The Emperor in Pain: Part Two

I wrote earlier about the physical pain suffered by John VIII. This entry is going to be about John's salad and why his brother Theodoros wouldn't go to bed with his wife. 

Look at this picture of John's right ear, made in Florence 1439, when we know he was in severe pain:

I didn't see it at first, but Dr. Tom Morgan, with whom I was consulting about the reported incidences of gout among the Palaiologoi,wrote me about the earlobe:  "Several people to whom I have shown the images believe that there is a round swelling in the posterior, lower earlobe. What this may be is a gouty tophus, that is, a collection of uric acid crystals with surrounding inflamed, swollen tissue."    

Dr. Morgan summarizes gout this way: "Gout is due to abnormal production of uric acid from the diet and thus to increased amounts of uric acid in the bloodstream. The uric acid forms needle-like crystals especially in the joints and kidneys.  When the needles occur in the joints - especially in the great toe [podagra] - pain, often severe, and swelling occurs. The slightest movement induces severe pain; not only in the feet but also in the hands, wrists and elbows. The pain is episodic and debilitating and may be accompanied by fever and malaise. Ingestion of meat (especially kidney, brain, pancreas) and alcohol leads to high levels of uric acid and precipitates attacks."  

The same feature can be seen on the earlobe of the bust Pisanello made of John the same year, 1439. John was diagnosed by contemporaries as having gout, as was his uncle Theodoros I of Mistra, and his younger brother Andronikos who died of it in his twenties. 

On July 27 of that year, John -- with quite a large entourage -- was returning to Florence from a religious pilgrimage, which is shown on the reverse of the medal Pisanello also designed.  They stopped in Pistoia and asked Giovanni di Pigli for a place where John could rest and get something to eat.  Giovanni wrote down what happened that day, commenting that John had difficulty walking:

"And note, the first food the Emperor ate was a salad of purslain and parsley, with some onions, which he himself wished to clean. After that there were chickens and pigeons . . . As the dishes came, they were all placed before him, and he took what he wanted, and sent them along to the others. His last dish was eggs thrown on hot bricks where the other things were cooked."  

You may be asking just what the salad and the gout report of 1439 have to do with Theodoros' private life which centers on 1421.  John's earliest reported episode of gout was in 1432 so he can be discounted for a while. Recall that Theodoros was sent to Mistra in 1407 at the age of 10.  His uncle Theodoros I, Despot of Mistra, was dying in extreme pain from gout so the child was able to watch the sores, the smells, the excruciating pain, and know that this is what happened to people in his family. His brother, Andronikos, despot of Thessalonike, suffered extremely from gout.   Andronikos had a son, although we don't know how old he was when that happened, but in 1421 he was 21 years old.  [Late correction:  Andronikos actually didn't have gout.  Read this.]

In 1415, their father Manuel had visited Andronikos in Thessalonike, and then Theodoros in Mistra.  Traveling with him was the doctor Demetrios Papagomenos, a specialist in gout, and respected enough that his treatise on gout -- written at Manuel's request -- was continually printed, first in Greek and Latin in Venice in 1517, and then steadily afterwards in various translations for the next 250 years.  Manuel left Pepagomenos in Mistra to be court physician for Theodoros.

We can be absolutely positive that two of the books Theodoros owned and read thoroughly were Pepagomenos on gout, and his father on marriage. The combination would have been anything but encouraging to a young man. This is where the salad and Theodoros' marriage come together.

Pepagomenos' treatise on gout is about prevention and probable cure.   Cure consisted of planned vomiting, purging, and bleeding -- getting the bad humors out of the body.  Prevention consisted of a light diet, with a lot of green leafy vegetables and avoidance of meat and wine.  Eggs were fine.  (See what John was eating above.) And avoidance of excess sexual activity because -- I love this -- the motion required in sexual activity shook up the little particles in the body and precipitated them into the legs and joints.  Pepagomenos didn't specify what excess might mean, but he himself was married and had two adult sons, so the average intuitive person might have drawn reasonable conclusions from that.

But Theodoros, on the other hand, who was raised by clerics and intellectuals in an all-male environment -- except for  the cleaning women and laundresses -- learned nothing of marriage but a great deal about how to be a hyper-intellectual.  The poor man was set up to make the decision in 1421 -- perfectly rational from what he knew from books -- that sex, even in marriage, was something he could not do, if he was to avoid his uncle's fate. There is no doubt that he was encouraged in this by his religious advisors, particularly John Eugenikos who for reasons unclear to me is highly regarded even today as an intellectual but who totally opposed any Union of the churches, and who -- after Theodoros had married Cleofe and had a child -- was still encouraging him to take monastic vows.   (All wrong.  I have learned too much about Eugenikos.)

Sometimes these Mistra people are enough to make you want to forego the intellectual thing altogether.

We also have a letter from Battista (#3) reporting that Theodoros had said he would not have sex with Cleofe and he would not eat meat.  She seemed to have learned this at least second-hand, and by word-of-mouth, so the reasons might not have filtered through, or been understood.  But Theodoros who as a lonely child had watched the extremes of gout was desperately afraid.  This is, to be sure, another reading of the not-eating-meat statement which is conventionally interpreted to suggest that meat inflames sensual passions, but I have come to think that too simple an explanation.


The writing of history depends on survivals, coincidences, intuition, likelihood -- and faith that all of those can, together, make sense.

My gratitude to Vittorio Volpi, incomparable librarian in Iseo-Brescia, for tracking down those Pepagomenos PDFs for me.