Royal Medical Entourages: Analysis of the Roles of Doctors during the Episodes of Madness of King George III

Abstract

King George III (1738–1820) had episodes of major mental illness in 1788–9 and 1810–20. Detailed records clearly indicate conflict within and between the medical entourages, based on their experience and clinical knowledge as well as their differing political allegiances. The apparent ignorance of the physicians concerning important contemporary knowledge of mental illness, particularly that published by Dr William Black (1750–1829), was highlighted during their questioning by the Parliamentary Committees. In 1788, initial treatment by the royal physicians was unsuccessful and potentially fatal. The King’s recovery in early 1789 was largely attributed instead to the ‘mad doctors’ (psychiatrists) Dr Francis Willis and his sons, who minimised toxic medications and employed essentially broad spectrum psychotherapy. Had their treatment failed the Prince of Wales would most probably have replaced William Pitt’s Tory government with a Whig administration. In 1810, there was a further relapse which did result in the imposition of a regency. Although the initial prognosis was favourable, by 1812 it was clear that the King was unlikely to achieve an adequate remission. Advice given to the Prince of Wales as Regent by the then leading royal physician Sir Henry Halford (1766–1844), again prevented a change of government. These scenarios demonstrate that royal physicians varied in their knowledge of up-to-date medical practice, and that their words and actions impacted the political course of government.

Notes

1 I wish to thank Her Majesty the Queen for gracious permission to examine medical records in the Royal Archives, and Pamela Clark, Registrar, for her assistance and advice. The assistance and advice of Peter Basham, Royal College of Physicians, and Iain Milne of the Royal College of Physicians of Edinburgh, were particularly helpful. The Latin and German translations were performed, respectively, by Terry Hunt and the late Clive Willis. The expert advice and critical comments of Leonard Smith, Tim Underhill and Christopher Peters are much appreciated. The assistance of staff at the British library, Lambeth Palace Library, the Leicestershire and Rutland Record offices, the National Archives, the Wellcome Trust Library and the Parliamentary Archives are gratefully acknowledged.

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3 Timothy J. Peters and David Wilkinson, ‘King George III and Porphyria: A Clinical Re-examination of the Historical Evidence’, History of Psychiatry 8 (2010), pp. 3-19; Timothy J. Peters and Allan Beveridge, ‘The Madness of King George III: a Psychiatric Re-assessment’, History of Psychiatry 21 (2010) pp. 20-37; Richard J. Hift, Timothy J. Peters and Peter N. Meissner, ‘A Review of the Clinical Presentation, Natural History and Inheritance of Variegate Porphyria: Its Implausibility as the Source of the “Royal Malady”’, Journal of Clinical Pathology 65 (2013), pp. 200-205; Timothy J. Peters, ‘King George III, Bipolar Disorder, Porphyria and Lessons for Historians’, Clinical Medicine 11 (2010), pp. 261-264; Timothy Peters and Clive Willis, ‘Mad Monarchs: Comparison of the Nature, Cause and Consequences of the Mental Ill-heath of Maria I of Portugal and George III of Great Britain’, The Court Historian 19 (2014), pp. 28-42; John Cannon, ‘George III (1738–1820), King of the United Kingdom of Great Britain and Ireland, and king of Hanover’, Oxford Dictionary of National Biography [http://www.oxfordnb.com/view/article/10540, accessed 4 July 2013].

4 Royal College of Physicians, London, Baker Papers MSS 92-93; Royal Archives, Windsor, Halford Papers RA GEO/ADDIS15/874; Lambeth Palace Library, London, Manners Sutton papers, MSS 2107-39; British Library (hereafter BL), Willis Papers, Add MS 41690, 54202-6.

5 Charlotte Barrett and Austin Dobson (eds), Diary & Letters of Madame D’Arbly, vol. II, 1788–1791 (London, 1905), pp. 1-26; F. McKno Bladon (ed.), The Diaries of Robert Fulke Greville (London, 1930).

6 Parliamentary Archives (hereafter PA), House of Lords Committee Report, Touching the State of His Majesty’s Health, 11^th December 1788, pp. 1-17; PA, House of Commons Committee Report; Touching the State of His Majesty’s Health, December 1788, pp. 1-18; PA, Houses of Parliament Committee Report, Touching the Present State of His Majesty’s Health, 13^th January 1789, pp. 1-131; PA, House of Lords Committee to Report the Names of the Lords Appearing. 14^th December 1810, pp. 1-22; PA, House of Lords Committee Report; Touching the State of His Majesty’s Health, 20^th December 1810, pp.1-22; PA, House of Lords Examination of the Physicians Attending His Majesty, 28^th November 1820, pp. 1-5; PA, House of Commons Committee Report, Touching the State of His Majesty’s Health, 17^th December 1810, pp.1-39; PA, House of Commons Committee Report, Touching the State of His Majesty’s Health, 13^th January 1912, pp. 1-14.

7 Earl Stanhope, Life of The Right Honourable William Pitt (London, 1862), vol. 2, pp. x-xi.

8 Much of the following section is derived from Charles Chenevix Trench, The Royal Malady (London, 1964).

9 David Healy, Mania. A Short History of Bipolar Disorder (Baltimore, 2008), pp. 1-23.

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12 Leonard Smith and Timothy Peters, ‘Details on the Establishment of Doctor Willis, for the Cure of Lunatics (1796)’, History of Psychiatry 26 (2017), pp.365-377; Timothy J. Peters and Clive Willis, ‘Mental Health Issues of Maria I of Portugal and her Sisters: The Contributions of the Willis Family to the Development of Psychiatry’, History of Psychiatry 24 (2013), pp. 292-307.

13 Trench, The Royal Malady, pp. 93-4.

14 Francis Willis, A Treatise on Mental Derangement (London, 1823), pp. 177-8.

15 Munk, Munk’s Roll, vol. 2.

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17 George Baker, ‘De Affectibus Animi et Morbis inde Oriundis’ [The States of the Mind and Diseases that Arise from Them], M.D. Thesis, University of Cambridge, 1755.

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19 Munk, Munk’s Roll, vol. 2, pp. 242-4 (Richard Warren).

20 BL, Willis Papers Add MSS 41690, fol. 47r.

21 See Table 2; PA, House of Lords Committee Report, Touching the State of his Majesty’s Health, 11^th December 1788, pp. 1-17.

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24 PA, London. Houses of Parliament Committee Report, Touching the Present State of His Majesty’s Health, 13 January 1789, pp. 1-131

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32 Roy Porter, The Greatest Benefit to Mankind: a Medical History of Humanity (London, 1999)

33 Ida Macalpine and Richard Hunter, George III and the Mad-Business (Allen Lane, 1969), p. 155.

34 Munk, Munk’s Roll, vol. 2, p. 414 (Thomas Monro).

35 Munk, Munk’s Roll, vol. 2, p. 318 (Samuel Simmons).

36 Smith and Peters, ‘Details of the Establishment of Doctor Willis’, pp. 365-77; Timothy Underhill and Timothy Peters ‘The Short Hand of Robert Willis, Physician-in-Extraordinary to King George III’, Electronic British Library Journal, eblj article 22018.

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38 Christopher Wright, George III (London, 2005), pp. 130-31.

39 Guttmacher, America’s Last King, pp. 390-92; Wright, George III, p. 134; Janice Hadlow, A Royal Experiment. The Private Life of King George III (New York, 2014).

40 Peters and Beveridge, ‘The Blindness, Deafness and Madness of King George III’, pp. 81-88.

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43 Cannon, ‘George III’.

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48 Peters and Garrard, ‘Computer-based diagnosis of illness in historical persons’, pp. 161-8; Vassiliki Rentoumi, Timothy Peters, Johnathan Conlin and Peter Garrard, ‘The Acute Mania of King George III; A Computational Linguistic’, PLOS One 12 (2017), e0171626.

49 Munk, Munk’s Roll, vol. 2, p. 159 (William Heberden).

50 W. F. Bynum, Medicine in the English Court, 1688–1837 (London, 1990), pp. 263-301.

51 Margaret Pelling, Medical Conflicts in Early Modern London (Oxford, 2003), pp. 84-188; George Clark, A History of the Royal College of Physicians of London (Oxford, 1966), vol. 2, pp. 507-36.

52 Munk. Sir Henry Halford; Hibbert. George III. A Personal History, p. 398; Porter, The Greatest Benefit to Mankind, p. 350.

Additional information

Notes on contributors

Timothy Peters

Timothy J. Peters After a career in academic medicine including a period as Director of the King’s College Centre for the Diagnosis and Care of Patients with Porphyria, on retirement Timothy Peters completed the MA in Industrial Archaeology at the Ironbridge Institute, University of Birmingham. He is currently based at Coalbrookdale, Ironbridge Gorge Museum Trust, Telford, Shropshire where he continues to actively research Medical History and Industrial Archeology issues.