MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

King Charles

Lots of people have commented on King Charles’ swollen hands which can be seen in many pictures, not least the one on the cover of my biography of Charles. The king himself repeatedly referred to his ‘sausage fingers’ and has made light of the issue as far back as 1982. When William was born. At that time, he wrote to a friend: “I can’t tell you how excited and proud I am. He really does look surprisingly appetising and has sausage fingers just like mine.”

Now that he is King, we might need to worry; are his ‘sausage fingers’ a sign of a serious underlying disease?

Swollen fingers are normally due to fluid retention which can have many causes, e.g.:

Charles, The Alternative Prince: An Unauthorised Biography

  • allergy,
  • arthritis,
  • bursitis,
  • carpal tunnel syndrome,
  • diabetes,
  • gout,
  • heart failure,
  • injury,
  • infection,
  • kidney failure,
  • lymphoedema,
  • scleroderma,
  • sickle cell disease,
  • syphilis,
  • tendinitis,
  • tuberculosis.

The list is long and it contains some worrying diseases. Luckily, we can exclude many of them simply because Charles has had ‘sausage fingers’ for so many years. Thus, plausible options could be diabetes and scleroderma. The former can probably be excluded mainly because we would have long known about it.

But what about scleroderma?

Scleroderma (or systemic sclerosis, as it is also called) is a serious autoimmune condition that may be localized or generalized. The latter form is more serious. In 2020, it was noted that Charles’s feet also seemed to be swollen. In addition, his face often looks flushed (see also the cover of my book).

I know far too little about Charles’s health to make even a tentative diagnosis. Some features of scleroderma fit quite well, while others do not. In any case, I do hope Charles’s swellings have a more benign explanation. But, if scleroderma is the cause, the question obviously arises: is there a so-called alternative medicine (SCAM) for it?

A recent review stated that some study results have shown that vitamins D and E, probiotics, turmeric, l-arginine, essential fatty acids, broccoli, biofeedback, and acupuncture may be beneficial in systemic sclerosis care. However, large randomized clinical trials have not been conducted. In other words, SCAM has no proven benefit for the condition, and I would not recommend it.

Charles does know that, of course. In the past, he regularly made grand proclamations in favor of SCAM but, as soon as he was really ill, he always employed the best conventional healthcare can offer.

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