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“...the theory that he was poisoned with arsenic is utterly baseless

and is not substantiated by the medical evidence in any way whatsoever.” —

DAVID HOOPER B.Sc

No medical evidence

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No Medical Evidence for Poisoning of Srila Prabhupada by David R. Hooper

B.Sc (biochem.)

(Deva Gaura Hari Das)

The theory that Srila Prabhupada, founder-acharya of ISKCON was poisoned

with arsenic has been given recent impetus by the publishing of the book

‘Someone Has Poisoned Me’ by Nityananda Das.

This paper presents further medical evidence from the scientific and

medical literature which suggests that the symptoms of Prabhupada’s

physical disease were in no way consistent with arsenic poisoning. Lack of

specific clinical symptoms of arsenicosis such as Mees’ lines,

hyperkeratosis and raindrop pigmentation strongly suggest that arsenic

poisoning was not to blame. Rather, his condition was symptomatic of type 2

diabetes mellitus, causing high blood pressure, peripheral neuropathy and

heart problems, including myocardial infarction and stroke. In later stages

this progressed to

diabetic nephropathy (severe kidney damage due to diabetes), which led to

uremia (buildup of metabolic toxins which are normally excreted by the

kidneys) causing gastrointestinal disturbances and loss of appetite. In the

final stages the loss of appetite and poor

digestion led to malnutrition, and ultimately total systemic collapse. This

diagnosis has been confirmed by doctors Jacob and McIrving (who treated

Prabhupada in his final months) as well as Prabhupada’s personal nurse

Abhirama Das.

Introduction

Conspiracy theories regarding the poisoning of an important personality have

always captured the hearts and minds of people in general, and the alleged

poisoning of Srila Prabhupada is no exception. This paper aims to

concentrate on the clinical symptoms manifest in Srila Prabhupada’s body

throughout his well-documented physical illness. It deals primarily with 1.

The lack of symptoms of

arsenic poisoning, and 2. The marked presence of specific symptoms

associated with chronic diabetes.

Clinical Symptoms of Arsenicosis

The clinical features of arsenic poisoning include multi-organ failure and

other non-specific systemic indications, which sometimes

lead to incorrect or delayed diagnosis. However, there are specific

symptoms peculiar to arsenicosis. Bansal et al.1 report that prolonged

sub-acute poisoning usually causes neuropathy (peripheral

nervous system damage), with characteristic skin changes such as

hyperkeratosis (thickening of skin) of palms and soles, hyperpigmentation or

raindrop shaped depigmentation over the skin of

the trunk and Mees’ lines over the nails. Shin2 documents gastrointestinal

upset, multi-organ failure, dermatological lesions

and Mees’ lines as common findings and Dipankar Das3 et al. report arsenical

skin lesions as the most commonly observed symptom in a study of over

175,000 people drinking arsenic contaminated water in

West Bengal, India.

Therefore, while arsenic poisoning causes multi-system damage that imitates

many other diseases, the dermatological features (keratosis

of palms and soles, raindrop pigmentation), polyneuropathy, and Mees’ lines

are more specific to arsenicosis and shall be dealt with

in more detail, with specific reference to the clinical features displayed

by Srila Prabhupada.

Dermatological Features

Hyperpigmentation is reported to be the most common change seen in people

exposed to arsenic. This increased skin colouring can occur anywhere, but is

accentuated in areas which are more heavily pigmented such as the groin or

areola.4 There may be areas of lighter pigment among the darker areas,

giving the overall appearance of “raindrops on a dusty road.”4,5

Hyperkeratosis, a thickening of the skin on the palms and soles, is

also a very common indicator of arsenic poisoning.1,3 This is a very

obvious clinical symptom which can be observed by anyone having close

contact with the patient.

>From reports by Srila Prabhupada’s disciples who served him intimately

during his final weeks, it is clear that none of them noticed any of these

kinds of dermatological changes. These disciples were intimately serving,

massaging and constantly monitoring Prabhupada’s health. They were noting

carefully his fluid

intake, diet , regularity of bodily functions, medications and their

effects. We could assume that if such dermatological changes had taken

place, then certainly these disciples would have noticed them.

 

Prabhupada’s personal nurse, Abhirama Das gives a typical response to the

question of hyperkeratosis:

I massaged his feet and hands for a minimum of one hour every day. Some days

it was two or three hours. His skin was unusually soft, and his hands and

feet were the most flexible and soft that I have ever experienced.23

Personal servant Hari Sauri Das confirms this fact:

Srila Prabhupada's skin was soft and smooth right to the very end. I

always marveled at how soft the soles of his feet and the palms of his hands

were when I used to massage him (I mentioned this in the first volume of my

Diary also), and I didn't notice any difference at all during the last six

weeks in Vrindavana.15 In his book, Nityananda Das presents the alleged

poisoning of Napolean as accepted fact among the scientific and medical

community. Interestingly, most of the available literature on the topic

actually debunks the idea that Napolean was poisoned. In their

paper on the non-poisonous death of Napolean, Doctors Hindmarsh and

Corso6,7 use the same reasoning to counter the allegation of poisoning as

that given above:

The most prominent dermatologic feature of chronic arsenic poisoning

is also constant: raindrop pigmentation of the skin, particularly around the

axillae, groins, temples, eye, neck and nipples, although

it may also extend over the shoulders and chest anteriorly and posteriorly.

Hyperkeratosis of the palms of the hands and soles of the feet is also often

present, frequently associated with arsenic “corns”. These features were

clearly not present at death, as Henry

reports that the skin was “white and delicate as were the hands and

arms.”7 Dermatolgical effects are the most common indicators of arsenicosis.

Therefore the lack of observable dermatological signs and symptoms alone

throws great doubt on the arsenic poisoning theory. Peripheral Neuropathy

The most common effect of arsenic intoxication on the nervous system

is the appearance of a symmetrical polyneuropathy (nerve damage) which may

appear within days of a large dose, or gradually with smaller regular doses

of arsenic. This results in loss of touch and

pain sensation in the extremities.8 When making a diagnosis of neuropathic

symptoms it is important to determine whether the disease is a

polyneuropathy or mononeuropathy

multiplex. Polyneuropathy refers to bilaterally symmetrical affection of

peripheral nerves (i.e. both arms or both legs), whereas moneuropathy

multipex randomly affects different nerves.9 There is a large body of

literature confirming clinical polyneuropathy as a symptom of arsenicosis,

as exemplified by the study of J Oh Shin2:

In all cases, arsenic neuropathy was clinically characterised by a

subacutely developing symmetrical sensory-motor polyneuropathy.2 Nityananda

Das has asserted that the neuropathy exhibited by Srila Prabhupada was due

to arsenic intoxication, citing the example of Prabhupada suffering from

paralysis and extreme pain in one leg. However, this is clearly a

mononeuropathy, rather than a bilaterally

symmetrical polyneuropathy.

One of the primary causes of sub-acute mononeuropathy is diabetes, whereas

sub-acute symmetrical polyneuropathy may be caused by nutiritional

deficiencies, drug intoxication or heavy metal poisoning, including arsenic.

9 Although the extreme pain and paralysis in Prabhupada’s left leg is

consistent with a mononeuropathy resulting from diabetes, it is clearly not

a symmetrical polyneuropathy and therefore certainly rules out arsenic

poisoning as the cause of this symptom. The marked absence of a symmetrical

polyneuropathy further undermines the idea that Prabhupada was suffering

symptoms of arsenic poisoning.

Mees’ Lines

A peculiar phenomenon associated with arsenic intoxication is Mees’

lines, which are transverse bands of white and dark lines (usually from 1 to

3) on the nails of the fingers and toes. This is caused by

bandlike precipitations of arsenic within the keratin matrix of the

fingernails, and is first noticed approximately eleven days after onset of

disease and remains as a succession of bands for over three

months.10 Quecedo et al.11 reported three out of four cases of arsenic

poisoning demonstrating prominent Mees’ lines, with these being an important

clue for diagnosis. Shin described Mees’ lines as “the most helpful

diagnostic finding of arsenic polyneuropathy” 2, with over 80% of cases

exhibiting this symptom.

Abhirama Das gives first hand testimony about the clarity of Prabhupada’s

nails:

I always pinced his nails, during massage as a part of stimulating his

nerves. His nails where shinny, pink, smooth, with no discoloration or white

lines.23 Again, those who personally massaged Prabhupada’s hands and legs

daily failed to notice any unusual lines on the nails of his hands or feet.

Thus another classic sign of arsenicosis is found to be missing from the

symptoms shown by Srila Prabhupada. Summary of arsenic symptoms The only

symptoms of arsenicosis which Srila Prabhupada displayed (gastro-intestinal

upset and multi-organ failure) are those which are non-specific and common

to many other systemic diseases, most notably diabetes. The distinct lack of

any of the symptoms specifically associated with arsenic poisoning

(hyperkeratosis, raindrop pigmentation, sub-acute polyneuropathy, Mees’

lines) throws

grave doubt on the hypothesis that Prabhupada was actually suffering

from arsenicosis.

One may make a case for such poisoning based on personal interpretation and

speculatory innuendo, but based on available medical literature and the

clinical history of Srila Prabhupada’s illness, such a claim has no support

whatsoever.

Clinical Symptoms of Diabetes

Type 2 diabetes mellitus is one of the most prevalent and disruptive

diseases affecting the older population, with approximately 10% of all

people over 65 years of age suffering from the disease. 16 The cause is

improper insulin utilization by the body, and the clinical

features are well documented.

Diabetes damages small blood vessels throughout the body, affecting

the kidneys as well as other organs and tissues including skin, nerves,

muscles, intestines and the heart. Patients with diabetes can develop high

blood pressure as well as rapid hardening of the arteries, which can lead to

heart disease and eye disorders.16 The fact that Srila Prabhupada suffered

from diabetes was common knowledge among ISKCON devotees from at least

1969.15,20 Many doctors had diagnosed it and he himself was aware of it:

Gargamuni: My father, he also used to get swelling, but this was due

to diabetes.

Prabhupada: I have got diabetes also.

Room conversation January 19, 1977. Bhubaneswara.12

He also gave his personal servant Sruta Kirti Das and nurse Abhirama

Das the same information.21,23 Dr. McIrving, who treated Srila Prabhupada in

1977, made the following diagnosis of his condition:

1. Due to diabetes, he suffered swelling which affected the flow

in his urinary tract over many years 2. He had since birth a slightly

restricted urethra which further

reduced the urinary flow.

3. The combination of these two factors had put constant and harmful back

pressure on his kidneys, which along with a general deterioration due to age

had inflicted serious renal damage.13 Dr. Karl Jacob also confirms the

diagnoses:

Srila Prabhupada’s chronic diabetes, which was never medically properly

treated, was bound to lead to other serious consequent diseases which had to

increasingly manifest in his body: such as premature aging and degradation

of blood vessels, microangiopathy, high blood pressure, heart problems, and

diabetic nephropathy (severe kidney damage)…In addition his urethra was

constricted which

put a constant back pressure on the kidneys, increasing the renal

insufficiency and inducing further damage.13 Prabhupada exhibited many of

the classic symptoms of type 2 diabetes

mellitus (increased thirst, increased need to urinate, cardiovascular

disease with heart attack and stroke, kidney disease). These will be

documented to further substantiate the prognosis of diabetes mellitus.

Polydipsia (increased thirst)

Most people with type 2 diabetes experience an increased thirst along with

increased need to urinate, this is one of the most common

signs of diabetes type 2. 19 Although the fact that Prabhupada kept water by

his side constantly

is well known, the medical implication of this has previously gone

unnoticed. Srila Prabhupada’s personal servants Hari Sauri Das and

Srutakirti Das confirm that Prabhupada drank a lot of water. He always kept

a jug on his desk, and he frequently drank from it. This is certainly

consistent with the clinical features of type 2 diabetes mellitus, and

further points to this being the underlying cause for Prabhupada’s

degenerating health.

Polyuria (increased need to urinate)

This is the other most common effect of type 2 diabetes. This is documented

by Hari Sauri Das in his diary of May 4, 1976 He is again having trouble

with uremia, using the bathroom every hour.17 Cardiovascular disease

A common complication of diabetes mellitus is cardiovascular disease, often

leading to myocardial infarction (heart attack) or stroke.11 This is caused

by diabetic arteriosclerosis (hardening of

the arteries).16 Prabhupada’s history of cardiovascular disease is well

known. In September of 1965, he suffered two severe heart attacks while on

board the Jaladuta cargo ship on his way to America. Again in May of 1967 he

suffered from serious heart palpitations and a stroke which paralysed the

left side of his body.

14 This is referred to in many recorded conversations, including the

following one from 1976:

Prabhupada: Because the time was taken, extension. Then, in 1967, in

July, I thought, "Now the health is broken." I was very sick after

heartstroke. So I thought "Now I shall not exist. So let me go to Vrndavana

and die there." So I came back in July 1967. So this Brahmananda and others,

they were crying when I got on the boat. Hm?

The heart was so weak...12 Prabhupada’s personal servant, Hari Sauri Das

also reports similar problems in 1976:

He is experiencing disturbing heart palpitations and his uremia has

caused his legs and feet to swell again. It was a strain for him to

even be out.17 Thus the symptoms of cardiovascular disease with myocardial

infarction and stroke were prominent in Srila Prabhupada’s condition

from when he first left India in 1965, adding further weight to the

prognosis of chronic diabetes, causing heart disease and later kidney

failure.

Nephropathy (kidney damage)

Diabetes is the single leading cause of all chronic kidney failure in the

U.S.16 and at least one third of people with diabetes develop

kidney disease.11 Kidney disease was repeatedly diagnosed by doctors who

attended to Srila Prabhupada.

Tamal Krishna: No, but all along, all of the doctors say it is kidney

trouble. All of the doctors, allopathic and kaviraja agree kidneys are

defective. And the surgeon in London, he also said so.12

Room conversation, October 20, 1977. Vrindavan.

The National Kidney Foundation (U.S.) lists swelling of the legs and

increased need to urinate as sure signs that a diabetic is developing kidney

disease.16 These symptoms were repeatedly reported

as early as 1975 by Hari Sauri Das in his personal diary, and Prabhupada

himself attributed it to kidney damage causing uremia. Prabhupada is not

feeling well; swelling in his legs, feet and hands

trouble him. To see his body puffed with fluid is very disturbing…Prabhupada

said this is due to uremia, a toxic condition

caused by waste products in the blood normally eliminated in the urine. It

makes it very difficult for him to climb the steps to his

apartment when returning from the temple.

December 20, 1975.

He is again having trouble with uremia, using the bathroom every hour. His

feet are badly swollen and he is suffering dizzy spells. May 4, 1976.

He was ashen, and told me he was experiencing severe kidney pain and

could not translate. It was the same problem he had a few days ago.

July 15, 1976. 17

 

Doctors Jacob and McIrving confirm that severe kidney damage had taken

place, brought about by prolonged untreated diabetes. All available clinical

evidence and information from the medical literature fully supports their

findings.

Retinopathy

Diabetic retinopathy is the most frequent cause of new blindness in

adults aged 20-74.11 Damage is caused by constriction of small blood

vessels in the retina, which impairs vision. In his last 2 months,

Prabhupada suffered from partial blindness.20 This is consistent with

diabetic retinopathy.

Peripheral Neuropathy

Diabetes mellitus is often characterised by a tingling sensation and

loss of feeling in the legs.11 Due to Prabhupada’s policy of not discussing

his health situation unless it made it impossible for him

to work, it is not known if he experienced these more subtle clinical signs

of diabetes.

Srila Prabhupada exhibited motor-sensory loss in his left leg during

the final month of his illness, as documented in the diary of his personal

secretary, Tamal Krishna Goswami. 18 Prabhupada’s left leg was beginning to

feel very heavy. When he asked my opinion whether it was paralyzed, I

suggested that the blood was not circulating because of inactivity.

October 23, 1977

“I am not getting strength. Even to lift my leg, I need help. Practically

my left leg is not working. What should be done now, you consider.”

November 11, 1977

The problem in Prabhupada’s left leg, where he experienced severe pain and

paralysis during his last month, could have been due to a diabetic sub-acute

moneuropathy, as described by Herting and Frohberg9. As discussed earlier,

it was obviously not a bilaterally

symmetrical polyneuropathy, characteristic of heavy metal poisoning.

Dry, Itchy Skin The American Diabetes Association describes dry, itchy skin

as one of the six most common signs of type 2 diabetes.19 Prabhupada’s

routine of having a full body massage with mustard oil

daily prevented his skin from drying out, however, itchiness was experienced

by him during the last six months of his illness, as described in Tamal

Krishna Goswami’s diary. 18 When Prabhupada woke up at six thirty, he had me

scratch his back.

Then he went to sit in the garden.

June 7

When he wakes up, usually around 6:00 a.m., he opens his eyes and looks at

me. Then after some time, he holds out his arms and I pull

him up. I sit behind him and scratch his back, which has lines in the skin

from lying down. At this time, he usually talks casually. July 4 Prabhupada

interrupted and asked for someone to scratch his back. Kirtanananda Swami

responded. Prabhupada asked, “Anyone can scratch

very hard?” Kirtanananda Swami objected, “I’m afraid you’ll have no

back left!” October 9

That Prabhuapda experienced itchiness of his skin is a further positive sign

that he was suffering from advanced diabetes type 2. Table 1. Symptoms of

arsenicosis and their presence or absence in Srila Prabhupada’s condition.

 

Clinical symptoms of arsenicosis1,2,6

Clinical feature of Prabhupada’s condition Raindrop pigmentationNo Mees’

linesNo

Dermatological lesionsNo

HyperkeratosisNo

Symmetrical sub-acute polyneuropathyNo

Gastrointestinal upsetYes

Multiple organ failureYes

 

 

Table 2. Symptoms of diabetes and their presence or absence in Srila

Prabhupada’s condition.

 

Clinical symptoms of diabetes mellitus9,11,19Clinical feature of

Prabhupada’s condition

 

Polydypsia (excessive thirst)Yes

Polyuria (increased need to urinate)Yes

Heart attackYes

StrokeYes

Nephropathy (kidney damage)Yes

High blood pressureYes

Retinopathy Yes

Sub-acute moneuropathy Yes

Repeated or hard to heal infections of the skin or bladder Yes Dry, itchy

skinYes

 

 

Table 3. Symptoms of diabetes advancing to kidney disease and their

presence or absence in Prabhupada’s condition.

 

Clinical symptoms of diabetes advancing to kidney

disease16Clinical feature of Prabhupada’s condition Swelling of legs and

handsYes Morning sickness, nausea and vomitingYes

High blood pressureYes

Polyuria (increased need to urinate)Yes

Protein in the urineYes

Weakness, paleness and anemiaYes

 

 

Conclusion

There is no strong evidence either clinical or medical, that Srila

Prabhupada suffered from chronic arsenic poisoning. The only symptoms of

arsenicosis he experienced were those of a highly non-specific nature,

namely gastrointestinal upset and multiple organ failure. None of the

clinically specific signs attributable to

arsenic intoxication were observed in Srila Prabhupada. Interestingly, there

are many parallels between the claims made by Nityananda Das and those made

by S. Forshufvud22 regarding the death

of Napolean. In their 1996 rebuttal to the Napolean poisoning theory,

Doctors Corso and Hindmarsh make the following observations

in summing up their case.

Napolean…failed to show some of the classic signs of arsenic poisoning,

including thickening and pigmentation of the palms of the

hands, irregularities of the nail beds and a sensory neuropathy of the lower

legs. Specific note was made at autopsy of the clear and almost ivory-like

quality of his skin, certainly something not seen

in someone suffering from chronic arsenic poisoning…Also, Ernest Chioda, a

noted medical toxicologist and lawyer, stated at the debate that both from a

medical and a legal standpoint, no case whatsoever can be made for the

poisoning of Napolean as a criminal act.

On the other hand, there is significant and compelling evidence attested to

by eight doctors all present at Napoleon’s autopsy that

indeed he died of a cancer of the stomach complicated or associated

with a perforating chronic ulcer.6 In the case of Srila Prabhupada, we also

find that there is significant and compelling evidence, based on the

clinical record and testimony of doctors who personally treated him, that he

was suffering primarily the symptoms of advanced diabetes, which, having

gone untreated for decades, led to further complications, most notably

coronary heart disease and kidney failure. In contrast, the

theory that he was poisoned with arsenic is utterly baseless and is

not substantiated by the medical evidence in any way whatsoever. References

1. Bansal SK, Haldar N, Dhand UK, Chopra JS. Phrenic Neuropathy in

Arsenic Poisoning. Chest 1991;100(3):878-880 2. Shin J Oh.

Electrophysiological Profile in Arsenic Neuropathy. J Neurol Neurosurg

Psychiatry 1991;54:1103-1105 3. Das D, Chatterjee A, Mandal BK,

Samanta G, Chakraborti D. Arsenic in Ground Water in Six districts of West

Bengal, India. Analyst 1995;120:917-924 4. Shannon RL, Strayer DS.

Arsenic-induced Skin Toxicity. Hum

Toxicol 1989;8:99- 104

5. Yeh S. Skin Cancer in Chronic Arsenicism. Hum Pathol 1973;4:469-485

6. Corso PF, Hindmarsh T. Further Scientific Evidence of the

Non-Poisonous Death of Napolean Bonaparte Sc Prog 1996;79(2):89-96 7.

Hindmarsh T, Corso PF. The Death of Napolean Bonaparte:A Critical Review of

the Cause. J Hist Med 1998;53:201-218 8. Murphy MJ, Lyon LW, Taylor

JW. Subacute Arsenic Neuropathy:

Clinical and Electrophysical Observations. J Neurol Neurosurg Psychiatry

1981;44:896-900 9. Herting RL, Frohberg NR. Neurology: Peripheral

Neuropathy.

University of Iowa Family Practice Handbook, 3rd Edition, Chapter 14.

10. Conomy JP. A Succession of Mees’ Lines in Arsenical Polyneuropathy,

11. Butler RN, Rubenstein AH, Gracia AG, Zweig SC. Type 2 Diabetes:

Causes, Complications and Screening Recommendations. Geriatrics

1998;53(3):47-54 12. Bhaktivedanta Book Trust. Complete Works of Srila

Prabhupada.

1991 13. Hari Sauri Das, Jahnu Das. A Reply to the Poison CD. 14.

Satsvarup Das Goswami. Srila Prabhupada Lilamrita. 15. Hari Sauri Das.

Personal communication, September 1999. 16. National Kidney Foundation.

(U.S.) Internet Home Page Information, Jan 1997.

17. Hari Sauri Das. A Transcendental Diary.

18. Tamal Krishna Goswami. TKG’s Diary- Prabhupada’s Final Days 19.

American Diabetes Association. Internet Information Pages, 1997 20. Tamal

Krishna Goswami. Personal communication, September 1999.

21. Srutakirti Das. Personal communication, September 1999. 22.

Forshufvud S. Who Killed Napolean. 1961. London. 23. Abhirama Das.

Personal communication, September 1999.

 

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