@article{ref1,
title="Did poisoning play a role in Napoleon's death? A systematic review",
journal="Clinical toxicology (Philadelphia, Pa.)",
year="2020",
author="Marchetti, Daniela and Cittadini, Francesca and De Giovanni, Nadia",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: On 5 May 2021 we celebrate the bicentenary of Napoleon's death. Despite autopsy findings of a &quot;gastric cancer&quot; and, more importantly, gastric  perforated ulcer complicated with bleeding, the questions about the illness that  tormented Napoleon at St. Helena and whether the death was a consequence of a  poisoning, maintain an unbroken fascination. PubMed/MEDLINE lists hundreds of  articles. We also consulted Index-Cat library for articles dating back to the  eighteenth century. The present paper presents for the first time a systematic  review on this topic. <br><br>METHODS: The authors divided the selected articles according  to the methodology of the papers: (a) illness and autopsy evidence revised by  current pathological knowledge; (b) toxicological tests on Napoleon's hair performed  by modern analytical techniques. <br><br>RESULTS: None of the articles denied the  toxicological evidence from Napoleon's hair, although analytical papers did not  offer homogeneous results due to several biases. Few of them refuted the hypothesis  of death due to primary toxic substances. Most considered gastric bleeding is the  primary cause of Napoleon's death due to solely or nearly completely gastric cancer  or to medications containing antimony, mercury, or arsenic. <br><br>CONCLUSIONS: Upon review  of the contemporary and modern evidence, we classify Napoleon's 1821 death as  &quot;unnatural&quot; with massive gastric bleeding due to primary involvement of toxic  substances that may have precipitated or exacerbated an underlying &quot;natural&quot;  pathological condition or a disease as likely could be a stomach carcinoma; it does  not imply criminal intent.<p /> <p>Language: en</p>",
language="en",
issn="1556-3650",
doi="10.1080/15563650.2020.1843658",
url="http://dx.doi.org/10.1080/15563650.2020.1843658"
}