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(Overview and Summary)

Oliver Cromwell is one of history's best known neurotics! During his life he consulted at least nine different
doctors, often all at the same time, and each of these physicians prescribed medications for him. Alongside
his propensity to neurosis, he also chain-smoked and drank vast quantities of alcohol, ostensibly to 'dull his

His history is interesting psycho-pathologically as it demonstrates a man with an increasing dependence on

Laudanum-containing concoctions, in ever-increasing doses and a long-term dependence on alcohol, which
he drank alongside taking vast quantities of prescribed opiates.

Little is known of his early medical history other than vague references to his moody persona at times and a
tendency to introspection. However, subsequent to his election in 1628 as MP for Huntingdon, there is a
fairly continuous medical timeline, well sourced by medical casebooks, Parliamentary records and letters and
memoirs of the period. His first recorded medical episode occurred approximately six months after his
election in 1628 and, at this time, he consulted not only Dr Simcott, a local Huntingdon doctor, but also the
esteemed Dr Theodore de Mayerne, the Swiss academic who had been brought over to England to treat The
Stuarts and their Royal Court. It is unclear exactly what prompted Cromwell to demand de Mayerne's
attendance but one must presume his illness was serious enough to be debilitating because, at this time, he
had little or no money and was under extreme financial pressure and therefore unlikely to be consulting
Royal doctor's unless there was serious need.

Both Simcott and de Mayerne come to very similar conclusions, although Simcott was less diplomatic than de
Mayerne! Both felt that he was neurotic and Simcott specifically labels him as a hypochondriac. However,
both at this time and throughout the subsequent decade (late 1620s and 1630s), he consulted a number of
other physicians as well for similar complaints which seem to mostly consist of intrusive dreams, pain in his
abdomen, chronic pain of non-specific origin elsewhere, severe boils, and ongoing 'bladder' issues. It is likely
that the bladder issues were, in fact, renal calculi, and his abdominal pain may be accounted for in this way,
but we also know that he suffered from gallstones and they, too, could have caused considerable pain. He is
known to have been prescribed Laudanum-containing medications throughout this period in increasing doses
as Dr Bate's, in particular, seemed obsessed with Laudanum as a cure-all at this time as evidenced by his
Pharmacopoeia Bateana (a pharmacology reference book published by Bate later in the 17 th Century). Bate
also recounts much of Cromwell's treatment in his Elenchus Motuum (a recounting of the English civil wars
and his part in them), also published later in the 17th Century and both Bate's records and de Mayerne's
Medical Casebooks record the same.

There are various episodes in Cromwell's life which give serious cause for concern psycho-pathologically, in
particular, during the 1630s he underwent some type of religious conversion experience about which
Cromwell himself wrote at great length in his letters and speeches of that time period. Several of the early
letters are extremely concerning as they illustrate a growing pattern of delusional thought processes in
which Cromwell believed he was 'appointed by God' to somehow save the country. Simcott in particular
makes a fairly full account of these beliefs but finds no organic cause to account for them. It is noted that
during this period (1630s) Cromwell often believed he was about to die and called for a doctor in the middle
of the night, with no evidence of illness being detected. He also suffered increasingly severe insomnia and
intrusive dreams it is unclear whether or not Cromwell was actually asleep during these 'dreams' or
whether he was experiencing some type of psychotic episodes as he recounts that, at times, he wanders into
the local town and stands or sits by a local cross which was erected in the town center as he felt very
connected to it in some way and also seems to have believed that he was sent direct messages from God by
being close to it. His insomnia continued throughout his life and nothing appeared to much ameliorate it.

His feelings of 'impending doom' which accompanied these dream-like states would also signify the
possibility of some type of psychotic episode.

As his use of both alcohol and Laudanum-containing medicines continued and increased, his mood and
behavior was affected directly, with many contemporaries noting his wild mood swings, profuse sweating,
and 'wild, staring eyes' which were strangely 'alive' and, increasingly during the 1640s and 1650s, his violent
outbursts and rages. Such mannerisms would well indicate an opiate addiction and the later inability to
control his rages would also seem to support this.
It was thought, at one time, that Cromwell may have suffered from bipolar disorder but this has been more
or less universally ruled out as the manifestations of his illnesses really do not fit this diagnostic criteria.

He was noted, initially during the 1630s, to suffer periods of near-catatonia which would fit well with a
diagnosis of psychosis of some description and that, alongside various contemporaneous diagnoses of 'valde
melancholicus' and 'melancholy' may fit with a major depressive episode with psychotic and catatonic
features. However, his alcohol and opiate usage should also be taken into account as it may well be that his
psychiatric issues were medication-induced, particularly later in his life when his usage of opiates was so
regular and at such high doses.

The catatonic episodes could indicate a form of schizophrenia, but this can probably be ruled out too as
other aspects of his character and behavior do not really conform to such a diagnosis. However, it is
possible that he displayed schizophreniform characteristics during major ongoing depressive episodes, or
what we might now call a 'mixed' major depressive episode.

It is likely that Cromwell himself had little or no idea of the effects of long-term opiate usage, or even
whether he had any clear idea of the effects of long-term alcohol use but it is clear that Dr George Bate DID
understand these effects as they are listed in his Pharmacopoeia Bateana clearly and are fairly consistent
with the side-effects listed today for such drugs.

The main manifestations of Cromwell's bizarre behavior are:

Significant and unpredictable mood swings

Violent Rages
Use of totally inappropriate language during these rages (completely inappropriate abuse of individuals at
inopportune moments such as during the 'Rumpus at the Rump'.)
Profuse sweating
Unusual 'staring' eyes (as reported by many of his contemporaries) which were constantly watering.
Abdominal pain alongside non-specific pain everywhere else (excluding his abdominal pains which can
probably be accounted for by renal calculi and gallstones, his other pain is consistent with a chronic pain
syndrome of no specific origin).
Severe insomnia
Periods of near catatonia
Feelings of imminent death and 'impending doom'
Tremor of hands (probably a postural tremor)

It is clear that Cromwell did indeed have several serious physical illnesses during his life, most notably
recurrent malaria. He also received several battle injuries, most of which appear to have been relatively

He was consulting and receiving treatment from so many physicians at any one time that it is a fairly difficult
job to follow the timeline of his illnesses but, when one does, a reasonably clear pattern emerges of a man
who was over-medicated with opiates among other things including Myroxylon (Myroxlon was regularly
prescribed for colds and pimples at this time). We now know that this can cause deliriums and precipitate
fevers and, indeed, many 19th Century historians believed that this contributed to Cromwell's eventual death.
It is entirely possible that this medication could have precipitated further episodes of hallucinations,
psychosis, confusion and probably also contributed to his 'constantly shaking hands' (postural tremors). The
use of Myroxylon alongside alcohol and opiates could indeed have produced a catastrophic effect at some
point, depending on how long he continued to take the Myroxylon. It is unclear what the longer term effects
of such a drug would have been.

He also experiences episodes of rage which manifest in very public accidents, such as his two carriage
accidents, one of which landed him in the river Thames! At the time these were much parodied and there
was much written questioning his sanity.

It should also be noted that Cromwell aligned himself to Col. Thomas Harrison, a Fifth Monarchist, who had
apocalyptic religious views and in 1650 Cromwell installed Harrison as President of the Commission for the
Propagation of the Gospel in Wales.
On 20th April 1653, when Cromwell delivered his, now famous, dissolution speech to the Rump Parliament
and the so-called 'Rumpus at the Rump' occurred, Harrison attended with him dressed in scarlet robes
bedecked with gold and silver lace, covered in glitter and sat himself at the feet of Cromwell. Harrison was
later executed as a regicide but, while alive, he was a contrary and somewhat flamboyant man who created
great controversy wherever he went.

Cromwell's health continued much in the same vein for the remainder of his life, culminating in his final
illness (consisting of seizures, fevers, abdominal pains, confusion, nausea and sickness) which ended on
September 3rd 1658 when he died.

It is undoubtedly true that Cromwell's health seriously deteriorated after the death of Elizabeth Claypole, his
favorite daughter, and it is clear that his grief may well have contributed to his overall demeanor and low
mood at this time. However, this did not kill him!

There are many theories as to what finally killed Cromwell. McMains has tried to make the case that he was
poisoned, personally I do not subscribe to this theory as I do not believe the contemporaneous evidence
supports this theory. Others believe he died from malaria, which is certainly a more likely cause of death
than poisoning! But, as yet, the jury's still out. Every year there are more theories put forward, some better
than others, and the dialogue will no doubt continue for many years to come. Personally, I believe that
whatever eventually killed Cromwell, his ongoing alcohol and drug-addiction certainly contributed to his final

Cromwell is a fascinating individual in so many ways, not least of which is his peculiar and, at times,
downright pathological behavior. The inconsistencies in Cromwell's demeanor and behavior would certainly
indicate to me, that there is a very good case to be made that much of Cromwell's psychiatric history was
worsened, if not directly induced by, a continual over-medication by his treating physicians, some of which
may well not have been aware that others were also treating him at the same time. Equally, drugs such as
Myroxylon, combined with opiates and alcohol would, most definitely, have affected his behavior and
thought processes.

Maia Newley 2016