The belated autopsy of a forgotten Revolutionary War hero

John Paul Jones died in Paris on this day in 1792, lonely and forgotten by the country he helped bring into existence. Shortly before his death, he began to lose his appetite. Then his legs began to swell, and then his abdomen, making it difficult for him to button his waistcoat and to breath. When he died shortly thereafter, the American minister to France had no interest in wasting public funds on a grand burial and gave instructions for the dead hero to be “interred at the least possible expense.”

If this were all we knew of John Paul Jones’ terminal illness, there would have been no hope of determining its cause. Fortunately for posterity, an autopsy was performed, which demonstrated the existence of a fatal inflammatory disorder confined to the kidneys.

When Jones died at the end of the 18^th century, autopsies were not yet being performed, at least not ones capable of detecting inflammation of the kidneys. Not until a century later, as a result of the work of Rudolf Virchow, did the autopsy as we know it today come into existence. How then did John Paul Jones happen to have an autopsy capable of detecting microscopic abnormalities of the kidneys some one hundred years before Virchow, the father of cellular pathology, made microscopic examination an integral part of post mortem investigations?

The answer lies in large part with the French government, which saw to it that John Paul Jones, the forgotten Revolutionary War hero, was interred with sufficient care in a lead-lined coffin (in case the United States, which he had served with so much honor, might one day wish to reclaim his remains). That day came more than a century later in 1905 when investigators hired by General Horace Porter, the American ambassador to France, located Jones’ coffin in Paris’ abandoned St. Louis Cemetery “for foreign Protestants.” Inside was a well-preserved corpse, evidently originally submerged in alcohol, which had long since evaporated. The body was transported to the Paris School of Medicine, where 113 years after Jones’ death, post mortem examination revealed injury to the kidneys, consisting of inflammation of the microscopic filters (the” glomeruli”) and surrounding tissues (the “interstitium”). Based on these abnormalities, the French professors performing the autopsy diagnosed “interstitial nephritis” and “interstitial glomerulitis.” In clinical practice today, the most common cause of this pattern of inflammation of the kidneys is the disorder known as “IgA nephropathy.”

Eventually, President Teddy Roosevelt had Jones’ remains brought back to the United States and enshrined in a marble sarcophagus beneath the rotunda of the US Naval Academy chapel as part of a campaign to promote America as a maritime world power. However, it was the French who made it possible for the lost American naval hero to be found and for us to understand the nature of the disorder that carried him into harm’s way and took his life.

Feature Image: US Naval Academy chapel. Photo by Rdsmith4, CC-BY-SA 2.5 via Wikimedia Commons.