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Sunday, 18 November 2012

Boris Godunov

Boris Godunov
@HealthMed The RSC is currently running a new version by Adrien Mitchell of Pushkin's Boris Godunov - in which Godunov is accused of the murder of the young epileptic son of former Tsar Ivan the Terrible, following which he (Godunov) allows himself to be 'persuaded' to became the new Tsar. 

Tsar of Russia Boris Godunov is said to have died in mid-April 1605 after a lengthy illness, the cause of death attributed to a stroke. 

Hippocrates is considered to have been the earliest to describe stroke - then called apoplexy [for Gk for to strike down/incapacitate]. As insight into Roman views on the cause of apoplexy, the Latin translation (sideratio) indicates a disease caused by a constellation.  It wasn't until several decades after Godunov's death that Swiss pharmacologist and pathologist Johann Jakob Wepfer linked apoplexy both to bleeding within the brain and to blockage of a blood vessel in the brain. His work on strokes was published in 1658 as Historiae apoplecticorum. 

Depicted as well-fed, Godunov by the age of 54 would have been at risk of hypertension, diabetes and hyperlipidaemia. Other causes of apoplexy could have included a primary or secondary cerebral tumour, indolent brain infection/abscess such as tuberculosis, or indeed a ruptured congenital vascular anomaly. Poisoning was of course then an occupational hazard. Slow onset heavy metal or other toxins could have contributed to his reported long terminal illness.

Apoplexy has attracted fascination from historical reports (e.g. from Petrarch to Copernicus and Catherine the Great, surgeon John Hunter's suspected caused of death - reportedly during a meeting with the board of management, and President Woodrow Wilson) to fictional references - often with a hint of retribution (e.g. Villefort's father in the Count of Monte Cristo, Rip van Winkle's wife ... ). 

For more on general aspects of apoplexy, see History of Stroke by Maurizio Paciaroni and Julien Bogousslavsky.

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