On the whole, I’d rather risk my chances than put myself in the hands of 18th Century doctors. All I find are horror stories, particularly around childbirth. Who can forget Sir Richard Croft, accoucheur to Princess Charlotte? After starving and bleeding the girl in the late stages of her pregnancy, he failed to intervene when the baby was in trouble and then warmed the mother up when she showed signs of haemorrhaging (the accepted method then was to apply a cold compress, so goodness knows why he decided a fire and blankets were in order). Just look at the unpromising trio above! As George III was to find out, 18th Century doctors may have been foolish when it came matters of the body, but they were even less equipped to deal with matters of the mind.

Blistering, leeches, mustard plasters, purges: these are just some of the miseries George had to endure. There were other favoured methods for treating madness: plunging the suffer in cold water repeatedly, restricting them to a diet of only apples for a month. As you can imagine, none of these really worked. But even if they had been effectual, it doesn’t follow they would have helped the King. Personally, I lean towards the theory that George III had acute porphyria. It was something his doctors stood no chance of diagnosing.

It is interesting to speculate who else in the royal family may have suffered from this metabolic disorder – or indeed, madness, if that truly was the trouble with George. Porphyria’s symptoms can include purple urine, skin sensitivity, abdominal pain, mood swings, delirium, sensitivity to sunlight, weakness, insomnia, and breathing problems. When I look at other members of George’s family who were accused of being “mad”, some of these crop up too.

Firstly, let’s consider George’s daughter, Princess Sophia. Sources confirm she was troubled with ill health all her life, but if we look at the symptoms in closer detail, we can see hints of porphyria. Described as a “moody” Princess, she certainly experienced the mood swings and insomnia detailed above. We also see repeated “spasms”, particularly in her stomach. She and George both experienced visual symptoms with their illnesses, and indeed both were to die completely blind. Interestingly, there was a period in 1793-4 when Sophia started to show alarming symptoms of her father’s “madness”. Her correspondence from the time shows a worrying tendency to paranoia; she writes to tell her father unpleasant things are happening and she is sure “Princess Royal is behind everything”. Her family was certainly worried enough to ship her away from sight for rest and recuperation; in a tactic that echoed the removal of King to Kew in his madness, she was not told she was going away and simply woke up one day to find her family had deserted her and a carriage ready at the door. What porphyria doesn’t account for are the fits Sophia used to fall into or her “swallow”, as she refers to it.  She never really elaborates on what this was – it could literally be a problem with swallowing, a sore throat or a breathing difficulty.

From Sophia it’s natural to move on to Ernest, a brother with whom she shared a close relationship. By his behaviour, Ernest certainly merited suspicions of mental instability. But I can locate no physical symptoms or episodes of delirium; on the whole, Ernest was fit as a fiddle, always well amidst ailing brothers at Gottingen University. I think we simply have to accept Ernest was boisterous and a bit of a rotter. The reports that he supposed attacked women and wanted to seduce nuns may or may not be true. But with Ernest, I can see only character flaws – no hint of the “King’s Evil”.

Travelling from “characters” in God Save the King to those in A Forbidden Crown, we find a wealth of new material. I have written in other posts about Caroline of Brunswick’s eccentricity; I literally cannot count the sources I have found from contemporaries swearing she was mad. Even her mother broke down in tears before Queen Charlotte and asked her to excuse Caroline because she was (tapping her head) “Not quite right in here”. Could the same be said of her sister Augusta, who Friedrich of Wurttemberg was so eager to separate from? It’s also interesting to note some of Caroline’s brothers played a shadowy role in the court of Brunswick because they were “idiots” (18th century term, certainly not mine). But with Caroline we can chart the physical symptoms too. From an early age, she had “cramps, nervous debility and hysteria. All that excites her arouses the disorder”.  Her mother was terrified. Indeed, all the way up to her death she suffered with pains in her stomach, although the symptoms could point towards a cancer that eventually killed her.

But what of Caroline’s husband, George IV (who I will refer to as Prinny to avoid confusion with his father)? We often laugh at Prinny for behaving like a toddler and mock his severe mood swings. Few people have considered his behaviour in the light of an illness. I find it extremely telling that Prinny was always eager to conceal any illness that befell him (I mean real illness – he was keen for people to know about the ones he staged for attention) for fear of rumours that he suffered with his father’s malady. It’s hard to tell with a flamboyant character like Prinny what is fact and what is fiction. But he certainly had worrying mental symptoms; contemporaries joked that he could tell a story so many times that he actually came to believe it. This has darker undertones than the light Regency banter suggests. Prinny really did believe his fantasies and definitely suffered from acute paranoia. At the first Regency crisis, Prinny turned on his hitherto (and later) adored mother, convinced she was out to poison the government against all her children. When he married Caroline, his suspicions took on farcical proportions. Again, a contemporary declares that “nothing but madness” could explain the way he treated his wife.  Prinny’s physical symptoms are difficult to extract – so many could be caused by the opulent lifestyle he led. All the same, he was addicted to opium in later life and repeatedly bled himself – he even had a special lancet secreted for the purpose when the doctors refused to cut him.

It’s easy to see how the gene pool had got into this state – and a state it was, regardless of whether anyone had porphyria or not. Continual intermarriage had brought things to a level where even George III disapproved of unions between first cousins. The necessity to marry within their Protestant religion and royal blood limited most Hanoverians to Germany, where they hailed from. It was impossible to marry someone who was not at least distantly related. Moreover, if you follow the madness theory, this strict circle of acceptable spouses was mentally suffocating. For each royal that showed signs of delirium, there were certainly surrounding circumstances that could conceivably have driven a person “mad”.

What I find most interesting is the way madness stalked George III through life. I don’t mean just his own disorder – I am talking the mental derangement of others. His sister Caroline Matilda (later referred to as Caroline Mathilde) married Christian of Denmark, another famously mad King. Christian’s disorder was perhaps more disturbing than George’s, given the violent nature of it. George himself declined marrying the Princess of Hesse-Darmstadt for fear that her father, who claimed to be able to talk with the spirit world, was mad. Oh, the irony! And then there were  the assassins lurking in the shadows. The first, Margaret Nicholson, who tried to stab George outside St. James’s Palace, was carted off to the mad-house. She thought England’s crown was hers by right and the country would be deluged in blood for a thousand years if she didn’t get it. Poignantly, the King – who had not experienced “madness” himself at this point – urged people not to hurt her, because she was only a poor mad woman.  There was another man ruined by the war-time effect on the stock market that killed himself right in front of George. More famously, we have the case of James Hadfield: the man who tried to assassinate George at Drury Lane Theatre. His trial led to the Criminal Lunatics Act 1800 which is rather fabulously represented in one of my favourite programmes, Garrow’s Law.

As you can see, poor George was pretty much surrounded by “madness”. If you would like find out more about him and his illness, and read fictionalised accounts of some of these events, look out for my novel God Save the King at the end of September 2012.


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