The baldness of King Richard
Where is House when you need him? And what the heck is Arnaldia?
After this, both of the kings were attacked with a malady known by the name of “Arnaldia,” in which they were nearly reduced to the point of death, and lost all their hair.
— Roger of Hoveden, writing around A.D. 1192
Welcome to new subscribers to this Substack, which is about the world of Richard the Lionheart specifically, and the medieval world more broadly. Our last episode covered siege tactics, with a particular focus on the (first) siege of Acre (1189-1191), which I am studying at present.
Disease was an ever-present risk for Crusaders. More Crusaders died from disease than from battle. The overall death rate while on Crusade was astronomical. A noted Crusade expert, Dr. Christopher Tyerman, estimates the death rate at 30% for nobles and much higher, perhaps 70%, for the common soldier.1
Disease was often used as a weapon, by the way. From catapulting diseased or dead animals or humans, to contaminating water supplies (not to mention scorpion bombs, Greek Fire, and other non-traditional weapons), there were many ways to kill enemies without hitting them with a weapon.
The situation at Acre was particularly dire. The Crusaders had been there for close to two years, blockaded on one side by the citadel of Acre which they were besieging, and behind them by the forces of Saladin, so supplies were scarce. Men ate their horses; foot soldiers were said to have eaten grass or gnawed the rotting bones of dogs. Food prices were incomprehensible - a week’s pay for one egg, and so on. The ditches before the city walls were constantly re-filled with new corpses, and the nearby river ran red with blood. The stench of bodies brought flies, and the camp must have smelled incomprehensibly bad. With the malnutrition came all manner of disease. Then came the bad weather. From Ambroise’s History of the Holy War (Ambroise was a poet at the siege):
Then a disease ran through the army - wait while I tell you about it - it was the result of rains that poured down such as have never been before, so that the whole army was half- drowned. Everyone coughed and sounded hoarse; their legs and faces swelled up. On one day there were a thousand [men on] biers; they had such swelling in their faces that the teeth fell from their mouths.
—History of the Holy War, Ambroise, Marianne Ailes (translator)
Here we see scurvy, the scourge of the British Navy, making an appearance in 1191. The flies and poor hygiene brought dysentery, perhaps malaria as well.2
Within a week at arriving in Acre, both Richard and King Philip of France fell ill. In addition to losing their hair, their fingernails fell out and fever struck them both. The peculiar nature of their symptoms has long puzzled researchers, with many proposed diagnoses.
Where is House, TV’s consummate fictional diagnostician, when you need him?
At the time, the affliction was named ‘arnaldia’ (Roger of Hoveden’s Latin term) or ‘leonardie’ (Ambroise’s French term). The latter word seems intriguingly like ‘leonine’, which is evocative of Richard’s epithet ‘lion-heart’, but this is probably a false cognate (although, see below).
The definitive biography of Richard, Richard I by John Gillingham, attributes this disease to either scurvy or trench mouth. But these diagnoses are problematic. Richard had just come from Cyprus, and was awash in good food, citrus particularly, for weeks, and was celebrated at his arrival in Acre for all the supplies he brought. He was unlikely to have scurvy at that point, so soon after his arrival. Trench mouth, whose primary symptom is gum swelling, is mostly a mouth disorder and doesn’t really explain the hair loss or fever. Neither diagnosis explains why Philip, who had traveled completely separately from Richard since Sicily, was struck at the same time.
It is interesting to compare the reactions of Richard and Philip to their illness. Richard, impatient but weak, had himself carried to the front, and from a covered area lay on a couch and fired crossbow bolts at the Muslim defenders of Acre, striking some. Philip took the first opportunity after Acre fell to blame his illness and use it as an excuse to return home, much to the chagrin of his men.
Wagner and Mitchell explore a variety of biological and etymological explanations for both the disease itself and the words used to describe it. One possibility they explore was called ‘fox disease’ at the time and is now known as alopecia. It is an immune system reaction, and can either cause or be caused by fevers, although the symptoms don’t seem to align entirely. Mange, caused by burrowing mites on dogs, is another possibility, and according to Wagner & Mitchell the term ‘arnaldia’ was in use as late as 1809 in England to describe sheep mange.3
Philip’s French doctor, who does not mention Richard at all, thought Philip had been poisoned, rather than having an illness (relationships with Richard were, shall we say, strained at that point).
Myths & Microbes suggests ‘trench fever’ (not to be confused with ‘trench mouth’), a disease spread by body lice (sounds about right for a camp disease), but again the symptoms are not a complete match. Lastly, we must consider that this was 800 years ago and the disease or infection they contracted may no longer exist.4 Consider how rapidly Covid came to define our existence only a few years ago, or how rapidly ‘bird flu’ rose and fell as a threat to humans. It is not hard to imagine the disease that hit them simply no longer exists.
Wagner and Mitchell investigate the etymology of the words ‘arnaldia’ and ‘leonardie’ and conclude that the words are rarely used prior to this incident, and were mostly only applied to Richard and Philip at the time, and conclude that perhaps the words are ‘made up’—new words to describe a new illness. To wit:
In a folkloristic approach Gaston Paris, La poésie au moyen âge (Paris, 1885), p. 245, assumed that literary antagonism of the wolf and the fox was anticipated long before in oral tradition. As a jongleur Ambroise might have known stories and tales such as Renard. With that in mind, it is possible that he knew one particular episode, which deals with the "illness of the lion" (written down presumably between 1180 and 1190). This branch is called "Renard médicin" and tells the story of the fox curing the lion, who is ill with fever - according to the poem a fièvre quartaine. One might wonder if Ambroise's leonardie/l'ennaudie could allude to this animal legend of a sick king.5
Of the diagnoses I’ve read, ‘trench fever’ sounds the most likely to me. We’ll probably never know for sure. Interestingly enough, Richard’s heart survived in burial and was analyzed not that long ago. The researchers were able to determine he was not killed by a poison arrow, as the legend goes. But no word on Arnaldia, trench fever, or other infectious disease.
https://legacy.npr.org/programs/wesun/transcripts/2005/feb/050227.tyerman.html
The Illnesses of King Richard and King Philippe on the Third Crusade: An Understanding of arnaldia and leonardie, Thomas Gregor Wagner and Piers D. Mitchell, in Crusaders, Vol 10, Zadar et. al. (editors). https://www.mgh-bibliothek.de/dokumente/b/b072788.pdf
Wagner & Mitchell, op. cit.
https://mythsandmicrobes.com/2017/09/26/king-richards-fingernails-a-disease-of-the-3rd-crusade/
Wagner & Mitchell, op. cit.