Arthur Tudor died at the young age of 15 on 2 April 1502 at Ludlow Castle, on what was considered the Welsh boarder at the time. It is springtime here in south Wales, and hills are covered with wildflowers and fields full of woolly little lambs. It seems exceptionally sad that Arthur died at this time of year, when he was a newlywed and also just entering the spring of his life.
Adding to the tragedy of his death is that no one is sure exactly why he died. A contemporary source records that Arthur’s ailment was “the most pitiful disease and sickness, that with so sore and great violence had battled and driven, in the singular parts of him inward, [so] that cruel and fervent enemy of nature, the deadly corruption, did utterly vanquish” the teenage prince. The onslaught of the illness that killed him began on 27 March, and final breath Arthur took was less than a week later. What could have killed him in such a short space of time?
There has long been speculation that the newlywed prince died of the sweating sickness, but the course of the sweating sickness – whether to resumed health or to the grave – went much faster. The illness usually over, one way or another, in 24 hours. Since it took Arthur almost a week to succumb, it was either an oddly long time for the sweating sickness to progress or it wasn’t sweating sickness at all.
While either Influenza and/or pneumonia could have certainly killed Arthur in a week’s time, Tudor physicians would have known and named either condition as the cause of death. However, they didn’t think the prince had either of these conditions. Nor were the doctors convinced it was consumption, or what now commonly called tuberculosis. Just as the prince’s death was too slow to have been caused by the sweating sickness, it was too fast to have been TB. Any of his physicians would have noticed that Arthur was consumptive in the months, or years, leading up to his death.
Testicular cancer has also been suggested as a reasonable explanation for Arthur’s rapid decline, but the odds are good that one of his physicians would have noticed and tried to treat a tumorous mass on Arthur’s scrotum – especially if the prince’s health was failing. Medieval physicians were aware of cancer and its progression, could have doubtlessly identified the smell that comes with end stage cancer, an unbearably fetid odour of sweetness and rot. Like influenza or pneumonia, Arthur’s doctors could have named the disease for what it was, even though they were helpless to treat it or stop it’s progression.
I think Arthur’s fatal illness might have been genetic. I think that Arthur, along with his nephews King Edward VI and Henry Fitzroy, might have had atypical cystic fibrosis.
God knows that genetic conditions could flourish in a closed breeding population like the nobility. As many as 1/25 people of Northern European decent are carrying the recessive gene for CF, so it wouldn’t be very far-fetched for cousins Henry VII and Elizabeth of York to both have the gene. Neither it is beyond belief that both Henry Fitzroy’s mother, Bessie Blount, and King Edward VI’s mother, Jane Seymour, (who were both descendants of minor Plantagenet houses) to have had the recessive genes as well.
Atypical CF usually doesn’t cause any major health problems for the patient until later in childhood or until the patient is in his or her teens. Atypical CF would explain why some eyewitnesses reported Arthur as being healthy while other described him as seemingly ‘delicate’; his perceived health would depend on whether his atypical CF was causing him issues at the time and whether or not you were aware of his chronic cough and/or indigestion. However, his lungs would have been internally weakening until a cold or flu virus caused one final, fatal round of bronchitis.
Moreover, bronchitis complicated by atypical CF can look a hell of a lot like tuberculosis to the untrained eye — except the patient goes suddenly downhill must faster than usual. A Spanish physician in Katherina of Aragon’s household reportedly diagnosed the prince with “tisis, a Spanish catchall word covering everything from pulmonary tuberculosis to any wasting, feverish disease the produced ulceration of some bodily organ” (Tremlett, 2010:91). Atypical CF would explain why the prince started manifesting seriously consumptive-like symptoms a few weeks prior to his death, while his English physicians had thought him healthy enough to head for Wales.
Atypical CF can also involve copious amounts of malodorous sweat, which may explain why they thought Arthur might have had some weird form of the sweating sickness, one which seemed to have elements of consumption with it. The physicians would have been mystified by his not-quite-right symptoms of multiple diseases, and would have had no way of knowing what was killing him any more than they had any way to save him.
Decades later, both of Arthur’s nephews by King Henry VIII would also die in their early teens from a consumption-like disease that wasn’t actually consumption. The genetic expression of atypical CF would explain the commonalities of their tragic deaths.