteries.

Another possible cause of death was a dissected aortic aneurysm, but the aorta was intact. If the cause had been spontaneous bilateral pneumothorax, severe respiratory symptoms would have been more prominent.

A third possible cause was syphilitic heart disease, which warrants special notice. Venereal disease was prevalent throughout Europe in the 18th century, and Hunter was considered an expert on this disorder. There is evidence from his notes that at age 39 years, in an effort to understand the pathophysiology of syphilis, he injected a person with pus from an infected patient. It is unclear from his records whether the experiment was performed upon himself or another person. The autopsy findings do not suggest syphilitic heart disease, nor was there any evidence of mental deterioration during the 3 remaining decades of his life -- a finding often associated with long-standing untreated syphilis.[1]

Because of the many episodes of chest pain and syncope he sustained during the latter part of his life, Hunter was well aware of the fragility of his health. He has been quoted as saying, "My life is in the hands of any rascal who chooses to annoy and tease me." He died on October 16, 1793, the date on which Marie Antoinette was beheaded.