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BATTLES AND BOWEL DISEASE: THE GASTROINTESTINAL COMPLANTS OF GENERAL JAMES WOLFE
IL Epstein, D Leddin
Division of Gastroenterology, Dalhousie University, Halifax, Nova Scotia
The battle fought on the Plains of Abraham, outside Quebec city, on September 13, 1759 was a decisive event in the history of Canada. The British forces were led by General James Wolfe (1727 – 1759). There is evidence that Wolfe, who was killed during the battle, suffered from a chronic gastrointestinal illness. The purpose of this review is to summarize Wolfe’s gastrointestinal complaints and speculate on what the underlying condition may have been.
METHODS: Sources of information include original documents, historical accounts, later popular accounts, and scholarly works describing Wolfe’s life and his physical condition at the time of the siege. These are accessible through library databases, online sources, in the Webster Canadiana Collection at the New Brunswick Museum in Saint John and at the McCord Museum of Canadian History in Montreal.
RESULTS: Wolfe struggled with bouts of illness throughout his adult life, starting at age 14. In his lifetime no specific diagnosis was made. Crohn’s disease was not described in Wolfe’s time but celiac disease, which was first recognized in the 1940’s, recurrent infections, ulcerative colitis, or post infectious irritable bowel syndrome are possibilities. At age 32, despite his health concerns, Wolfe was appointed to command the British forces at Quebec city. The British and French were fighting for control of North America. The capture of Quebec city would have given the British control of the St Lawrence. The British laid siege to Quebec but were not successful in taking the city during the summer months. It was unlikely that the British could have sustained the siege through the winter. They decided on a high-risk attack on the city from the Plains of Abraham. As the battle approached Wolfe’s physical health deteriorated to the point that he remained bedridden between August 22 to 31, 1759. His symptoms have been described in historical journals, letters and memorandums as ‘gravel, rheumatism and dysentry’. It is clear that he had significant fever, fatigue, dehydration, abdominal pain and diarrhea during this week – symptoms compatible with either a flare of ulcerative colitis or seronegative arthritis secondary to infectious colitis.
Discussion: While it remains difficult to provide a definitive diagnosis, Wolfe may have suffered from a chronic gastrointestinal disease. His illness before the final battle, by depriving the forces of their general, could have had significant consequences for the British. However the British were victorious at the battle of the Plains of Abraham despite the bowel complaints of their general.