title: The Death of Balzac (1799-1850) and the Treatment of Heart Failure During the Nineteenth Century.
abstract: Overweight, workaholic, and a caffeine abuser, Honoré de Balzac lived a life of excess. He prematurely died at the age of 51 owing to gangrene associated with congestive heart failure. Textual sources allow us to take a glimpse into his last 3 months of life. Because of ventricular hypertrophy, Balzac's respiratory conditions were appalling and he developed severe leg edemas and possibly stasis dermatitis. Here we report on Balzac's demise and provide first evidence of a pioneering medical treatment applied to save his life: the use of a trocar to drain leg edema. Based on the empirical observation of the benefits derived from an accidental leg drainage, Balzac's physicians anticipated the invention of the "Southey tube", whose use evolved in the following century to treat obstinate edema in heart failure patients. Unfortunately, following the daily maneuvers for trocar insertion and in the absence of adequate disinfection measures and antibiotics, bacteria infected the open wound and gave rise to the gangrene, which caused the writer to die within 24 hours of its onset.
authors.affiliation: Department of Medicine, "San Giovanni di Dio" Hospital, Gorizia, Italy. Electronic address: antonioperciaccante@libero.it.
authors.forename: A
authors.initials: A
authors.lastname: Perciaccante
authors.affiliation: School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Riva
authors.affiliation: Department of Surgery, "San Giovanni Decollato-Andosilla" Hospital, Civita Castellana, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Coralli
authors.affiliation: Section of Medical and Forensic Anthropology (UVSQ & Paris 5 University EA 4569), Montigny-Le-Bretonneux, France; Centre d'Accueil et de Soins Hospitaliers (CASH) and Institut de la Précarité et de l'Exclusion Sociale (IPES), Nanterre, France.
authors.forename: P
authors.initials: P
authors.lastname: Charlier
authors.affiliation: Department of Public Health and Pediatric Sciences, Legal Medicine Section, University of Turin, Turin, Italy; Unité Mixte de Recherche (UMR) 7268, Laboratoire d'Anthropologie bio-culturelle, Droit, Etique & Santé (Adés), Faculté de Médecine de Marseille, Marseille, France.
authors.forename: R
authors.initials: R
authors.lastname: Bianucci
mesh_terms: D005197:Famous Persons; D005602:France; D006333:Heart Failure / Q000175:diagnosis* / Q000628:therapy*; D049671:History, 18th Century; D049672:History, 19th Century; D006801:Humans; D008297:Male; D061213:Mortality, Premature / Q000266:history*
keywords: 19th century France; Heart failure; septicemia; trocar