Cesare Borgia and the Great Pox

Cesare Borgia by Altobello Melone
One of the most well known facts about Cesare Borgia, aside from the fact that he was a bit (a lot) of a sociopath who seemed to enjoy having people killed, is that he suffered from Syphilis and often tended to go about wearing a mask. It is said that he wore the mask to cover up the disfigurement on his face that came from the disease – he was considered to be the most handsome man of his day and so it must have been a bit of a shock when he started noticing the tell tale symptoms of the Great Pox making a show of itself on his face. Anyway, I’m going off on a tangent that should be happening later on in the post. How did Cesare Borgia contract syphilis? How did he cope with it? How did he have it treated? By the time he died in Navarre was he cured or did it send him mad enough to rush to his own death?
The disease itself was really first noticed after the French invasion of Naples in 1495 where it began to spread across Europe. In a way, it was as if Naples was the epicenter of the disease. But how was it spread by the invading French? It is thought that the disease was spread through Spanish mercenaries serving under Charles VIII, who caught it in the New World and then spread it amongst the citizens of Naples who then spread it back to the French. The French then spread it further and thus across Europe. Complicated. The disease back then was incredibly lethal and led to thousands and thousands of people developing it and it’s deformities, even leading to widespread death. 
In 1497, Cesare Borgia was sent to Naples as Papal Legate. It had been just six weeks since the death of his brother Juan, Duke of Gandia and he left with a small army of retainers. When I say small, small involves retainers, camp followers and prelates as well as over 700 horse. Cesare Borgia certainly didn’t do things by half. They headed to Capua, where the Coronation of Federigo as King of Naples was to take place on the 6th August but soon after they arrived he fell ill – Sancia and Jofre were dispatched from Rome to nurse him back to health and by 11th August he was well enough to crown Federigo. The ceremony itself was lavish but the barons of the Kingdom of Naples failed to show up – it was one of Cesare’s jobs to reconcile them with their new King, but that went down the pan rather quickly. In the end, the only people of note at the ceremony were his brother Jofre and his wife Sancia – the Prince and Princess of Squillace. Following the coronation ceremony, Cesare was determined to enjoy the Kingdom of Naples. Before he left Naples on 22nd August, Cesare and his travelling court had almost impoverished the already poor King of Naples. He also brought something else back with him…
“Monsignor of Valencia has returned from the Kingdom after crowning King Federigo and he is too sick of the French disease”
After Cesare contracted the disease, his physician Gaspare Torella condemned the use of mercury in treating  it and prescribed Cesare a course of ointments, potions and sweating in hot baths. Obviously it wouldn’t have made all that much difference but within a month or so of returning to Rome it would have seemed like the disease had gone, and no doubt Torella thought his ointments and potions had cured him. It really didn’t. The first stage of Syphilis tends to disappear within ten to ninety days before reappearing later as the secondary stage. 
Sergio Peris-Mencheta as Cesare in the traditional black mask
By August of 1498, Cesare began working towards getting rid of his Cardinal’s robes. By this point he was determined to step into his brothers shoes and become a soldier. He took part in bullfights on horseback and practiced leaping astride mules and horses in one leap without touching the harness. He was incredibly proud of both his athletic body and his appearance but by now the symptoms of secondary syphilis were starting to show. The rash began to show itself on his face, somewhat disastrously for the handsome young man who was planning on impressing his intended new wife and the French court with his good looks. 
Gian Ludicco Cattaneo wrote, “He is well enough in countenance at present, although he has his face blotched beneath the skin as is usual with the great pox”
At this point, Cesare was just twenty three. Can you imagine how such a young man would have felt when this started happening, when the disease he thought himself cured of suddenly slapped him in the face again? He wasn’t to know that it would disappear on it’s own (only to reappear later on again – it would haunt him until the end of his life, appearing and reappearing) and he must have been really worried about the blotches on his face spoiling his marriage prospects – it seems he was so worried he even kept signing his letters as “Cardinal Valentino” as if he couldn’t quite bring himself to believe in his secular future and that the disease would mean he wouldn’t marry and would end up back in the church. Even Cattaneo mentions this, “Nonetheless he signed himself up to the last moment as Cesar, Card. Valentino…and this perhaps as a precaution if things did not come out as he wished or that perhaps, because of that face of his, spoiled by the French disease, his wife might refuse him”.
Shortly after Cesare arrived in Marseilles in the October of 1498, he was struck down again with the malady; as was Cardinal Giuliano della Roverre. Both seemed to recover quickly enough, and Cesare’s illness didn’t stop him from marrying the wealthy heiress Charlotte D’Albret in May of 1499.
As can be seen in the screencap above, many still believe that Cesare spent much of his time hiding his blotched face behind a mask. It seems that most of these descriptions come from contemporaries hostile to the Borgias who always jumped at the chance of discrediting the family – and according to Bradford in her biography of Cesare, the image we have of Cesare hiding in the mask is completely fictitious based on a description written by Paolo Giovio in which he said Cesare looked swarthy and he was disfigured by the blotches of Syphilis. It seems that after the blotches disappeared the chances of disfigurement were really small and would only have appeared many many years later! At the point in which Giovio was describing Cesare as ravaged by the disease, others such as Capello in around 1500 (and it must be said, many others!!) were pointing out that Cesare at the age of “twenty five is physically most beautiful, he is tall and well made…” – although this same man later goes on to describe Cesare as a sadistic murderer who had his own brother killed.
Sergio Peris-Mencheta as Cesare in the traditional black mask
The next mention we have of Cesare’s syphilis is in 1504, just after his fathers death and after his imprisonment in the Vatican by Pope Julius II. The year previously, just before his father’s death, he had fallen ill with the same fever that killed Pope Alexander – It was most likely to be a malarial fever although many attribute it to either poison or some sort of food poisoning. In April 1504 Cesare had made his way to Naples where he was still quite unwell and Carvarjal reported that at Ostia Cesare had been in a lot of pain with the “French disease” and his face was hideously blotched with nasty looking pustules. It should be noted that we know now that fever, and in particularly malarial fever, was used as a treatment and cure for Syphilis up until the advent of penicillin – Cesare’s nasty illness the previous year would very likely have cured him and the after effects of said fever. and his imprisonment was probably what caused him to look so rough.
By the time Cesare was killed in Viana in 1507, did he still have syphilis? Some say he did and it has been suggested that the disease had affected the senses in his brain so much that he had gone mad and so, in a fit of madness had ridden to his death. It is however an unlikely explanation – Cesare contracted syphilis in 1497 and tertiary syphilis can appear at any point from 5-20 years after the first stage manifests itself. He had syphilis for less than ten years and it’s really quite dramatic and unlikely to say that in ten years it would have progressed so far as to make him go mad, and indeed in the lead up to the day of his death there is no evidence at all that he had gone mad at all. He certainly seemed to be in control of his senses and even in the bleakest moments he never lost hope and always kept his mind on the prize. He was a reckless man certainly, and the way he rode to his death on his own is very similar to a description made of him in 1503 when he rode at a group of Orsini’s (again, completely on his own), saying he would rather die in the saddle than his bed. And as mentioned previously, it’s really very likely that he didn’t even have the disease thanks to the dangerous fever that he suffered from in 1503. 
We must remember though that after 506 years it is almost impossible to say whether he died as a result of syphilis affecting his brain or whether he did indeed still have it at the time of his death. All that we can say is that he did have it, and that it certainly affected his life in many ways although, like many things with Cesare’s story most of what we think about his illness today comes from anti-Borgia propaganda  Did he hide his ravaged face behind a mask? Probably not. Did he wear a mask? Yes, but it was more likely to keep himself disguised so he wouldn’t be noticed, not to hide a blotched face away – the blotches would have disappeared any way, and physical disfigurement in such a short space of time was highly, highly unlikely. But, like the incest stories, it’s another of these stories that many seem determined to hold on to and why? Because it makes the man come across as more monstrous than he ever, truly was.
Further Reading
Sarah Bradford – Cesare Borgia: His Life & Times
Sarah Bradford – Lucrezia Borgia
Christopher Hibbert – The Borgias & Their Enemies

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