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Notable Notes
July 2015

Scrofula and the Divine Right of Royalty: The King’s Touch

Author Affiliations
  • 1Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
JAMA Dermatol. 2015;151(7):702. doi:10.1001/jamadermatol.2015.0449

Weeping, festering sores—physical manifestations of the nation’s sin—swathed the neck, head, and face of the diseased poor. The afflicted wretches, stricken with scrofula, gathered en masse to receive the “King’s Touch”—a ceremonial laying on of hands believed to cure the lesions, and further, to cleanse the nation of collective transgressions against God. Through the King’s Touch, the monarch served as God’s agent on earth, thus affirming his Divine Right to rule.

Today, scrofula is best known as tuberculous cervical lymphadenitis. The lesions are caused by Mycobacterium tuberculosis and other nontuberculous mycobacteria and are highly curable.1 Prior to modern medicine, however, scrofulous lesions grew slowly and festered over months to years. The disease was known as the “King’s Evil” and, to the common people, represented sin.2 Many medieval physicians believed that scrofula resulted from gluttony and therefore recommended restrictive diet and avoidance of “all things that fill the head with fumes,” such as garlic and onions, strong wine, shouting, worry, and anger.3 Medicinal treatment often consisted of a plaster of lily root, unripe figs, bean flour, and nettle seed. Attempts might be made to rupture the lesions with the help of blister beetles. Surgery consisted of incision of the scrofulous node, scraping away and clamping the flesh overlying it, and removal of any attached nodes.3 Alternatively or when other methods failed, the scrofulous individual could appeal to the king for cure. On occasion, these lesions entered into spontaneous remission. Thus, scrofula lent itself to stories of miraculous cures. The reigning monarch offered the healing benediction for the scrofulous patient, and if cure was effected, the royal professed divine authority to heal. Furthermore, cure evidenced God’s sanction of the royal throne.2