Wednesday, November 13, 2013

Did King Edward IV Have Type 2 Diabetes?



This article first appeared in the September 2011 issue of the Ricardian Register, Vol. 42 No. 3. 
Edward IV King of England 1461-83, the original type two diabetic?
Peter Stride
Then you conclude, my grandma, he is dead.
The King mine uncle is to blame for it.
King Richard 111, II, ii 12-131

Abstract:
Edward IV, second son of Richard, Duke of York and Cecily Neville, was born on 22nd April 1442. Edward IV was renowned for his radiant good looks on ascending the English throne. He was the epitome of youthful vigour and health. Why did the warrior king with an exuberant lifestyle die of natural causes at forty? The new hypothesis of diabetes is suggested.

Introduction:
The death of Edward IV was a pivotal point in history. The good aspects of the following Tudor and Stuart dynasties are currently the dominant English perception, but these two tragic centuries included a widespread civil war, regicide, religious schism and genocide, torture and execution of women, the risk of foreign invasion and the destruction of England’s architectural heritage.

The Young King:
Edward was a huge man. His skeleton, exhumed in 1789, measured 6 feet 3-3/4 inches, thus in 15th-century England he was nearly a foot taller than average. Contemporary writers described Edward in superlatives, "the tallest", "the fairest", "the strongest”, and was well renowned for his fair complexion and good looks. The Croyland Chronicles2 described Edward as “a person of most elegant appearance and remarkable beyond all others for the attractions of his person.” Thomas More,3 a Tudor supporter, described his appearance:

“He was of visage lovely; of body mighty, strong and clean made; howbeit in his latter days, with over liberal diet, somewhat corpulent and burly but nevertheless not uncomely.”

Ross described Edward as neither scholar nor saint, but noted his charm, courage, affability, leadership and especially his retentive memory.4

Edward’s Martial Prowess and Victories on the Battlefield:
Edward first fought in battle at nineteen, exhibiting a mature and calm control beyond his years, and beyond that of his opponents. Edward destroyed the House of Lancaster in a brilliant series of spectacular military victories. Friend and foe could see his inspiring leadership in the front line of battle, using his great height to advantage, and smashing his battle-axe at the nearest enemy.
Edward was also an outstanding battlefield commander. Edward’s knowledge of flanking movements and feints gained tactical battlefield advantages. Edward could ‘read’ a battleground and position his forces favourably. He manoeuvred his forces, at both Barnet and Tewkesbury in the dark, such that Lancastrian commanders found themselves in unfavourable situations by dawn.
Edward also had Napoleon’s favourite characteristic, luck, winning decisive battles when nature and fortune intervened. A snowstorm at Towton and heavy fog at Barnet helped turn those battles into decisive Yorkist victories. Edward fought and won seven battles, though twice he fled rather than risk a battle on unfavourable terms. Paul Murray Kendall, described Edward as “The mightiest warrior in Europe.5

Health Issues:
Edward enjoyed excellent health for many years. He had an acute illness, the sickness of the pockys,”6 perhaps measles, in 1462, but recovered uneventfully.7 Edward escaped the plague, though this disease claimed his son George in 1479. Edward‘s control over his destiny and his instinctive mastery of events deserted him in the 1469 rebellion, before he regained his throne, following the battles of Barnet and Tewkesbury. Falkus theorized that Edward had a nervous breakdown. Speculation draws parallels to Henry VI’s periodic insanity, and perhaps porphyria, present three centuries later in the Royal Family.7

Declining Health:
On regaining the throne, he ate and drank excessively. Mancini reported that he used emetics 6, but still appeared grand and regal. Commynes saw Edward in 1475 during the French Campaign and noted Edward was beginning to get fat and I had seen him on previous occasions looking more handsome.”4 Household records in 1478 state that Edward had health officers including the doctor of physic, who held consultation with the cook and stood much in the kings presence at his meals, counseling or answering to the king’s grace which diet is best according, and to tell the nature and operations of all the meats.”8 Doctor’s advice clearly fell on deaf ears in the 15th century as it does today!
Edward's health began to fail, with increasing ailments. Between 1480 and 1482, England and Scotland engaged in warfare. Edward planned to join Richard, Duke of Gloucester in both 1481 and 1482 on Scottish campaigns. He ordered eighty butts of wine for his 1481 campaign.3 Edward reached Fotheringhay Castle to plan strategy with Gloucester in 1482, but returned to London, perhaps with failing health and energy,7 never joining the campaign. A reluctance to campaign in Scotland could reflect intolerance to cold, a symptom of hypothyroidism or alternatively as common sense.
After Richard’s army captured Edinburgh, Edward granted Gloucester extensive land, income and power in the north of England in January 1483. Scofield7 described this as extravagant and ill-advised, and that “the fatal illness now fast creeping upon him had so weakened his judgement and understanding that he did not realize what he was doing.” Scofield is an acknowledged Edward IV expert. She wrote a two-volume history of Edward, and read extremely widely among primary and secondary sources about him. She did not offer any medical evidence, but believed Edward had an underlying disease.

Death:
Edward fell fatally ill at Easter 1483, initially collapsing while fishing on 30th March, and improved transiently, but weakened daily. He improved to add codicils to his will, naming his brother Richard as Protector. He then died on 9th April. The king’s barber-surgeon and physician present at his death were Jacques Freis and William Hobbes. Hobbes was appointed Serjeant Surgeon to Edward in 1461, being the first holder of this eminent office persistent today with a current appointee.9 Hobbes received a salary of 40 marks, with a meat and drink allowance. The key to this analysis is the medical knowledge base of the time, plus the experience and skills of Hobbes.
Scofield, Falkus, Hicks10 and Ross give accounts of his death, quoting the primary sources of Edward’s last days. Suggested causes include apoplexy, indigestion, typhoid, appendicitis, cirrhosis and even poisoning. The Croyland Chronicle, so often accurate, reports that the court was baffled, and gave a cryptic comment.2

“The king took to his bed neither worn out with old age nor yet seized with any known kind of malady, the cure of which would not have appeared easy in the case of a person of more humble rank.”

Mancini wrote that Edward was depressed when his treaty with the Flemings unravelled, that splendid Royal theatrical performances hid his sorrow, and that a cold was the terminal event.8

“Edward fell into the greatest melancholy, lamenting that by his inactivity the Flemings, ancient friends, had been permanently estranged from him.
“...so as to mitigate or disguise this sorrow, yet was he never able altogether to hide it
“...they say there was another reason for his death was, that he being a tall man and very fat though not to the point of deformity allowed the cold damp to strike his vitals, when one day he was taken in a small boat, with those whom he had bidden go fishing and watched their sport too eagerly. He there contracted the illness from which he never recovered.

Mancini said the reconciliation between the Woodvilles and Lord Hastings occurred two days before death, though More stated this was a few hours before death.8 Commynes thought he was depressed following the Treaty of Arras, and twice states that apoplexy caused death.11 Vergil said the cause was unknown, but hinted at poison.12 Tudor historian Edward Hall suggested the malaria Edward caught in France in 1475 had “suddenly turned into an incurable quarten fever.” Thomas Basin, a French historian, said that a too-hearty dinner on Good Friday killed him.8
After Edward’s death his body was laid upon a board all naked, saving he was covered from the navel to the knees” for public display for 10-12 hours.7 No visible abnormality was recorded.

Exhumation:
David Hughson detailed Edward’s exhumation. His skeletal measurements provided little medical information beyond the height and apparent lack of skeletal trauma.13

“The body, enclosed in a leaden and trooden coffin, measuring six feet three inches in length, appeared reduced to a skeleton.”

Possible causes of death:
There are no recorded clinical features of Edward’s terminal illness; hence his cause of death remains undiagnosed. His character fluctuations with periods of immense physical prowess, vigorous leadership and initiative, alternating with periods of inertia and poor insight impose problems in detecting developing medical problems between 1480 and 1483. Most historians believe Edward’s obesity and inactivity contributed to his ailments, and eventually to his death. His demise from an apparently minor infection suggests an underlying, undetected ailment exacerbating the acute condition. Edward fell ill after catching a cold on a fishing trip, rallied briefly, then deteriorated and died, probably of pneumonia.
Rosemary Hawley Jarman’s novel, We speak No Treason, places William Hobbes, Edward’s physician, at the bedside, setting “blood irons to the royal veins and vainly all but drained that vast body.”14 Though fictional, this is a possible contributing factor to the king’s demise. Seven generations later, excessive bleeding by equally enthusiastic but ignorant physicians contributed to the demise of Charles II.
Edward was a mediaeval sex addict, his legendary sexual activities and numerous partners suggesting a sexually transmitted disease (STD). Mancini wrote he was licentious in the extreme...he pursued with no discrimination the married and the unmarried, the noble and the lowly: however he took none by force.”8 Edward IV had ten children with his queen, Elizabeth Woodville, and perhaps five illegitimate children, between 1466 and 1480, and then no more, suggesting secondary infertility or erectile dysfunction, though Jane Shore appeared happy with his company until his death. However, syphilis, the most severe venereal disease, was not endemic in Europe for another decade15, and the genital symptoms of other STDs were not recorded in his partners, nor his partners’ other sexual contacts. Edward’s intact cognitive function on his deathbed excluded the dementia of tertiary syphilis. Henry VIII probably was the first English monarch with syphilis, though he may also have been diabetic.
All Edward’s reports indicate progressive weight gain, not terminal wasting or internal bleeding, making cancer or tuberculosis improbable. Mancini’s implication of a stroke is unlikely with intact speech, cognitive and motor functions during the deathbed scene. Increasing weight and lethargy suggest endocrine disease, with diabetes and hypothyroidism possible. Cushing’s disease and gigantism are feasible but very rare diseases of the pituitary gland, which will not be further explored in this article.16
Hypothyroidism, a deficiency of thyroid hormone, causes fatigue, weakness, weight gain, intolerance to cold, depression, constipation, impaired memory and cognitive function and decreased libido, then ultimately life-threatening depression, heart failure or coma. The Greeks were aware of goitres, but in mediaeval days diagnosis and treatment of hypothyroidism were several centuries away. Hypothyroidism in England was found in Derbyshire, the only landlocked county, from deficient iodine in the diet, hence the term Derbyshire Neck, a synonym for goitre. Edward clearly enjoyed a diet of quantity, quality and variety, including fish, excluding dietary iodine deficiency.
Annette Carson in Richard III: the Maligned King17 suggested arsenic poisoning causing Edward’s death. She reviewed many original documents, but accepts Collins'18 recent flawed medical analysis that arsenic poisoning caused Edward’s death. However, arsenic causes severe abdominal pain, diarrhoea and vomiting, thirst and excessive salivation; dryness in the throat with a hoarse voice, difficulty of speech, then convulsions, circulatory collapse, delirium and death. Arsenic is an improbable cause of Edward’s death, as these severe symptoms were not recorded.
Collins excludes diabetes in Edward IV as a wasting disease. He does not differentiate the improbable juvenile type 1 diabetes with weight loss from the possible type 2 diabetes associated with obesity. Collins incorrectly excludes “...proposed mycoplasmosis (sic) pneumoniae, an amoebic(sic) disease contracted from stagnant water” believing that pneumonia always causes death within hours, not days. Mycoplasma pneumonia are small bacteria lacking a cell wall found in animal hosts.

Diabetes:
Polyuria or excess urine output, a symptom of diabetes, was first described three and a half millennia ago by the ancient Egyptian physician Hesy-Ra in the Ebers Papyrus, and named diabetes by the Greek Aretaeus of Cappadocia in 250 BC. The attraction of ants to diabetics’ urine was noted in India at about the same time.
The Persian physician, Avicenna, (980-1037) noted the sweet taste of diabetic urine, the abnormal appetite and erectile dysfunction in his textbook, The Canon of Medicine19, still used in 15th century England, and European Universities as late as 1650 suggesting little medical advance for six centuries. In Edward’s time medical knowledge was probably less than in the Middle East four hundred years previously. Gaddesden’s authoritative text Rosa Medicinae 2 written between 1307 and 1314, and possessed by many doctors, refers to diabetes, but omits the taste of urine.20
Getz does not mention diabetes in her Mediaeval Medicine text.21 Gilbertus Anglicus’s translation of Compendium Medicinae22 around 1240 was often used by 15th century English doctors. Anglicus stated diabetes is an vnmesurable pissing of vrinand considers it is caused by moche medling with wymen and it cometh of drinking of stronge wyne. Anglicus appears to be ‘on to something’ lost in today’s’ texts perhaps relevant to Edward! However he does not mention sweet urine. It is unknown whether William Hobbes and Jacques Freis were aware of this condition, but the available texts cast doubt on the ability of 15th century physicians to diagnose diabetes.
The English physician Thomas Willis revived the tasting of sweet urine, and in 1675 added the word mellitus. Matthew Dobson discovered sugar to cause the sweet taste of diabetic urine in 1776. William Heberden, a forefather of English medicine, wrote his celebrated text in 180223. He considered diabetes a rare wasting disease, typical of insulin dependent type 1 diabetes, having seen 20 or less cases. He omits the current common type 2 diabetes of obesity, Edward’s postulated condition.
Sir Harold Himsworth’s publication in January 1936, 543 years after Edward’s death ,clarified the distinction between juvenile type 1 diabetes and the maturity onset type 2 diabetes with obesity and insulin resistance.24 Today the association between obesity and type 2 diabetes is well understood. 20% of the Australian population are obese, 50% are overweight, 10% have diabetes or pre-diabetes, and diabetes is four times more common in the obese.
Maria de Medici, Queen of France, is also hypothesized to have been diabetic. She died in 1642, one hundred and fifty-nine years after Edward IV, still in a medical period when type 2 diabetes was unknown and when testing for sweet urine was not practised. Maria became grossly obese with overeating, died with gangrene of her right leg and skin infections. Her autopsy revealed both hardening of the arteries (arteriosclerosis) and pancreatic atrophy, both features of diabetes25. Maria’s autopsy information is not available for Edward, but both became grossly obese with overeating, and died of infections, suggestive of type 2 diabetes.


Conclusion:
·         Edward clearly suffered from obesity and lethargy
·         He may have been depressed by his failed foreign policy, and appears uncharacteristically unmotivated in his last year of life.
·         He may have suffered a terminal pneumonia.
·         Some underlying but undiagnosed disease may have been present. Diabetes and hypothyroidism are possible explanations of increasing obesity and lethargy, which could exacerbate a mild infection, contributing to death. Diabetes is the more likely.

 End Notes:


1. Shakespeare, William. The Complete Works of William Shakespear.e Collins. London. 1961. pp 701-747
2. Historia Croylandensis translation Ingulph’s Chronicle of the Abbey of Croyland ed H. Riley Bohn’s Antiquarian Library London 1854 -The Croyland Chronicle: Part IX The Third Continuation of the History of Croyland Abbey: July, 1485 - Apr, 1486 with Notes. 
3. More, Thomas. History of King Richard III. ed Sylvester R. Yale. 1963. p3
4. Ross, C. Edward IV. University of California Press Berkeley and Los Angeles. 1974. p9, p314-315, p232, p280
5. Kendall, P. M. Richard the Third. Redwood Press. Trowbridge. Wiltshire. 1955. p414
6. Falkus, G. The Life and Times of Edward IV. Book Club Associates. London. 1981. p64, p113, p206
7. Scofield, C. The Life and Reign of Edward the Fourth. Frank Cass. London. 1923. II p161, I p264, II p218, II p359, II p365-366
8. Mancini, D. The Usurpation of Richard III. trans. C. A. J. Armstrong. (Oxford, 1969, reprinted Gloucester, 1984). p 67, p69-71
9. Talbot, C, Hammond E. The Medical Practitioners in Medieval England. Welcome Historical Medical Library. London. 1965.
10. Hicks, Michael. Edward IV. Hodder Headline Group. London. 2004
11. Commynes, P. de. Memoires de Phillipe de Commyne.s ed B de Mandrot. Paris. 1901 p304, p344.
12. Vergil, Polydore. Three Books of Polydore Vergil’s English History. ed Ellis H. Camden Society. John Bowyer Nichols and Son. 1844. pp 171-172.
13. Hughson, David. London: Being an Accurate History and Description of the British Metropolis. J Stratford. London. 1808.
14. Jarman, R H. We Speak No Treason. William Collins. Glasgow. 1971.
15. Stride, Peter. Did Perkin Warbeck’s Mercenaries Introduce Syphilis Into the UK. Ricardian Bulletin. 2010. (Dec) 4:36-38.
16. Braunwald, E, Fauci, A, Kasper, D. Harrison's Principles of Internal Medicine, 15th Edition McGraw-Hill Professional, Maidenhead, UK pp 318-323.
17. Carson, Annette. Richard III, the Maligned King. The History Press. Chalford, Gloucester. 2008.
18. Dening, J, Collins, R. Secret History, The truth about Richard III and the Princes. The Lavenham Press. 1996.
19. Avicenna. The Canon of Medicine. Trans: Gruner O, Luzac and Co. London. 1930.
20. Cholmeley, H. John of Gaddesden and the Rosa Medicinae. Clarendon Press. Oxford. 1912.
21. Getz, Faye Marie. Medicine in the English Middle Ages. Princeton University Press. Princeton, New Jersey. 1998.
22. Anglicus, G. Healing and Society in Medieaval England A Middle English Translation of the Pharmaceutical Writings of Gilbertus Anglicus. Edited Getz F. University of Wisconsin Press. Wisconsin. 1991.
23. Heberden, W. The History and Cure of Diseases. T Payne. London. 1802. p141.
24. Himsworth, H. Diabetes mellitus: its differentiation into insulin-sensitive and insulin-insensitive types. Lancet. 1936. 1:127–130.
25. de Leeuw, I. J R Coll Physicians. 2009. 39: 185-6.

Thursday, March 7, 2013

Elizabeth, Lady Scales:


The First Wife of Anthony Woodville
Susan Higginbotham
Anthony Woodville, Earl Rivers, married twice: the first time to Elizabeth Scales, the second time to Mary FitzLewis. This article discusses Anthony’s first marriage—a match that owed nothing to the royal alliance Anthony’s sister Elizabeth made.
Elizabeth was the daughter of Thomas, Lord Scales, and his wife Ismania, whose name is also spelled variously as Imania, Ismanie, and Esmania. Ismania was a daughter of a Cornishman by the name of Whalesburgh. [1] Described in Anthony’s inquisitions postmortem as 24 or older at her father’s death in 1460, [2] Elizabeth Scales was born around 1436. Besides Elizabeth, Lord Scales and his wife had a son, Thomas, who predeceased his father. [3]
Elizabeth Scales’s mother was among those ladies sent to escort Henry VI’s new bride, Margaret of Anjou, to England in 1445, and was one of her principal attendants, receiving forty pounds per annum in 1452-53. [4]
Lord Scales, born around 1399, had a long record of military service in France, where he remained almost continually from 1424 to 1449. He was made lieutenant-general of western Normandy in 1435; it is possible that Elizabeth was born there. [5] One source estimates his wealth in 1436 as 376 pounds per year. [6] At Rouen in 1442, Lord Scales had served as a godfather at the christening of the future Edward IV. [7]
During Christmas of 1445, Lord Scales was at his principal manor at Middleton when the mayor and council presented a nativity play there, with a cast that included a John Clerk as the Virgin Mary and a person with the surname of Gilbert as the angel Gabriel. [8] Nine-year-old Elizabeth would have been at an age to enjoy this thoroughly.
Elizabeth’s father had strong ties with the Woodville family from early on. Created a Knight of the Garter in 1425, Lord Scales successfully nominated Anthony’s father, Richard Woodville, Lord Rivers, as a Garter knight in 1450. [9] That same year, King Henry VI appointed Lord Scales, Lord Rivers and other men to put down Jack Cade’s rebellion. [10] Interestingly, when Richard, Duke of York placed his grievances before the king that autumn, Lord Scales and Lord Rivers were said to have accompanied him. [11]
However, Lord Scales remained loyal to Henry VI during the upheavals of the 1450’s. In the summer of 1460, when the exiled Earls of March, Warwick, and Salisbury returned to England with the intention of seizing power, Lord Scales and Robert, Lord Hungerford, held the Tower for the king. Besieged by the Yorkists, the forces inside the Tower shot guns and cast wild fire into the city, to the injury of “men and women and children in the streets,” as reported by the English Chronicle. [12] When the Yorkists, having defeated the Lancastrians at Northampton, returned to London with Henry VI in their power, Scales and Hungerford surrendered on July 19. [13]
Uncertain how he would fare at the hands of the Londoners, Scales, accompanied by three others, found a boat late that evening and rowed toward Westminster, with the intention of taking sanctuary there. Tipped off by a woman who recognized Lord Scales, a group of boatmen surrounded him, murdered him, and dumped his naked body at St. Mary Overy at Southwark. He lay there for several hours before his godson the Earl of March (later Edward IV) came upon the scene and arranged a proper burial for him. It was, as the English Chronicle noted, a “great pity” that “so noble and worshipful a knight,” who had served so valiantly in France, should meet such an ignominious death. [14]

Chroniclers seldom bothered to record the reactions of the wives and daughters of those slain during the Wars of the Roses, and they made no exception in the case of Elizabeth Scales. By the time of her father’s death, Elizabeth had likely already suffered the loss of her first husband, Henry Bouchier, the second son of the Earl of Essex by the same name. An August 27 letter in the Paston collection announcing his sudden death at Ludlow from an unspecified cause probably dates to 1458. [15] If any children were born to the couple, they did not survive.
Exactly when Elizabeth married Anthony Woodville is unknown, but contrary to what is sometimes claimed, it is beyond dispute that the marriage took place well before Anthony’s sister became the queen of England. The couple had certainly married before April 4, 1461, when William Paston reported mistakenly that Anthony, Lord Scales—the title that Anthony took in right of Elizabeth—had been killed at the battle of Towton. [16] Richard Beauchamp, Bishop of Salisbury, writing three days later, also reported that the dead included “Anthony, son of Lord le Ryver, who was recently made Lord le Scales.” [17]
Earlier, following the Lancastrian victory at the second battle of St. Albans on February 17, 1461, the Londoners had included Jacquetta Woodville, Duchess of Bedford, Anne Stafford, Duchess of Buckingham, and Lady Scales in a delegation sent to Margaret of Anjou to beg for mercy for the city. [18] Does “Lady Scales“ refer to Elizabeth or to her mother? Ismania had been prominent among Margaret’s ladies and would thus be a natural candidate for the task of negotiating with the queen, but it is not certain that she was still alive at this date; there is no indication that she held any lands in dower or jointure, as she would have if she had survived her husband. It may be, then, that “Lady Scales” refers to Elizabeth and that she had joined the Duchess of Bedford, Anthony’s mother, in the negotiations. This, of course, would push Elizabeth’s marriage to Anthony back to at least February 1461.
Whether Anthony and Elizabeth’s families helped bring the couple together, or whether the couple themselves initiated their marriage, is unknown. Elizabeth’s inheritance as Scales’s only surviving child was of obvious interest to Anthony, and his own status as the eldest son was of obvious interest to Elizabeth, but there is nothing to indicate whether personal attraction played a role in the marriage as well. Their age difference is not certain. Anthony was listed in his mother’s 1472 postmortem inquisition as being “of the age of thirty years and more,” which would put his birth date at around 1442 (to Elizabeth Scales’s probable birth date of 1436), but “the more” allows plenty of hedge room and leaves open the possibility that he was born earlier in his parents’ marriage, which took place by March 23, 1537. [19]
Elizabeth’s inheritance included lands in Norfolk, Cambridgeshire, Hertfordshire, Essex, and Suffolk. [20] The heart of the Scales estate was Middleton, near Bishop’s Lynn (later King’s Lynn). The town of Lynn often sent gifts of wine or fish to Lord and Lady Scales, whose minstrels also appear in the records. [21]
Lady Scales features in the household books of John Howard, who later became the Duke of Norfolk. In September 1464, Howard rewarded her messenger in the amount of six shillings and eight pence for bringing him a letter from Elizabeth. When with the king at Reading in November, Howard lent Elizabeth, who was also there with her husband, eight shillings and four pence to play at cards. The party moved on to spend Christmas at Eltham with the king; there, on January 1, 1465, Howard gave twelve pence to “my lord Scales chyld.” Anne Crawford has pointed out that the “child” was probably a page who was bringing a New Year’s gift to Howard from Anthony and Elizabeth, as opposed to the offspring of either Lord or Lady Scales, although Anthony did have an illegitimate daughter. [22]
Meanwhile, of course, Elizabeth Woodville, Anthony’s sister, had married Edward IV, the godson of Thomas, Lord Scales. Lady Scales was prominent among the attendants of her sister-in-law the queen. In 1466-67, like the queen’s sister Anne, who was married to William, Viscount Bouchier, Lady Scales received forty pounds per annum for her services (the same rate that her mother had received when serving Margaret of Anjou). She and Anne were the highest paid of the queen’s attendants; the next tier of ladies received only twenty pounds a year. [23]
In 1466, Anthony and Elizabeth engaged in a series of complex legal maneuvers, detailed in his inquisitions postmortem, to ensure that if Elizabeth predeceased Anthony without having borne him a child, the Scales estates would stay in Anthony’s hands instead of going to Elizabeth’s heirs. While this did have the effect of subverting the normal laws of inheritance, there is no reason to assume that Elizabeth was forced into the transaction by her husband or that she would have preferred that the land go to her rather distant cousins instead of to Anthony. [24]
When Edward IV’s sister Margaret traveled to Burgundy to marry its duke, Charles, in July 1468, Anthony Woodville served as her presenter. [25] Prominent among the English ladies accompanying Margaret to her wedding was Lady Scales. The marriage took place with all the ceremonial splendor one could expect of the Burgundian court. It certainly overawed John Paston, who wrote in a letter home, “And as for the duke’s court, as of lords, ladies and gentlewomen, knights, squires and gentlemen, I have never of none like to it, save King Arthur’s court. And by my troth, I have no wit nor remembrance to write to you, half the worship that is here.” The festivities featured jousting, in which Elizabeth would have seen her husband take a leading role. [26]
Anthony and Elizabeth’s return to England was soon followed by tragedy: in August 1469, Richard Neville, Earl of Warwick, having rebelled against Edward IV and taken the king temporarily into his custody, ordered the executions of Anthony’s father, Earl Rivers, and of his younger brother John—executions that were entirely illegal, as both Earl Rivers and John had been supporting the king that Warwick himself still recognized as his ruler. Anthony and Elizabeth now had  each suffered the murder of a father.
The continuing political upheaval led to Edward IV fleeing England in October 1470. A number of loyal supporters went into exile with him, including Anthony (now Earl Rivers). Where Elizabeth Scales spent the next few months is unknown. She may have joined her mother-in-law, Jacquetta, and Queen Elizabeth in sanctuary at Westminster, but I know of no source placing her there.
After Edward scored a Yorkist victory at Barnet, he returned to London briefly before marching out to encounter Margaret of Anjou’s forces. Anthony Woodville and the Earl of Essex, Elizabeth Scales’s father-in-law from her first marriage, were left to defend London from an attack by the Bastard of Fauconberg. Queen Elizabeth and her children were lodged in the Tower for their safety; perhaps Elizabeth Scales was with them.
Edward IV was back on his throne in May 1471, but Elizabeth Scales had little time to enjoy the peace that followed. According to Anthony’s inquisitions post mortem, she died on September 2, 1473. [27] She did live long enough to join in the festivities that took place when Louis de Bruges, Lord of la Gruthuyse, who had assisted Edward IV and Anthony while they were in exile, visited Edward’s court in September 1472. At a banquet in the queen’s chamber, Lady Rivers “sat at one mess” with the king and the queen, their daughter Elizabeth, the Duchess of Exeter, and Louis de Bruges himself. [28]
Anthony married Mary FitzLewis around 1480. He was executed on orders of the future Richard III at Pontefract on June 25, 1483.
In his will, written at Sheriff Hutton two days before his death, Anthony, having left the Scales lands to his brother Edward, asked that 500 marks be used for prayers for the souls of Elizabeth Scales, her brother Thomas, and the souls of all of the Scales family. [29] This provision has been interpreted as a slight by Lynda Pidgeon, who wrote that in his will, Anthony “makes no affectionate mention of [Elizabeth] or desire to be buried beside her” and that he appeared to do only the bare minimum to provide for her soul and those of others. Pidgeon concluded, “The will was business like: it met the requirements of his soul and those of his family and little else.... Perhaps he simply did not have feelings for anyone else.” [30]
Pidgeon’s judgment overlooks the fact that many wills of the period are businesslike documents, without sentimental effusions; it also fails to consider that Anthony, unlike testators expecting to meet a natural death or preparing for the eventuality of dying honorably in battle, was under the enormous stress of facing execution for a crime he most likely did not commit. Moreover, as he was about to be executed, he could expect his lands to be forfeit to the crown and would have to hope that arrangements would be made to pay his debts and honor his bequests. He was hardly in a position to make extravagant provisions for the dead. As it was, it does not appear that his will was ever admitted to probate during Richard III’s reign.
Anthony, possibly anticipating that he would be brought to London for the trial before his peers that was his right as an earl, initially asked in his will that if he died beyond the River Trent, he be buried in the chapel of St. Mary the Virgin besides St. Stephen’s College at Westminster, known familiarly as the Lady of Pewe. The Pope himself had recognized Anthony’s “singular devotion” to this chapel in 1476. [31] Contrary to Pidgeon’s surmise, Anthony’s failure to request burial beside Elizabeth Scales (whose burial place is not known) need not show lack of affection for her; it may simply indicate a strong devotion to the Virgin or to the chapel that took precedence over earthly attachments. Moreover, as a condemned man Anthony could not expect that the crown would go to the expense and trouble of bringing his body to lie beside that of Elizabeth, unless she had been buried at a convenient place for her husband’s burial. He had, in fact, little choice in where he would be buried, as he implicitly acknowledged at the end of his will, when having learned that he would be executed at Pontefract, Anthony asked to be buried there with his nephew Richard Grey, who was also facing execution, before an image of the Virgin Mary. [32] We can only guess at how close Anthony and Elizabeth Scales were to each other, but it is hardly fair to infer based only on this will that he was an indifferent husband.
In her thirty-seven years on earth, Elizabeth Scales lived through the violent deaths of her father, her father-in-law, and political upheaval; yet as with so many other women of her day, she left little behind to give us a clue about the woman behind her title. At the very least, it would have been nice to know what was in the letter her servant brought Lord Howard.

Endnotes:
1.  Myers, p. 182 n.1.
2.  TNA: C 142/1/36 (Cambridge); C 142/1/37 (Hertford); C 142/1/38 (Norfolk); C 142/1/39 (Suffolk).
3.  He is named in Anthony’s will, PROB 11/8. Printed in Pidgeon, p. 43.
4.  Griffiths, p. 486; Myers, p. 182.
5.  Castor.
6.  Wilkins, p. 194 n.17.
7.  Scofield, vol. I, p. 1.
8.  Lancashire, p. 227; Report on the Deeds and Records of the Borough of King’s Lynn, p. 88.
9.  Castor; Smith, p. 46.
10. Harvey, p. 81.
11. Griffiths, p. 707, n.108.
12. Davies, p. 96.
13. Scofield, vol. I, p. 92.
14. Scofield, vol. I, p. 92; Davies, p. 98.
15. Castor; Paston Letters, no. 574, part II, p. 175.
16. Paston Letters, no. 90, part I, p. 165.
17. Milan, no. 80, April 7, 1461,.
18. Kingsford, p. 173; Milan, no. 65, February 22, 1461.
19. C 140/42/49; Calendar of Patent Rolls 1436–1441, p. 53. A handwritten note by Robert Glover, Somerset Herald on a late fifteenth-century visitation suggests that Anthony may have been the Woodvilles’ oldest child. Visitations of the North, part 3, p. 58.
20. See n. 2; Pidgeon, pp. 30, 35.
21. Manuscripts of the Corporations of Southampton and Kings Lynn, pp. 224–25.
22. Crawford, Household Books, pt. I, pp. 281, 480–82; Crawford, Yorkist Lord, pp. 41–42, 156.
23. Myers, p. 288.
24. See note 2; Pidgeon, p. 35. The heirs in 1485 were John de Vere, Earl of Oxford, returned home after a long exile and imprisonment, and William Tyndale. Ross, p. 91.
25. Phillips, pp. 327, 329.
26. Paston Letters, no. 330, part I, p. 539. I have modernized the spelling.
27. See note 2.
28. Madden, p. 278.
29. PROB 11/8; Pidgeon, p. 43.
30. Pidgeon, p. 41.
31. Calendar of Papal Registers. 1476. 5 Kal. May. (27 April.) St. Peter's, Rome. (f. 99v.).
32. TNA PROB 11/8; Pidgeon, pp. 43, 45.

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