Henry VIII suffered from chronic, infected leg ulcers that plagued him for roughly the last 20 years of his life. What began with jousting injuries evolved into open, draining wounds that never fully healed, left him increasingly immobile, and likely contributed to his death in 1547 at age 55.
The 1536 Jousting Accident
On 24 January 1536, during a tournament at Greenwich Palace, Henry’s horse fell on him mid-joust and trapped him beneath its full weight while he was in full armor. Eyewitnesses reported the king lay unconscious for two hours. He survived, but the crushing injury to his legs caused constant pain that worsened over time and compounded ulcer problems that had already been developing for years.
Henry had experienced earlier leg injuries from his active sporting life, but the 1536 accident marked a turning point. Before the accident, he was still jousting, hunting, and moving freely. Afterward, his mobility began a steep, permanent decline.
What the Ulcers Were Actually Like
The wound on Henry’s leg was not a simple sore. It was a deep, chronically infected ulcer that formed channels (called fistulae) between internal abscess cavities and the skin’s surface. These channels would occasionally heal over on the surface, sealing pus and infected fluid inside. When that happened, the trapped infection caused dangerous fevers and sepsis.
In March 1541, the French Ambassador reported from the English court that “one of his legs, formerly opened and kept open to maintain his health, suddenly closed to his great alarm, for, five or six years ago, in the like case, he thought to have died.” The ulcers eventually affected both legs, producing constant seeping and discharge. Henry himself wrote privately to the Duke of Norfolk, confessing that “a humour has fallen into our legs” and that his physicians advised him not to travel in the heat of day.
By the final years of his life, the stench from his infected ulcers could reportedly be detected three rooms away, often announcing the king’s arrival before he appeared.
How Tudor Doctors Treated It
Henry’s physicians understood, through painful trial and error, that the ulcers had to stay open and draining. When they healed over on the surface, trapped infection nearly killed him. So they deliberately kept the wounds open, sometimes lancing them with red-hot pokers to burn through sealed tissue and allow the fluid to escape. This was, as one historical account dryly noted, “a therapy unlikely to have improved the King’s ill-temper.”
There were no antibiotics, no sterile surgical techniques, and no real understanding of infection. Tudor medicine operated on the theory of “humours,” bodily fluids that needed to be balanced. Draining the wounds fit this framework, and in Henry’s case it happened to be the one thing that kept him alive. Every time the drainage stopped, he developed life-threatening fevers. During one such episode, a diplomat at court reported that Henry went “sometime without speaking, black in the face and in great danger” for ten to twelve days.
What Modern Doctors Think Went Wrong
No autopsy records survive, so modern diagnoses are educated guesses. The leading theories center on chronic osteomyelitis, a deep bone infection that develops after severe trauma. The 1536 crushing injury could easily have damaged the bone beneath the skin, allowing bacteria to establish a permanent foothold. Osteomyelitis produces exactly the kind of deep abscess cavities and draining fistulae described in contemporary accounts, and it is notoriously difficult to cure even with modern medicine.
Chronic venous insufficiency is another strong possibility. Severe leg trauma can damage the veins that return blood from the lower legs, causing fluid to pool and skin to break down into ulcers that resist healing. Henry’s massive weight gain created a vicious cycle: the leg pain made him sedentary, the inactivity made him heavier, and the extra weight put more pressure on already damaged veins and tissue. His armor records tell the story clearly. His waist went from a trim 34 inches in his athletic prime to a staggering 54 inches in his later years.
A more recent theory published in the Journal of the Royal College of Physicians of Edinburgh proposed that Henry may have had McLeod syndrome, a rare genetic blood condition that causes progressive physical and mental deterioration. This would help explain both his chronic wounds and his dramatic personality shift from a charismatic, athletic young king into an increasingly paranoid and brutal tyrant. The theory also connects to his well-documented reproductive difficulties, since a related blood group incompatibility (Kell antigen) can cause repeated miscarriages in partners, which Anne Boleyn and Catherine of Aragon both experienced.
How the Leg Changed His Body and Reign
The leg problem reshaped Henry physically. Unable to exercise, hunt, or joust as he once had, he gained enormous amounts of weight while continuing to eat lavish Tudor meals. By the end of his life, he needed a walking stick, used a wheelchair, and had a pulley mechanism installed at Whitehall Palace to lift him up and down the stairs. The athletic young prince who had once been celebrated across Europe for his sporting prowess could barely move between rooms.
The chronic pain and recurring fevers also appear to have transformed his personality. Historians have long noted that Henry’s most erratic and cruel behavior intensified after 1536. His temper became explosive, his paranoia deepened, and his willingness to execute close advisors and wives accelerated. Whether this was caused by chronic pain, repeated bouts of sepsis affecting his brain, an underlying condition like McLeod syndrome, or simply the psychological toll of years of suffering is impossible to know for certain. Most likely, it was some combination of all of them.
Henry died on 28 January 1547, just four days after the eleventh anniversary of the jousting accident. His final months were marked by fever and declining health. While no single cause of death was recorded, the chronic infection in his legs had been pushing him toward sepsis for years, and repeated episodes of blood poisoning would have steadily weakened his heart and organs. The leg that Tudor doctors fought to keep draining for two decades ultimately could not be managed any longer.