Multidisciplinary medical identification of a French king’s head (Henri IV)
BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c6805 (Published 15 December 2010) Cite this as: BMJ 2010;341:c6805
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Dear Editor,
Your paper on the identification of a French king’s head (Henri IV) in the 2010 December issue attracted considerable attention in France [1]. Responses calling for (28 October 2013), and opposing (31 October 2013) the retraction of the paper were posted on the BMJ site. Debates among French experts are still hot at the end of 2013. Historians think that there is no evidence to support this identification, and a book has been published opposing it [2]. I don’t have an opinion on a possible forgery, as I lack forensic competency. I think that the paper was not properly peer-reviewed, since the identification’ methods employed were poorly described; thus, it is difficult to appraise the paper. Do papers published in the Christmas issue follow the standard peer-review process? The BMJ name was later used by the first author to prove that the paper was ‘validated’. Having editorial experience, I know about dysfunctional authorship in France, as shown by the interviews with 39 experts [3]. I decided to inquire about the authorship of the paper, and determining it was more difficult than I expected.
I tried to contact the 20 authors listed in the BMJ paper to confirm their contributions. I wrote a formal letter that I sent by email and posted on my blog (http://www.h2mw.eu/redactionmedicale/2013/11/nous-nous-sommes-%C3%A9tonn...). My questions were ‘Do you fulfil the four ICMJE criteria?’ and ‘Do you have an opinion on the possible retraction of the paper?’I mentioned the ICMJE (International Committee of Medical Journal Editors) criteria in the letter.
Most of the 20 authors did not want to comment on the ICMJE criteria. I did not reach four authors (the 16 remaining authors did not provide me with the four missing email addresses), even through social networks. The first two authors (PC, IHC) told me that they fulfilled the four ICMJE criteria; one (EL) fulfilled criterion number 1 and another (GLDLG) criterion number 2. I tried to obtain information on the DNA extractions and analysis, as stated in the contributors’ listing: ‘PFC, EW, MTPG, CK and BL, did ancient DNA extractions and analyses’. I did not receive confirmation from the five concerned co-authors.
It is clear that 18 authors were honorary (assuming that the four who were not reachable were honorary). Does this mean that only two authors fulfilled criterion number 3 (final approval of the version to be published)? How does one judge the fairness of a paper when so many authors don’t want to confirm their contribution? I had an email from the second author (IHC) explaining that ‘honorary authors’ don’t exist at her hospital (Pitié-Salpétrière, Paris). More questionable is the position of the guarantor of the paper, C. Keyser, as she did not accept to confirm that she still was a guarantor! Most of the authors were probably not aware that being an honorary author is misconduct!
Was this work fair, questionable, or fraudulent? Conducting an investigation on site is the right way to proceed. There are no research integrity officers at French universities. Surprisingly, the president of the ‘Société Française et Francophone d’Ethique Médicale’ is a forensic specialist and knows the actors. He did not reply to my questions. He is in a position to investigate, but the relationship between leaders facilitates a non-decision. Two key forensic opinion leaders did not agree to give me information. Honorary authorship raises serious ethical and legal concerns, bearing on the integrity of medical research. Medical journals, academic institutions, and professional disciplinary bodies have thus far failed to enforce effective sanctions. Does honorary author’s claim for credit of an article constitute legal fraud? [4]. Should we, like our Italian colleagues, ‘call the cops’? [5].
I will continue to investigate, and scientific journalists should be interested in pursuing the investigation. In the meantime, BMJ should publish an ‘expression of concern’ and call for a local investigation.
References
1. Charlier P, Huynh-Charlier I, Poupon J, Keyser C, Lancelot E, Favier D, Vignal JN, Sorel P, Chaillot PF, Boano R, Grilletto R, Delacourte S, Duriez JM, Loublier Y, Campos P, Willerslev E, Gilbert MT, Eisenberg L, Ludes B, de la Grandmaison GL. Multidisciplinary medical identification of a French king's head (Henri IV). BMJ 2010;341:c6805
2. Delorme P. “La mauvaise tête de Henri IV. Contre-enquête sur une prétendue découverte, F. Aimard /Y. Briend Editeur, 2013.”
3. Pignatelli B, Maisonneuve H, Chapuis F. Authorship ignorance: views of researchers in French clinical settings. J Med Ethics 2005;31:578-581 doi:10.1136/jme.2004.009449
4. Stern S, Lemmens T. Legal remedies for medical ghostwriting: imposing fraud liability on guest authors of ghostwritten articles. PLOS Medicine 2011;8(8): e1001070. doi:10.1371/journal.pmed.1001070
5. Call the cops. [Editorial]. Nature 2013;504:7
Competing interests: No competing interests
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Medico-historical identifications imply an objective over-view on both the subject and the methodologies employed. Any criticism cannot ignore all the previous publications and justifications given by authorities in the field of History.
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Regarding the absence of craniotomy on the mummified head of Henri IV:
Professor Donatella Lippi has shown that such a skull opening was not systematic at this period in France and Italy [1,2], including for Kings, Queens and relatives (for example the uncle of Henri IV, the cardinal Charles Ier de Bourbon, died in 1590).
Jean-Pierre Babelon (Académie of Inscriptions and Belles-Lettres), Bruno Galland (public director of the National Archives) and Jacques Perot (president of the Henri IV Society) have shown after an exhaustive analysis of first-hand archives, that such a skull opening is not attested in the case of Henri IV (no mention in the autopsy record from 1610, no mention in all the contemporaneous manuscripts of the exhumation in 1793). Only a late and very dubious mention is present in a novelistic text from 1801 (the same author describes also a skull opening on the mummy of Louis XV… an impossible lesion as this King did not support any autopsy nor embalming due to smallpox) [3-5].
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Regarding the traceability of the mummified head, we have reconstructed its course from the exhumation (1793) to its reappearance (1919): stolen during the profanation by Alexandre Lenoir; given by Alexandre Lenoir to Jean-Etienne de la Vallée-Poussin (died in 1802, Lenoir published and prefaced its drawings); heritage of Emma Nallet-Poussin (grand-daughter of the last) sold in 1919 by a furniture warehouse at Drouot and bought by Joseph-Emile Bourdais (public reappearance of the head) [4].
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Regarding the genetic study co-signed by Prof. Cassiman and the people journalist at Point-de-Vue-Images-du-Monde Philippe Delorme [6]:
This publication clearly shows that it is hopeless to try to match a family tree and a series of genetic links on such a long period. What could the explanations be?
Medical literature shows there exists from 1 to 4 % of children born from a father different from expected (rate per generation) [7-8]. There are 13 generations between Henri IV and the three living subjects considered in the study, raising the risk of false legit paternity to between 12 and 41 % over the span of these 13 generations.
For instance, one of the family trees involves Louis-Philippe, duke of Orleans, a.k.a. "Philippe-Egalité" whose mother (Louise-Henriette de Bourbon-Conti) said about the father of her children: "Quand on est tombé sur un fagot d'épines, sait-on celle qui vous a blessée ?" ("When one falls on a bundle of spines, does one know which hurt you?"), explicitly acknowledging she could not tell who was Philippe-Egalité's father. Same doubts exist with Philippe-Egalité's children, whose paternity is not certain, including that of French king Louis-Philippe [9-10]. Other doubts exist as well with Louis XVI's paternity [11].
No documented statistics exist in the scientific literature on non-maternity risks, for instance due to child exchange or secret adoption. One can note that 10 generations separate Henry IV (died in 1610) from the retained common maternal ancestor (Anne de Habsbourg, died in 1327), and 20 more additional generations until the person tested ("Louis XVII", died in 1795), for a total of 30 generations between the two subjects [12]!
Lastly, it has to be said that the genealogic trees presented by the authors of the publication are much more complex in reality, with frequent ramifications from one branch to the other [12].
A statistical modeling of the identification arguments was also carried-out with Lionel Mathelin (LIMSI-CNRS, Orsay). The probability that the match of the genetics between samples from “Henri IV's head” and so-called “Louis XVI's blood” [13] was only due to chance is estimated to only 1 in 71,280 or 1 in 641,520 depending on the retained model.
Further genetic analyses will be necessary on the “Louis-XVI’s blood” in order to confirm or not its authenticity, and explain the potential contradictory results.
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From a morphological point of view, recall that 22 objective arguments have been given (both from anthropological and historical point of view) and allow authentication of the head as belonging to Henri IV beyond reasonable doubt, as expressed in our initial publication [14].
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Lastly, with Philippe Froesch (VisualForensic, Barcelona), a three-dimensional comparison was recently carried-out between Henri IV's death mask and the mummified head. Unlike a first anatomical comparison (published in 2010 in BMJ) [14], based on a few key anthropological points, this new comparison relies on a very large number of points and curves since it was done in 3-D. It has shown that the anatomical match was complete, and this could not be due to chance. Further, the asymmetry of the face as seen on the different death masks is also clearly visible on the skull under consideration. This study will be published in an international forensic journal, as it may be sufficient by itself for an individual identification.
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Hence, at the anthropological, historical and statistical levels, the many arguments allow to come to the conclusion, beyond reasonable doubt, that the head is authentic and belongs to Henri IV. Recent genetic analyses [6] clearly question the heterogeneity of the genetic heritage within the Bourbon/Orleans family.
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As a consequence, no argument is sufficient to ask for a retraction of the BMJ article as it meets none of the criteria: scientific misconduct, plagiarism, serious errors, and duplicate/concurrent publishing (self-plagiarism) [15].
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Controversy is part of any important scientific publication, and particularly frequent for medico-historical identifications. But passions should be left aside in favor of objectivity and rigor. In any cases, a researcher has to accept that he will never be able to convince some skeptics colleagues in the case of a multidisciplinary study.
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References
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1. Lippi D. About craniotomy. BMJ online, 15/02/2011 (http://www.bmj.com/rapid-response/2011/11/03/about-craniotomy).
2. Lippi D. Illacrimate sepolture. Curiosità e ricerca scientifica nella storia delle riesumazioni dei Medici. Firenze (Italy): Firenze University Press, 2006.
3. Charlier P, Babelon JP, Galland B. An historical identification is not an improvisation. BMJ online, 14/02/2011 (http://www.bmj.com/rapid-response/2011/11/03/historical-identification-n...).
4. Gabet S, Charlier P. Henri IV, l’énigme du roi sans tête. Paris, Vuibert, 2013.
5. Charlier P, Grilletto R, Boano R, Gourevitch D, Galland B, Babelon JP, Perot J. Ouvrir un corps de roi : pourquoi, comment ? Le cas d'Henri IV. Rev Prat. 2011;61(6):880-5.
6. Larmuseau MHD et al. Genetic genealogy reveals true Y haplogroup of House of Bourbon contradicting recent identification of the presumed remains of two French Kings. Eur J Hum Genet 2013 Oct 9. doi:10.1038/ejhg.2013.211.
7. Anderson KG, Kaplan H, Lancaster JB. Demographic correlates of paternity confidence and pregnancy outcomes among Albuquerque men. Am J Phys Anthropol. 2006;4:560-571.
8. Sykes B, Irven C. Surnames and the Y chromosome. Am J Hum Genet. 2000;4:1417-1419.
9. Anonyme. Les Six d'Orléans. Essai historique sur la branche cadette de la Maison de Bourbon. Paris: Dentu, 1835, pp. 131-132.
10. Castelot A. Philippe Egalité, le prince rouge. Paris: Perrin, 1951.
11. Pinoteau H, Gandrille F, Papet-Vauban C. Etat présent de la Maison de Bourbon (4th edition). Paris: Le léopard d'or, 1991.
12. Fogg RN, Boorjian SA. The sexual dysfunction of Louis XVI: a consequence of international politics, anatomy or naïveté? BJU Int. 2010;106(4):457-459.
13. Charlier P, Olalde I, Solé N, Ramírez O, Babelon JP, Galland B, Calafell F, Lalueza-Fox C. Genetic comparison of the head of Henri IV and the presumptive blood from Louis XVI (both Kings of France). Forensic Sci Int. 2013;226(1-3):38-40.
14. Charlier P, Huynh-Charlier I, Poupon J, Keyser C, Lancelot E, Favier D, Vignal JN, Sorel P, Chaillot PF, Boano R, Grilletto R, Delacourte S, Duriez JM, Loublier Y, Campos P, Willerslev E, Gilbert MT, Eisenberg L, Ludes B, de la Grandmaison GL. Multidisciplinary medical identification of a French king's head (Henri IV). BMJ 2010;341:c6805.
15. Kleinert S. COPE’s retraction guidelines. Lancet. 2009;374(9705):1876-1877.
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Competing interests: No competing interests
Dear Editor,
In 2010, the article entitled “Multidisciplinary medical identification of a French king's head (Henri IV)” [1] was published in your Journal. Results of the genetic comparison of the mummified head and the presumptive blood from Louis XVI were published earlier this year [2]. Robust scientific arguments recently published negate the conclusions of the studies carried out by Charlier et al. Many historical facts calling into question the identification have been detailed by the French historian Philippe Delorme [3]. He highlighted, in particular, the absence of craniotomy, a consistent finding for Kings and Princes who died in the same period, and also the lack of traceability of that head, that anonymously emerged in 1919 [3]. A second major argument was the genetic analysis [4] which led to the conclusion that the analyzed samples in the study published this year [2] were not from the French Kings.
Consequently, on the basis of the above information, the retraction of the article [1] is now justified, as a rigorous scientific anthropological study should have excluded the hypothesis (and the findings) that the head belonged to Henri IV.
References
[1] Charlier P et al. Multidisciplinary medical identification of a French king's head (Henri IV). BMJ. 2010 Dec 14;341:c6805.
[2] Charlier P et al. Genetic comparison of the head of Henri IV and the presumptive blood from Louis XVI (both Kings of France). Forensic Sci Int. 2013 Mar 10;226(1-3):38-40.
[3] Delorme P. “La mauvaise tête de Henri IV. Contre-enquête sur une prétendue découverte, F. Aimard /Y. Briend Editeur, 2013.”
[4] Larmuseau MH et al. Genetic genealogy reveals true Y haplogroup of House of Bourbon contradicting recent identification of the presumed remains of two French Kings. Eur J Hum Genet. 2013 Oct 9. doi: 10.1038/ejhg.2013.211.
Competing interests: No competing interests
The identification of the head of the French King Henry IV, performed by Philippe Charlier and Colleagues, represents a very interesting case of multidisciplinary research: literary, iconographic and paleopathological sources are taken into consideration. As responsible of the Medici Project for the University of Florence, I have deeply studied the archive documents regarding the exhumation of the Medicis of 1947: on that occasion, the oldest members of the dinasty were also exhumed. There is no evidence of craniotomy. As far as the Grand Ducal branch is concerned, craniotomy was generally performed, but there are many exceptions (Francesco I, for example). Among the reasons of these different procedures, we must not forget that the medical interest in brain was a late conquest of anatomical research.
Competing interests: None declared
Competing interests:
An osteo-archaeological identification must be based on both solid anthropological and historical data. But primary sources must be taken into account, not only late and indirect ones. Professor Tognotti, Rollo and Fornaciari's gaps can be easily filled and doubts assuaged.
Hair characteristics, particularly the natural red and white colour of all the hairs studied, were confirmed by histology examination, avoiding any postmortem discoloration.
The left upper maxillary bone scar lesion is localised bone production, and cysts are defined by osteolysis.
All facial superimposition and reconstitution were conducted and analysed according to the highest and most current standards of forensic anthropology.
Lastly, the two texts by Alexandre Lenoir and Dom Poirier are much later than 1793. A direct analysis of the original texts conserved in the Archives Nationales (AE1 15) and the Archives of Paris (6A223, article 1391) shows that the description of the Henri IV opened skull is absent from the original manuscripts. The only original (and anonymous) source is a "Historical Journal of the Coffin Extraction", which does not mention any opening in the skull. Many supplementary comments appear in subsequent versions of the texts by Dom Poirier and particularly Alexandre Lenoir (dating from 1801), transforming these primarily chronicle texts into true novel ones. To summarise, there are no serious data about a craniotomy having been performed or seen on the skull of Henri IV.
Putting all these arguments together, absolutely nothing goes against the certainty of this osteo-archaeological identification.
Competing interests: None declared
Competing interests:
This study demonstrates that, in this field of research, the historical sources, the written records, and eventually analysis of data collected in order to learn more about the historic context are important as the numerous techniques employed (anthropological, paleopathological, radiological, forensic, and genetic implied) .
The article of Charlier and colleagues on the identification of the purported head of Henry IV of France use a wide range of different procedures: but in order to achieve a more scientifically founded identification of the purported head of Henry IV of France would have been important to refer to the important document cited by the professor Gino Fornaciari with which I agree : the detailed report of the exhumations of the French kings in Saint Denis written by the Benedictine dom Germain Poirier and Alexandre Lenoir, who witnessed the exhumations of October 1793 and accurately described the embalmed body of Henri IV. In future it is hoped that among the approaches it can be better considered also the historic one .
Competing interests: None declared
Competing interests:
Charlier and colleagues present an interesting report on the identification of the purported head of Henry IV of France. To achieve a positive identification they utilize, among other approaches, craniofacial superimposition of the digital image of the skull to a funerary mask and a statue of the king kept at Pau Castle. Unfortunately, as far as one can judge on the basis of the published figures, the conclusions of the Authors about the results of the superimposition tests i.e. that they show complete similarity with regard to the considered anatomical features, do not seem justified. Rather, the comparison evidences several elements of incompatibility between skull and plaster mould, namely in the forehead curve, the depth of the nasal bridge, the shape and projection of the nasal bones. These are precisely the areas indicated by Austin-Smith and Maples (1) to be of particular importance for comparison in lateral photographs. As for the results of the superimposition test utilizing the statue at Pau, one can remark that the comparison of a skull with a piece of art, either a painting or a sculpture, cannot be used as a mean of individual identification. Conversely, provided the identity of the skull is known, the technique can help understanding the way of painting/sculpturing of an earlier portraitist (2).
1.Austin-Smith D, Maples RW. The reliability of skull/photograph superimposition in individual identification. Journal of Forensic Sciences 1994,39:446-455.
2.Rollo F, Mascetti M, Cameriere R. Titian's secret: comparison of Eleonora Gonzaga delle Rovere's skull with the Uffizi portrait. Journal of Forensic Sciences 2005;50:602-607.
Competing interests: None declared
Competing interests:
This study well describes an interesting multidisciplinary approach performed by an international team of specialists to identify a possibly important "relic" of the Modern Age, the head of Henri IV. Unfortunately, evidence of this identification seemed to be rather meagre from the very beginning, in particular from a medical point of view: the use of earrings was very common in 16th century males; the maxillary bone "lesion" looks like a cyst; the nasal nevus is not well evident; red and white hairs, moustache and beard, caused by post-mortem discolouration, are usual in mummified bodies; post-mortem baldness in very manipulated mummies, as in this case, is also very common; digital superimposition, very difficult between two individuals one with open and and the other with closed mouth, does not correspond, especially at the level of the nasal bones.
However, there is a more serious obstacle for a positive attribution of this natural mummified head to Henri IV. We have an impressive and detailed report of the exhumations of the French kings in Saint Denis: the Benedictine dom Germain Poirier and Alexandre Lenoir, responsible for historic monuments, who witnessed the exhumations of October 1793 on behalf of the Committee of Monuments, accurately described the embalmed body of Henri IV: "Le samedi 12 octobre 1793...Son corps s'est trouve' bien conserve', et les traits du visage parfaitement reconnaissables... Ce cadavre, considere' comme momie seche, avait le crane scie', et contenait a la place de la cervelle, qui en avait ete otee, de l'etoupe enduite d'une liqueur extraite d'aromates, qui repandait une odeur encore tellement forte qu'il etait presque impossible de la supporter" (1).
Therefore, on the basis of these events, attribution of the head to Henri IV should be reconsidered.
1. Boureau A. Le simple corps du roi. L'impossible sacralite' des souverains francais (XVe-XVIIIe siecle). Paris, Les Editions de Paris, 1988, p. 77-78.
Gino Fornaciari
Professor of History of Medicine
Director, Division of Paleopathology, History of Medicine and Bioethics
University of Pisa, Medical School, Via Roma 57, 56126 Pisa, Italy
Competing interests: None declared
Competing interests:
Re: Multidisciplinary medical identification of a French king’s head (Henri IV)
We confirm that we are all full authors of the publication (satisfying the authorship criteria of the ICMJE).
We confirm that we are against any retraction of our article published in the BMJ in december 2010.
An updated version of this letter may be posted with the adjunction of the last remaining authors of the paper.
Competing interests: No competing interests