Calvin’s Illnesses

CALVIN’S ILLNESSES AND THEIR RELATION TO CHRISTIAN VOCATION by Charles L. Cooke, M.D.: FAcp John Calvin suffered from a number of severe medical prob- ably by Emile Doumergue.’ Calvin’s most recent biographer.

Wi1liam J. Bouwsma, presents a man anxiously animated by external much on Calvin’s mind: [Calvin] thought much, not only about weakness and He fatigue, but also about aging, iilness, and death.. that life con- sought to impress his congregation.

sists in growing older…. He followed closely his own bodily decline, a personal momento mori.

“well. it is true,” he observed,'”That I see my body decaying., If any strength remains. it declines from day to day, and I con- template death without having to seek it ten leagues The preceding observation by Calvin of his bodily decay was made quite productive for another ten years unti1 his demise in 1564 at the age of fifty-five.

One gains some sense of the progression of Calvin’s ill- nesses from ‘his portraits, beginning with one done about the time he received his graduate degree and ending with a death-bed One of the earliest portraits depicts a handsome and scene.

distinguished-looking Calvin as a young man in a robe. Similar- ly: portraits thought to have been done about 1536, the year in which he completed the first edition of his Institutes of the Christian Religion, reveal a man of vigor. Turning to portraits of Calvin’s later years, however, we confront a cachectic. emaci- ated individual. As the years advance. Calvin is pictured with a white beard, a significant amount of weight 1oss, and looking bent over and physically decrepit.

Our purpose here is to examine Calvin’s iilnesses from a clinical perspective. Too often we overlook the infiuence of the body and its illnesses upon the mind. We undertake this examina- conviction that some understanding of these problems may help to illumine Calvin’s personality and theological perspective and 41

42 Several sources of information on Calvin’s illnesses have informed our investigation. we know the names of Calvin’s physi- cians.

Dr. Benedict Textor, who practiced in Geneva, was Cal- 1556.

Textor was succeeded by Dr. Philibert Sarrazin, who re- mained Calvin’s physician until Calvin died. Some of Calvin’s comments about these physicians are available. Professionally. they were guite capable: as for religion, they adhered to the evangelical.faith. Unfortunately. their medical records are no Ionger extant. we do haves however. certain of Calvin’s letters well as a letter to a group of consultant physicians in Mont- pelier, France. The Life of Calvin by Calvin’s contemporary biographer, Theodore Beza, also gives us a good deal of medicai information relating to the reformer.

One may wonder whether reliable diagnosis of Calvin’s ill- nesses is possible after the passage of 424 years. Speculation about medicai diagnoses without the appropriate diagnostic tools. such as a physical examination, X-ray, 1aboratory studies, CAr scans, and similar devices is a hazardous undertaking. Stili, of all the instruments used in medical diagnoses. the carefully taken medical history remains the most important. It is safe to sdy that about 85% of diagnoses wi1l come from medical history. A corollary to this is that if one finishes a careful medical history and yet has no good idea of the patient’s problem, the odds are considerable that the problem will remain a mystery. Here, Calvin himself has helped us immensely. for he wrote about his medical problems with the same superb prose style which characterized all his work. His letter to the Montpelier physi- cians dated February 8, 1564, just over two months before his death, remains the most important evidence he produced in this regard.

Presented here is a new translation of Calvin’s Mont- pelier letter. It is by Mary Beaty, Ph.D. of Davidson College. Calvin’s wurks are Victorian and are heavily sanitized. Like Luther, Calvin was quite blunt and direct. He does not hesitate to describe his hemorrhoids to a duchess. Here Calvin enumerated his problems with a meticulousness that would satisfy any con- temporary hospitai inspection team: When Saracenus, the doctor most concerned with looking after my health, recently brought me the remedies you who had undertaken this task without my knowledge. He replied that, at the request of a colleague of ours who is with you, he had put together a summary of facts which might enable you to give me useful advice. From your since you have been. of your own accord, so anxious to

43 prolong it. If you had been willing to undertake this iabor for someone requesting it of you, even this would have been a service not to be scorned; as it is. because you have taken the initiative, I am all the more in- debted, but I have no method or opportunity of expressing gratitude unless you, in turn, take some spiritual medi- cine from my writings.

Twentyyears ago the outstanding Parisian doctors Acatius: Tagautius, and Gallus showed me the same kind- ness. But at that time the pain of gout was not attack- ing me: and I had no trouble with kidney stones or gravel or with gripings of the bowels or with anal pain, and I was not threatened with a discharge of blood. All these enemies have rushed upon me with a unified attack, troop upon troop, as it were. Just as I was recovering from a quartan fever, an intense, sharp pain seized the calves of my legs and recurred a second and a third time after lessening a little. Finally it turned into a disease of the joints which extends from my feet to my knees. For a long time a sore on my hemorrhoidal veins tortured me: since at that time worms (from which I am free now) were causing me to itch and I had scratched with my nails in When the itching returned, my nails made the my steep.

trouble recur.

The next summer nephritis seized me. I was carried into the countryside on a litter since I could not endure the part of the trip on foot. I had scarcely gone a mile when a weakness of the kidneys forced me to stop. When I tried to urinate. I was surprised that blood came out instead of urine. I went to bed when I got home. Neph- ritis attacked me very sharply, with only moderate relief from remedies. At last a stone was passed, though only after very distressing effort, and’this relieved the trouble. ‘The stone was so large however, that it in- jured the veins, and the flow of blood could only be stopped gy.the injection of a woman’s milk through a syringe.* Since then, I have forced out many stones, and the heavy feeling which presses upon my kidneys shows clearly that there are stili stones there. Nevertheless. of moderate size, are coming out.

The disease in my feet forces me to be inactive, and this takes away any hope of good health. I am even prevented from horseback riding by anal pain. For although no sore is apparent, the veins are so swollen that. because of the constriction, whatever I force out is rather like a chicken’s droppings.

To add to my troubles: my poorly

12 very thickness, block the anus as if with glue. I am 13 often forced to take injections for this. doubling that labor, forcing you not only to give advice but to read my trifles. Farewell, you distinguished men who are taking care of me with sincere attention. May the Lord always guide you with his spirit, sustain you with his goodness, and enrich you more and more with his gifts.

Based on this letter and the other sources mentioned above, there can be little guestion that Calvin suffered from chronic topha- ceous gout. Indeed, as the above quotation shows, he calls the disease by name. In Calvin’s day gout was a term used for any form of arthritis. It was not until the twentieth century that the numerous forms of arthritis were distinctly separated in medical literature. I Nevertheless, Calvin describes attacks of the disease in enough detail to render diagnosis certain. The pain began in the feet, coming quite intermittently and spreading to other joints. Consider the following remarks to Theodore Beza: 0ctober 7 1561: My joint pain is not pleasant. I still have not had much rest, because for two days I suffered from intense pain in my right foot. It got better the day before yester- day,, butinot to the point of no 1onger’keeping my foot cradled.

Or consider this comment over a year later: God keeps me bound by my feet. The acute pains have ceased, but it is difficuit for me to creep from the bed to the table. loday I preached. But I had to be carried 15 to the church.

of the problems which Caivin faced. Gout is a disease of purine metabolism, and the key to understanding the disease is a sub stance called uric acid, which is a natural product of the body. It is dissolved in body fluidsa including blood and urine, and as long as it remains dissolved in solution, it causes few problems ——— if any at all. When uric acid comes out of solution and forms crystals: however, trouble soon sets in. These crystals have the ability to produce an intense inflammatory reaction. Monosodium urate crystals can be seen under a polarizing microscope and are indeed quite beautiful. It is difficuit to imagine that anything formed within a joint, the pain is exquisite, and the joint be- comes swollen and fiery red. Typically these attacks start in and are so characteristic that they have a particular name: “podagra.”

Attacks begin quite abruptly. The initial attacks

45 subside, but as the disease continues, more joints are involved and destroyed. Advanced untreated gout is called chronic topha- appear in many locations on the body, including the ears, bursae: and joints. ‘In the advanced stage, these have a grotesque ap- pearance and often open and drain monosodium urate crystals. which closely resemble chalk dust. They are not only grotesque in appearance but can be painful. Monosodium urate does not just 1inger in or around the joint but actually has the ability to erode the joint tissues and to destroy them completely. To make matters worse, in Calvin’s time and in our own time, the diag- nosis of gout carried with it something of a stigma in some circles. It was once thought that gout was the result of too tures of the rich man indulging in all these vices while at the same time suffering the pangs of an attack of gout are all too familiar.

Uric acid is excreted mostly by way of the kidneys, and if crystals form in the urine, they are capable of producing kidney stones. This was unquestionably the cause of the multiple kidney stones about which Calvin writes. Indeed, one of his contempo- raries said of him that he formed so many stones his body was a quarry. Passage of these kidney stones, which Calvin describes quite vividly, is even more painful than an acute attack of gout. At present. I am relieved from very acute suffering: hav- ing been delivered of a Lstonel about the size of the kernel of a filbert. As the retention of urine was very painful to me, by the advice of my physician, I got upon horseback that the jolting might assist me in discharging the Lstonel. On my return home I was surprised to find that I emitted discoloured blood instead of urine. The bladder into the urethra. Hence still more excruciating tortures. For more than half an hour I endeavoured to disengage myself from it by a violent agitation of my whole body. I gained nothing by that, but obtained a sight relief by fomentations with warm water. l Mean whiie, the urinary canal was so much lacerated that 16 since I am delivered from these pains.

Calvin also had chronic pulmonary tuberculosis. Tubercu- losis can involve many areas of’ the body, but most commonly the lungs. It often starts with infection of the pleura or covering of the lungs by the causative organism, mycobacterium tubercu- losis. At this stage it produces severe and prolonged pleurisy or pain with breathing. Most people with tuberculosis experience fever and drenching sweats. Finallys when the disease is quite

46 bleeding which leads to expectoration of blood. The disease causes severe weight loss or emaciation. In fact, another name for it in the past was consumption. The body was consumed by the disease. Even in the twentieth century tuberculosis also carries with it a stigma. As evidence for this condition, Calvin gave an excellent description of an episode of pleurisy, sharp cut- ting pain in his chest. aggravated by coughing or breathing. Doumergue relates the incident as. follows: March 14. 1558 Calvinl speaks of a pain in his side which stops him from dictating more than a few ines. and made him almost “useless” for an entire month. Sunday. December 24, 1559, it became more serious. The next day. as he was eating, he was seized with a violent cough and began to cough up a lot of blood. The doctors thought he hemoptysis stopped.

Calvin’s pleurisy had been compounded by what were known in his time as tertiary and,&hen quartan fevers (Calvin first experi- 18 enced these in 1556).

He had severe sweating at night and then developed a much-feared complication of tuberculosis: namely hemoptysis or coughing up blood. The hemoptysis confined him to bed. This phase of his iliness lasted for approximately eight months: according to Beza, although Calvin remained debilitated thenceforth.

As testimony to his indefatigable resolve, Calvin dictated the final and definitive edition of his Institutes of French during the time he was confined to bed with hemoptysis. the printing of his.lessons on the minor prophets. This would have been a tremendous amount of work even for someone in robust health.

Calvin also had intestinal parasites. – There are a number of intestinal parasites which infest the intestine. There visible to the eye without aid of a microscope are worms: such as hookworms, tapeworms, and the 1ike. As was typical, Calvin left little to the,imagination, vividby describing passage of these Intestinai parasites of this parasites in his bowel movements.

nature are usually accompanied by a great deal of blood loss; if cause abdominal pain and some of them cause severe itching around the anus.

detail, and referred to an “ulcer” which held him captive. From his description of the pain involved, it is obvious that some of these became thrombosed or developed blood clots, which can be extremely painful. Today with medications and surgery hemorrhoids really are quite a transient problem. In the six- teenth century: however, hemorrhoids had’one very devastating

47 resuit. The only method of rapid land transportation was on horseback; hence one with severe hemorrhoids could hardly travel. This helps to explain why Calvin spent his latter years in Geneva traveled quite widely. This malady not only deprived Calvin of transportation but also deprived him of a great source of pleasures since he had been quite fond of horseback riding in his younger years.

Calvin also seems to have had what would be diagnosed today as spastic bowel syndrome or irritable colon. Irritable produces cringing abdominal pain and constipation alternating with diarrhea. Stools are mixed with a great deal of mucus. Not only the presence of these symptoms antedating his intestinal parasites and hemorrhoids. but their great duration is typical. Beza tells zs that for at least ten years, Calvin ate oniy one meal a day.

Eating one meal a day would worsen the nutritional status of a man who already had tuberculosis and parasites. Additionally, Calvin gives an excellent clinical descrip- tion of migraine headaches. These bothered him sometimes for days on end, and he found that with fasting for thirty-six hours they would often abate.

The headaches continued for years and therefore could not have been caused by a brain tumor or other similar illnesses. He would never have survived as long as he did with a tumor.

An intractable lifelong case of “workaholism” also seems to have characterized Calvig’s condition. Theodore Beza wrote of Calvin’s boundless energy.

He worked until quite late at night and then arose early in the morning to review his previous day’s work. Calvin had ‘ittle time, says Beza, for things not directly related to his work. while dictating. Calvin could be inter- middle of the sentence where he had left off. As his most recent biographer, william J. Bouwsma, puts it, Calvin was “a driven man, driven by external demands but above all by powerful im- pulses within himself. We might now cal1 him an overachiever; he was never satisfied with his own ‘perfarmance, always contrasting Calvin therefore had multiple medical problems, problems that did not come and go in sequence but rather were additive. To use his own words in the letter to the physicians of Mont- pelier, “At present all of these ailments, as it were, muster in troops against me.

These illnesses have several things in common. All are capable of causing severe pain or severe diffi- culty in breathing. All are capable of producing severe weight loss, anemia, and weakness. Calvin’s single da’ily meal and fast- situation. He was described several years before his death as a

48 skeleton covered by skin. But, as Beza puts it, “a brave spirit was the master of a feeble body.” For’ the last’severai years of his ‘ife: and until eight days before his deaths Calvin continued chair. Calvin’s remark in the dedication to his commentary on Second Thessalonians is more than hyperbole: “my ministry.. is dearer to me than 1ife.”

The immediate cause of his death was probably septicemia, or shock due to bacteria growing in his blood stream. In other times, this was known as ‘”blood poisoning.” Calvin’s gout and many kidney stones could well have caused renal failure or uremia. In his Life.of,rCalvin, Beza records that Calvin died quietly and peacefully.

This is quite consistent with the manner of death in persons dying of septic shock. 11 Our purpose has been to evaluate Calvin’s medical problems from a clinical perspective. Insight into the gravity of his illnesses can only enhance our admiration of Calvin’s achieve- ment. Although it must be left to Calvin specialists to evaluate the historical and theological significance of the foregoing material three 1ines of inguiry can at least be suggested. First, Calvin lived with a vivid awareness of the tenuous- ness of 1ife. Nowhere is this awareness more strikingly recorded than in the Institutes: Hence appears the immeasurable felicity’ of the godly mind. Innumerable are the evils that beset human iife; innumerable, too, the deaths that threaten it. We need not go beyond ourselves: since our body is the receptacle of a thousand diseases——— in fact holds within itself and fosters the causes of diseases——— a man cannot go about unburdened by many forms of his own destruction, and without drawing out a life enveloped, as it were, with death. For what eise would you call it. when he neither freezes nor sweats without danger? Now, wherever you turn. all things around you not only are hardly to be trusted but almost openly menace, and seem to threaten immediate death.

Embark upon a ship, you are one step away from death. Mount a horse, if one foot slips, your life is imperiled. Go through the city streets. you are subject to as many dangers as there are tiles on the roofs. If there is a weapon in your hand or a friend’s harm awaits. All the fierce animals you see are armed for your destruction. But if you try to shut yourself up in a walled gardeng seemingly delightful, there a serpent sometimes lies

49 hidden.

Your house, continually in danger of fire. to collapse upon you. Your field, since it is exposed to hail, frost. drought, and other calamities, threatens you with barrenness, and hence, famine. I pass over poison- ings, ambushes, robberies, open violence, which in part besiege us at home, in part dog us abroad. Amid these tribulations must not man be most miserable, since, but half alive in life, he weakly draws his anxious and languid breathzsas if he had a sword perpetually hanging Doubtless. the contingency of Calvin’s own physical well-being contributed to this sense of life’s frailty. Second, an understanding of Calvin’s illnesses renders all letters. In 1546, in a letter to Monsieur de Falais, who himself had been suffering from protracted iilness Calvin wrote: Aithough your weakness may be protracted, it is much that you go on steadily though by slow degrees, in the way of amendment. And when I’ consider the complaint, I feel that there is sti’l greater reason to be well con- tent. Notwithstanding, we shall not give over praying to God that it would please him to confirm you entirely. brink of the grave. Besides, I hope. from present ap- pearances, that he is minded yet to make use of you in health, since he has employed you in sickness. For al- though laid powerless upon a bed, we are by no means useless to him, if we testify our obedience by resigning ourselves to his good pleasure.——— if we give proof of our faith by resisting temptation.——— if we take advantage of the consolation which he gives us in order to overcome the troubies of the flesh. It is in sickness, especially when prolonged, that patience is most needful; but most of ali in death. Nevertheless, as I have said, I confide in this good God, that after having exercised you by sickness he will stil1 employ your health to some good purpose. Meanwhile, we must’ beseech him that he would uphold us in steadfast courage: never permitting us to fal1 away because of lengthened on-waiting. Calvin’s appeal to “usefulness” in illness is somewhat ironic in view of his own herculean efforts to work in spite of his ail- ments. In 1563, the year before he died. he wrote in a 1etter to us from worldiy affections, and retrench what is superfluous in us, and since they are to us the messengers of death, we ought to learn to haveoone foot raised to take our departure when it shall please God.i28

50 Third. Calvin’s many illnesses may help explain his teach- ing on passivity of the body in relation to the active soul. place in Calvin’s anthropology.

Another scholar Margaret Miles, has spoken of Calvin’s “rather curious ambivalence about the body.”

says Miles, casts the body “in the role of Given the severity of Calvin’s illnesses.

such assessments as these are entirely understandable. John Calvin had a goal, a purpose. and a power which en- abled’ him to-overcome his many physical’impediments. His iil——— nesses were not alleviated, they were not cured, nor were they controlled. Notwithstanding the tremendous drain on his energy, Calvin became one of the most productive and influential thinkers in history. The source of’ Calvin’s strength and power. a strength that enabled him to withstand the ravages of the painful diseases detailed in this paper and a power that enabled him to be productive up to the very last weeks of his ‘ife, remains a source of inspiration to us today.

Acknowledgements Many people helped in the preparation of this paper. Mrs. English. ‘Dr. Mary Beaty translated Calvin’s letter to the physi——— cians of Montpelier from the original Latin. Ms. Lou Bolton, of the McGuire clinic. patiently typed the manuscript, and Dr. Charles Cornwell, Associate Pastor of the the paper with a critical eye.

Finally, this is dedicated to Dr. John Haddon Leith. Pemberton Professor of Theology at Union Theological Seminary in Virginia. Dr. Leith is a Calvin scholar without peer, and a most stimulating classroom teacher. This paper had its genesis in his Calvin seminar at Union Seminary in January, 1987. Notes lEmile Doumergue, La Genevue Calviniste (Lausanne: Geo.

Bridel, 1905). 509-526; “La Maladie Secrete de Calvin” fr0m le Christianisme au xxe siecle 59 (1930), 471-72. trait (New York and Oxford: 0xford University Press,”1988), 30. Emile Doumergue, Iconographie Calvinienne (Lausanne: Geo. Bridel & Co. 1909).

51 Doumergue has conveniently collected much of,the material pertaining to Calvin’s illnesses. Doumergue. La Genevue Calvin- iste. 509-526.

51bid., 511.

(Philadelphia: J. Whetham, 1836). Calvin, ed. Jules Bonnet. trans.j Marcus Robert Gilchrist (Philadelphia: Presbyterian Board of Publication. 1958) 4: 358-60: CR XLVII1, 252-54. parasites or worms. Scratching at the area in his sleep with his fingernails perpetuated the problem. 9.

Here Calvin describes laceration of the bladder and urethra due to passage of a kidney stone. Milk contains blood group antigens and other factors which wil1 clot blood and help stop bleeding. Hence, human milk was injected through the urethra into the bladder. ciating. Who but Calvin could ever be thankfui for the passage of smail ones?

Possibly “bowels” would be a good translation. oped a strictures i.e.: a partial obstruction of the passage of quoted in Doumergue. La Genevue Calviniste: 521. Cradling of the foot refers to the use of a devicetohold the sheets off the painful foot. The pain of acute gout is so severe that even the weight of a sheet on the involved joint is very painful. 15.

Letter to Bu11linger, December 27, 1562, 0c XIX, 602. quoted in Doumergue, La Genevue Calviniste: 522. 16.

Letter to Bul1inger, July 2. 1563, in Letters of John Calvin. 4:321.

52 18.

Ibid.

19 Beza, 71. 20 ‘Doumergue, La Genevue Calviniste, 516. 516. See also Letter to Peter Martyr, March 2, 1559 in which Calvin speaks of “hemorrhoids from which it is not possible to force blood, as they are of that kind which are commonly called b1ind.” Letters of’John ‘Calvin, 4:3l. 22Beza, 78. 25Beza, 93. 26.

Inst.I.17.10. 27 etters of John Calvin, 2:82. 281bid., 4:331. 29 Bouwsma, 80. 30 Margaret R. Miles: “Theology, Anthropology, and the Human Body in Calvin’s Institutes of the Christian Religion,’ Harvard Theol0gica1 Review 74 (1981):303-323, 311, 319.