Benjamin Franklin was an extraordinary statesman who helped lead the American colonies through their transition from British colonies to independent United States. He was also an avid scientist and inventor, a community leader, and an active diplomat.

His charm and witty demeanor drew people to him, and he kept close ties with family and friends across the Atlantic. But what diseases did he suffer from?

Smallpox

In the 1700s smallpox was one of the most feared diseases in colonial America. The acute infectious disease caused fever, headache and back pains as well as a painful eruption of pockmarks on the face and limbs. It killed 30 percent of the victims, mostly children, and left survivors disfigured.

Cotton Mather, a Congregational minister and scientist who influenced Franklin the printer, had heard from Onesimus that inoculation prevented smallpox. Mather teamed up with Boston physician Zabdiel Boylston to conduct the scientific study that proved smallpox inoculation was effective.

Despite the evidence, some Puritans remained against the procedure. One reason may have been a fear that inoculation was a “heathen practice” brought by people from Africa. More likely, some believed it defied God’s will. Franklin’s decision not to inoculate his son reflected these beliefs.

Syphilis

It’s well known that Benjamin Franklin had affairs and left his wife Deborah for years at a time, though the extent of these dalliances and their carnal nature remain a mystery. It’s also popular to say that Franklin died of syphilis, but the truth is more complicated. The syphilis that he likely had is called late-symptomatic neurosyphilis, which can present decades after the initial infection. This is usually referred to as meningovascular or spinal cord syphilis and can result in stroke, dementia, cranial nerve palsies and psychoses.

In the end, Franklin died of pneumonia, pleurisy and empyema—an inflamed abscess in his lung causing pain, cough and difficulty breathing. He didn’t die from venereal disease, but from a combination of pneumonia and the underlying diseases that he had accumulated throughout his life. He’s now seen as the embodiment of a medical legacy that began with his campaign against smallpox and ended with Edward Jenner’s introduction of vaccination.

Gout

A recurring condition, gout is caused by the buildup of painful crystals of uric acid. While it is known as the “disease of kings” because it tends to affect wealthy men, it can occur in people of any class.

Gout attacks are most likely to occur in the big toe or other large joints, such as the knees and elbows. These joint attacks are very painful and often occur at night.

If left untreated, a gout attack may cause permanent damage to the affected joint. In the long term, gout can also lead to high blood pressure, kidney and heart disease.

The risk of a gout attack can be reduced by avoiding foods that are rich in purine, such as shellfish, gravies, red meat and organ meats like liver. Medications such as allopurinol, febuxostat and uricosurics can help reduce uric acid levels and prevent gout attacks. Talk to your orthopaedic doctor for more information about gout.

Pneumonia

A lung infection (pneumonia) can be caused by bacteria, viruses or sometimes by inhaled chemicals. Pneumonia can be mild or severe, with symptoms like a flu-like illness or more serious symptoms such as shaking chills, fever, cough, chest pain, trouble breathing and a rash.

Older adults, babies and people with serious illnesses or weak immune systems are more likely to get pneumonia. They may also be at risk of a complication called pleurisy or empyema which is an inflammation with pus in the space between the lungs and chest wall.

Towards the end of his life Benjamin Franklin had gout and pneumonia which combined with attacks of pleurisy to cause empyema. He died from this in 1790 at the age of 84. Throughout his life he gave health advice including treatments for bladder stone and gout. He was also involved in discrediting the medical cult surrounding Franz Anton Mesmer, who promoted animal magnetism. Franklin wrote widely on health-related issues and was respected by physicians, scientists and even royalty.