An hour later, the king returned. ‘About one o’clock,’ reported Lady Harcourt, ‘he came into her room; he had not been in bed; he shut the door, and going to the chimney, he took up the light, and then went to the bedside; he held the light to the queen’s face and said, “Yes I am not deceived. I thought she would not leave me.”’ He then turned to Miss Goldsworthy, who was lying on the bed next to the queen, and added, ‘“Gooly, you are honest, I can depend on you, you will take care of her. They said the king was ill, he was not ill; but now the queen is ill, he is ill too.” He then put down the light and walked fast round the room.’ Finding her voice at last, ‘Her Majesty entreated him to take some rest; and he left her, shutting the door with violence, and locking it.’52 Fanny Burney heard the next day – perhaps from the queen herself – that the king had ‘stayed a full half-hour’ watching her in bed. ‘The depth of terror during that time no words can paint. The fear of another such entrance was now so strongly upon the nerves of the queen that she could hardly support herself.’53 In fact, this was the last time Charlotte would see her husband for six weeks.
*
In the early dawn of 6 November, Fanny ‘dressed in haste by candlelight, and … stole along the passage in the dark’ to go to the queen. Miss Goldsworthy ushered her inside. As soon as she saw Charlotte, Fanny burst into tears, overcome by the queen’s misery. ‘She looked like death, colourless and wan; but nature is infectious; the tears gushed from her own eyes, and a perfect agony of weeping ensued, which, once begun, she could not stop … when it subsided, and she wiped her eyes, she said “I thank you Miss Burney for making me cry; it is a great relief to me – I had not been able to cry before, all this night long.”’54 Despite her prostrate condition, there was no question of the queen moving to a less exposed location – she had been advised by the doctors not to do so ‘lest the king be offended that she did not go to him’ – so she, Fanny Burney and Miss Goldsworthy sat immured in her dressing room, forced to listen to the king next door. ‘He kept talking incessantly; his voice was so lost in hoarseness and weakness that it was rendered almost inarticulate.’ Its tone was, Fanny insisted, ‘all benevolence – all kindness – all touching graciousness’, but that did nothing to calm Charlotte. ‘She would not let me leave her now; she made me remain in the room and ordered me to sit down. I was too trembling to refuse.’ Together, the women heard the king repeatedly berating his doctors. ‘I am nervous,’ he cried, ‘I am not ill, but I am nervous; if you would know what is the matter with me, I am nervous.’55 The princesses asked permission to come and join their mother, but she refused. ‘She burst into tears and declared she could neither see them, nor pray while in this dreadful situation, expecting every moment to be broken in upon, and quite uncertain in what manner.’ Fear of what the king might do next had filled her with alarm. ‘Who could tell to what height the delirium might rise? There was no constraint, no power; all feared the worst, yet none dared take any measures for security.’56
Gossip circulating beyond Windsor suggested an even darker explanation for Charlotte’s frightened hysteria. Writing in late November, James Bland Burges, a politician with connections to the royal household, reported a disturbing story he had heard: ‘The first symptom of the king’s madness was his running naked into the queen’s room, he insisted upon throwing her on the bed and that the women in the room should stand by to see whether he did well.’ A few days later, Burges recorded that the king ‘seized the Princess Royal, and attempted to ravish her. She was rescued from him with great difficulty, and he was at such a rage at his disappointment as to strike the queen.’ Burges claimed as authority for the account Dr Majendie, an habitué of the royal household, ‘who was at Windsor when the affair happened’.57 It is impossible now to establish the truth of Burges’s allegations, but if nothing else, they illustrate the atmosphere of panic that had gripped Windsor, transforming it into a place where anything might be said to have happened.
It was at this point that Sir George Baker’s nerve failed him. Faced with a visibly deteriorating patient whose sickness seemed to follow no recognisable pattern, he declared he was not equal to managing the king alone. In the vacuum of all other authority, the twenty-six-year-old Prince of Wales took the decision to call in another physician, and summoned Dr Richard Warren. ‘From this fatal step,’ Lady Harcourt believed, ‘many of the evils that followed resulted.’58
In 1788, Richard Warren was considered to be at the very top of the medical profession. Even Lady Harcourt, who disliked him, did not deny that he was a clever man of undoubted skill; but she also thought him supercilious and arrogant, with ‘that sort of inflexible firmness that is rarely found in a feeling heart’. When it suited him to do so, he could be charming. He was especially skilled at dealing with wealthy female patients, to whom he judiciously recommended the kind of treatment they would have chosen for themselves, ‘dissipation in winter … and a spell at the watering place they liked best in summer’. In the light of such accommodating prescriptions, he had built himself a fashionable and very lucrative practice. He was extremely rich, and Lady Harcourt heard that he sometimes lent his patients money. When he looked at his own tongue in the mirror each morning, he was reputed to transfer a guinea from one pocket to another. But all of this paled into insignificance before Warren’s real besetting sin in the eyes of the king’s friends. His patients were drawn almost entirely from among the great Whig aristocrats, the Dukes of Devonshire and Portland, Lord Fitzwilliam and Charles James Fox. These men formed the opposition to the administration of William Pitt, the government party endorsed by the king. ‘Through their protection,’ wrote Lady Harcourt, ‘Dr Warren came to know the Prince of Wales and Carlton House [the prince’s London home] soon afforded him an ample field for the display of his talents in political intrigue.’59
None of Warren’s qualities, personal or political, was such as to commend him to the king, and when he arrived later that day, George refused point blank to see him. Undaunted, Warren eavesdropped on the king from outside his room, where he could hear all that he said. The queen had not been consulted about the summoning of Warren, ‘and would never have consented to the calling in of a physician for whom the king had a particular objection’, but now he was there, she was desperate to know what he thought about her husband’s condition. She waited ‘in dread incessant’ but ‘he neither came nor sent’. A message to Sir George Baker begging him for news was rebuffed: ‘he would not speak alone’. Eventually, Charlotte sent one of her ladies to find the recalcitrant doctor, but she returned with the appalling news that Warren had already left the house. ‘Run! Stop him!’ she said. ‘Let me but know what I am to do!’60
Charlotte was devastated to discover that rather than calling on her, Warren had instead gone straight to report to the Prince of Wales. There could have been no clearer demonstration of the speed with which her world was collapsing. As her husband’s authority fell away, that of her son grew by the hour. In a single day, the internal balance of the family had been completely overturned, and her position rendered entirely provisional.
Fifteen minutes later, Colonel Goldsworthy arrived in her room to bring the message which none of the physicians had been prepared to deliver themselves: ‘Her Majesty should remove to a more distant apartment, since the king would undoubtedly be worse from the agitation of seeing her.’61 Privately, Warren told the prince he believed ‘the king’s life to be in the utmost danger, and declared that the seizure upon the brain was so violent that, if he did live, there was little reason to hope that his intellects would be restored’.62 If this was what the queen suspected, no one discussed it with her.
Taken to her new room, which Fanny Burney noticed had only a single door, making it easier perhaps to secure against intrusion, she entirely lost control of her feelings. ‘The poor wretched queen once more gave way to a perfect agony of grief and affliction, while the words “What will become of me! What will become of me!” uttered in the most piercing lamentatio
n struck deep and hard into all our hearts.’ After nearly thirty years of marriage, a life beyond the all-encompassing presence and authority of her husband was unthinkable to Charlotte; the raw incomprehension of her cries suggests she could imagine no other way of being. ‘Never can I forget their desponding sound,’ wrote Fanny with a heavy heart; ‘they implied such complicated apprehensions.’ In her extremity, she at last agreed to see her daughters. ‘The three elder hastened down. Oh, what a meeting! They all, from a habit that is become second nature, struggled to repress all outward grief, though the queen herself, wholly overcome, wept even aloud.’63 For the princesses, the obligation to support their mother took precedence over the anguish they themselves must have felt. Even in the worst of times, their emotions did not come first.
In his part of the house, the king continually asked for the queen and his daughters, but ‘they were not allowed to go to him, under the pretence’, as Lady Harcourt asserted, ‘that they would agitate him’. But if that was indeed the doctors’ policy, it was a very ineffective one. The king’s enforced isolation did nothing to calm him; on the contrary, Sir Gilbert Elliot heard that the king ‘was extremely impatient under this separation, and was indeed violent and outrageous in his attempts to get to [the queen’s] apartments. He once forced his way to her door, and finding the outer door made fast, he was near crying and said, “Surely they might have thought one door enough to stop me?”’64
By the next day, 7 November, he was so agitated that ‘four men were obliged to be constantly by his bed to prevent his jumping out of it’.65 The well-informed Cabinet member William Grenville wrote to his brother that ‘the king has now been two days entirely delirious, and during part of that time, has been thought to be in the most imminent danger’. The doctors seemed helpless, unable to say whether recovery or death was the most likely outcome. ‘The other alternative is one to which one cannot look without horror – that of a continuance of the present derangement of his faculties.’66
Now Pitt himself came hurrying down to Windsor to confer with the Prince of Wales. He returned to London in a bleak frame of mind, penning a memorandum that concluded, in the light of all he had heard, ‘that on the whole, there was more ground to fear than to hope, and more reason to apprehend durable insanity than death’.67 To others, death itself looked pretty close. Jack Payne, the comptroller of the Prince of Wales’s household, heard late that night ‘that all articulation even seems to be at an end with the poor king’. The Archbishop of Canterbury was ready to attend him, ‘but he is not required to come down, it being thought too late’.68 ‘His recovery is hopeless,’ echoed Elliot, ‘but he may linger a few days … The queen’, he added, almost as an afterthought, ‘does not now see him; the state of his head probably rendering the scene too painful to her.’69
Isolated, desperate and with no idea what to do next, Charlotte effectively gave up. ‘She lived entirely in her two rooms, and spent the days in patient sorrow and retirement with her daughters.’ Fanny Burney felt helpless to comfort her. There seemed nothing to do but sit and wait. ‘Even my melancholy resource, my tragedy, was now thrown aside. Misery so actual, so living and present, was knit too closely around me to allow my depressed imagination to fancy any woe beyond what my heart felt.’70
On 9 November, it was widely reported that the king had died. ‘The belief was universal throughout the metropolis,’ maintained a contemporary pamphlet, ‘that His Majesty was no more, and that the awful event was withheld from publication.’ Even Lady Harcourt found it impossible to discover whether the rumours she too had heard were true, so hard was it to ‘procure authentic information’. The doctors issued no bulletins. Gilbert Elliot was convinced that this was a deliberate policy, intended to hide the reality of the king’s illness from the public. ‘The physicians … talk of fever, but I am inclined to believe he has never yet had any fever, in the common acceptance of the word, and that they avail themselves of some occasional quickness of the pulse to avoid the true nature of his distemper.’71 On 12 November, Dr Warren wrote to Lady Spencer, one of his Whig grandee friends, offering the diagnosis that many had begun to fear was both accurate and inevitable: ‘Rex noster insanit; nulla adsunt febris signa; nulla mortis venturae indicia.’ Cloaked in the deliberate obscurity of Latin, Warren stated his opinion that the king was mad, that there was no sign of fever, and no danger to life.
What had caused the king’s sudden descent into madness the doctors did not know. In mid-November, Warren told Pitt that they had ruled out ‘the idea of its proceeding from some local cause … such as water on the brain, or by some change in the texture of the brain itself, by induration or ossification’. Shortly afterwards, Pitt passed on to his Cabinet colleague Grenville the doctors’ first, tentative explanation for the king’s condition. ‘The cause to which they all agree to ascribe it, is the force of a humour which was beginning to show itself in his legs, when the king’s imprudence drove it from thence into his bowels; and the medicines they were then obliged to use for the preservation of his life, have repelled it upon the brain. The physicians are now endeavouring by warm baths and by great warmth of covering, to bring it down again into the legs, which nature had originally pointed out as the best mode of discharge.’72
From this diagnosis derived virtually all the medical treatment which the king received over the next five months. Some of the procedures were benign, if useless, such as the ‘prescribing of carded wool and woollen bootikins applied to the king’s feet’; other, more invasive techniques were positively dangerous. Throughout his illness, the doctors sought to raise blisters on the king’s legs as a method of drawing out the malign humour that had settled on his brain. To do so, they used an irritant made from Spanish fly applied as a mustard plaster. This caused eruptions on the skin, which, when infected, discharged pus. Contained in this pus, the doctors believed, were the humours which had caused the sickness, and though unpleasant, blistering was therefore vital in effecting a cure. In practice, the discharging pustules were not only extremely painful, but potentially very harmful. In an age before antibiotics, any infection could, and often did, result in very serious consequences for the patient; to introduce one deliberately was, in retrospect, an act of astonishing recklessness. Blistering also added hugely to the discomfort and misery of the invalid; in every case, it would have been better to have done nothing at all than to have subjected sick and anxious patients to a procedure which could only weaken and distress them.
Yet none of the king’s doctors were deliberately cruel, or indeed, by the standards of their day, uninformed. Sir George Baker was president of the Royal College of Physicians, and highly regarded for his application of rational scientific method to medical investigation. He had made his reputation by proving that ‘the endemic colic of his native Devonshire’ had been caused by the contamination of cider with lead.73 For all his fashionable manner and titanic self-regard, Richard Warren too was a serious physician who would not have risen to the top of his profession without significant medical skill. They were unable either to diagnose or treat the king’s illness not because they were ignorant or wilful, but because it was probably caused by a physiological condition unknown – and indeed unknowable – to them.
It was not until the 1930s that porphyria was eventually identified as an illness. It is a metabolic disorder caused by a genetic malfunction that alters the body’s chemistry, resulting in the overproduction of toxins which impact severely on the operation of the nervous system. Porphyrins are the purple-red pigments that give blood its colour. When too many of them are produced, they effectively poison the patient, causing pain and weakness in the limbs, impeding the automatic activities of digestive and respiratory functions, and sometimes affecting the brain, interfering with vision and producing sleeplessness, excitement and confusion.
In 1969, Ida Macalpine and Richard Hunter, a mother and son team, both psychiatrists with an interest in the history of mental illness, first linked the disease – which they term
ed ‘acute intermittent porphyria’ – to George III’s malady. Their highly influential book George III and the Mad-Business swept away years of conflicting interpretations of what ailed the king, replacing them with a diagnosis still accepted by many historians as the most convincing explanation. They identified a number of the king’s symptoms, particularly his discoloured, purple-hued urine, as indications that he was suffering from porphyria. Noting that it was an inherited disorder, they examined the medical histories of several of George’s ancestors, including Mary Queen of Scots, her son James I and grandson Henry, Prince of Wales, who died young, and concluded that they too had been affected by the condition. They speculated on whether some of the king’s more immediate relatives, including his youngest sister Caroline, might also have died from it.
However, more recent research has questioned many of their findings, arguing that ‘the porphyria diagnosis was based on weak foundations, bolstered by indiscriminate aggregation of symptoms and suppression of contrary indicators’. In a scholarly article written in 2010, T. J. Peters and D. Wilkinson conclude that ‘it remains very unlikely that the king was suffering from porphyria’. Peters and Wilkinson dispute many of the connections made by Macalpine and Hunter between the symptoms presented by the king and porphyria. They suggest that the hoarseness from which he suffered was more likely to be caused by incessant talking than by the disease, as loss of voice in a porphyric case indicated that the condition was so advanced and severe that, in the eighteenth century, it would ‘almost certainly be a prelude to death’. They argue that the lameness and limb pains from which the king suffered were spasmodic, and at other times he was capable of great strength and energy. They even dispute the well-known linkage between the discoloured urine produced by the king and the diagnosis, claiming that the relatively few examples cited by Macalpine and Hunter of this occurrence were subject to other interpretations, and that there were simply not enough of them to confirm a conclusion. The urine of a genuinely porphyric patient would have been noticeably and more consistently discoloured, evident to all the doctors treating the king. In rejecting the diagnosis of porphyria, Peters and Wilkinson were initially cautious about offering an alternative explanation: ‘It appears very unlikely that the king was suffering from porphyria, and therefore the causes of his “madness” remain an unsolved mystery.’74
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