St. Thomas Aquinas’s Cause of Death Revealed?

The famous scholastic doctor, who was awarded the title of "common doctor" of the Church, had a short life. Born in 1225, he died on March 7, 1274, aged less than 50, at the Abbey of Fossanova, while he was on his way to the Council of Lyon at the request of Pope Gregory X. Even if life expectancy then was lower than today, his death can be described as premature.

As in any diagnostic research that respects the rules, the authors first looked at the anamnesis, in other words the information provided by questioning the patient or his entourage. In this case, it was the historical sources that were questioned to try to reconstruct as best as possible the circumstances that preceded the death of the holy doctor.

The article tells us that the main sources include biographical notices of Pierre Calo, Guillaume de Tocco, and Bartholomew of Capua written a few years after the saint's death. Added to these are testimonies collected during his canonization process. Most of the sources date from the 13th and 14th centuries.

The authors also went to Priverno to examine one of the skulls attributed to St. Thomas Aquinas. In fact, another skull, preserved under the altar of the Jacobin convent in Toulouse, the cradle of the Dominican Order, claims to be the head of the holy doctor, but it has not been examined. This will be one of the goals of future research.

Until now, several hypotheses or theories have been put forward as to the cause of Aquinas's death: acute general illness, death following a mystical ecstasy, and even poisoning (the culprit of which is designated by Dante in his Divine Comedy, as being King Charles I of Naples). More recently, researchers have suggested a brain injury.

The reconstruction shows that St. Thomas left the convent in Naples on January 28, 1274, taking the Via Latina towards Rome. This route allowed him to pass through Maenza, where the saint’s niece resided. It was then, one of the witnesses relates, that St. Thomas fell violently, hitting a fallen tree, which “somehow knocked him unconscious” (fere stupefactus quodammodo).

Arriving shortly afterwards in Maenza, the party stopped for 4 or 5 days, and the same witness says that then Brother Thomas began to be seriously burdened with infirmities: nausea, lack of appetite, and general weakness, and that is why he asked “with great devotion that he be transported to the monastery of Santa Maria di Fossanova, which was done.” He had to be transported on the back of a donkey.

It should be noted that the Dominican rule at that time forbade the friars from riding horses or donkeys. The fact that St. Thomas agreed to be transported in this way shows the extenrt of his infirmity. The testimonies of his stay in Fossanova describe the general worsening of these symptoms: weakness, nausea, and lack of appetite, but without any marked neurological damage.

It is only necessary to point out a moment when, during a metaphysical debate, Brother Reginald, his companion, describes the saint as no longer knowing what to write and evading questions. But a few days later he gave a sermon. The witnesses speak of the preservation of his intellectual capacity: he dictated a commentary – unfortunately lost – on the Song of Songs.

The clinical picture can be summed up as follows: an initial injury that preceded a period of lucidity followed by symptoms of weakness, nausea, and lack of appetite that progressively worsened until death. This picture may suggest a subdural hematoma, or blood collection that gradually forms between the dura mater and the arachnoid.

There are in fact three "meninges" that surround the brain: the dura mater that is applied against the cranial bone, the arachnoid, located below, and the pia mater, immediately in contact with the brain. A subdural hematoma is located between the dura mater and the arachnoid. In most cases it results from minor or moderate head trauma.

Sometimes such a hematoma heals spontaneously if it is not very significant. But it also happens that it would gradually spread, causing various symptoms that develop over several weeks or more: this is then a chronic subdural hematoma. If left untreated, it will quite often lead to death.

The authors therefore conclude that it is highly likely that it was a chronic subdural hematoma, caused by the violent impact with a tree on the road between Naples and Maenza. They propose to continue their investigation by obtaining permission to examine the two skulls that are competing to be the relic of the angelic doctor.