What caused the madness of King George?

King George III reigned from 1760 to 1820 during which time he lost one empire and set about getting another. The United States won its independence but British rule extended into what is now Canada as well as the Indian sub-continent and other parts of the world. France under Napoleon was defeated. And the industrial revolution made Britain the economic powerhouse of the world. So – a mixed report card but on balance positive. However – for the king himself – his reign was marred by periods of madness.

Nobody doubts that from 1788, King George experienced episodes of mania. He would talk incessantly until he began to foam at the mouth. On one occasion, he planted a beef steak in the ground firmly believing it would grow into some kind of beef tree. And he tried to shake hands with an oak tree believing it was the King of Prussia. More worryingly, King George tried repeatedly to climb the very high Great Pagoda in Kew gardens. This and other odd behaviour led to him being physically restrained – which was an unprecedented way to treat a monarch.

Diagnosing mental illness properly is frankly something we still struggle with today. Must declare a personal interest at this point as my mother was on the medical staff at an asylum in the 1960s and 1970s. So, psychiatry has always fascinated me. My mother’s hospital pioneered a concept known as the ‘therapeutic community‘ where patients were involved to a degree in the running of the institution. King George was also subjected to a treatment regime that was fairly new – even revolutionary.

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Francis Willis and the Moral Treatment approach

The doctor who treated George III – Francis Willis – is remembered by most people for putting poor George in a straitjacket and humiliating him. However, although not without fault, he was a great deal more sympathetic to patients than was the norm in that era. Willis was already 70 years old when he began treating the king and had run an asylum in Lincolnshire with some recorded success.

Some of the snobbery directed at Willis by the court physicians – who had failed to tackle’s the king’s insanity – has percolated down to us today. There’s a perception that Willis was a barely qualified charlatan making it all up as he went along. This is hugely unfair. Willis may not have been a Fellow of the Royal College of Physicians and his approach involved a degree of experimentation but his approach was as scientific as anybody else – arguably more so.

Willis adopted a regime based on good manners. King George had to behave himself. If he didn’t, he’d be treated like a naughty child. He would then have to earn the right to see other people or have a knife and fork at the table by being good. This infantilised the king but was based on an idea Willis developed that mental illness was caused in part by over-stimulation. This was called the ‘Moral Treatment’ where outright brutality was replaced by a stern paternalism and would eventually earn Willis a handsome government pension in his retirement.

Some of his other treatments though were more questionable and based on the dubious idea – that persists into our own times – of ridding the body of “toxins”. This was done by applying purgatives, blistering the skin and administering arsenic. The latter led to dangerous levels of arsenic being registered in the king’s hair after he’d died. It could also have triggered the medical condition that many have argued caused his madness: porphyria.

The argument over Porphyria as a cause of the madness of King George

Porphyria refers to a group of disorders that involve a build up of porphyrin in your body. Now I don’t want to get too technical here but basically, this can lead to physical symptoms such as vomiting, skin disorders and palpitations but also psychological symptoms including confusion, paranoia and hallucinations. If it was true that porphyria was the cause of madness then the finger of blame could be partly directed at Willis – at least for later outbreaks of insanity – and that would undermine entirely his diagnosis and approach.

Since the 1960s and the work of two psychiatrists – mother and son team Ida Macalpine and Richard Hunter – porphyria has been widely accepted as the cause of King George’s madness. Like many scientists they had an underlying theory to prove. In their case, it was a rejection of Freudian psychoanalysis in favour of biological psychiatry. The king wasn’t mentally ill in the accepted sense but essentially experiencing a form of physical poisoning that sent him round the twist.

The Macalpine/Hunter view gained the ascendancy pretty quickly. Willis was made to look like a total fool. But in recent years, their view has been challenged. The rival opinion is that the king had four or five episodes of bipolar disorder. That it really was mental illness pure and simple.

Macalpine and Hunter did analyse the contemporary medical reports. They showed that the king suffered jaundice, abdominals pains, discoloured urine and other physical symptoms ahead of each incidence of insanity. The colour of his urine was very noteworthy and to them pointed to porphyria. In the 1990s theatrical play The Madness of King George – later a movie – the monarch’s blue urine before his 1811 burst of madness is one of the key dramatic moments.

But the opponents of the porphyria diagnosis point out that the king’s urine wasn’t always blue before a period of irregular conduct. Ahead of his 1811 madness, there were six recorded observations of clear urine and the king had also been prescribed extract of gentian that would have turned his urine violet.

There is, of course, a good reason to hope that Macalpine and Hunter were right and that this is to remove the stigma that bipolar disorder – which is hereditary – might be a recurring feature in the British Royal Family. Better to believe for political reasons that the origin of King George’s madness was biological rather than psychiatric. We don’t want to start thinking there’s something unstable about those Hanoverians.

Maddest rulers in history

Who were the maddest rulers in history? We’ve not been short of a few in my lifetime. Though some have been insane but wily while others had become incapacitated through mental illness. Colonel Gaddafi is a good example of insane but wily. While poor old Boris Yeltsin seemed increasingly unstable in his last years.

Dynastic systems breed the maddest rulers

When you have a political system where somebody inherits the top job, you’re not always assured of the best person for the role. That’s especially the case when the new king or queen is completely insane. Yet that’s exactly what has happened many times in history when the mad have taken over.

Charles VI of France (1368 to 1422) believed he was made of glass and wore protective clothes to prevent his body being shattered. Think what happens to the Night King in Game of Thrones and you get the idea. In one incident while out hunting, Charles was convinced he was under attack and killed four of his own retainers before being restrained.

The reign of Charles VI was very long because he took power when he was very young. And there seems to be a connection between assuming the throne in infancy and coming under tremendous mental strain. Think about it. You have had no preparation for absolute power and when things go wrong, it comes as an overwhelming shock.

Maddest rulers: Henry VI and his fits of deep depression

So, child monarchs don’t tend to have happy reigns. Henry III, Richard II and Henry VI in England are good examples of this. Henry VI suffered what looks like fits of depression that made him completely unable to rule for periods of time. Stress seems to have rendered him like a rabbit in headlights – he froze while his advisers around him panicked.

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Juana La Loca (literally Joanna the Mad) was Queen of Castille, part of modern Spain, in the early 16th century. This was when Spanish power around the world was reaching its height with colonies in the Americas, across Europe and Asia. But Juana was way too mad to be allowed to rule any of that so she was “secluded” (locked away) in a castle.

Maddest rulers from the bible and ancient Rome

The biblical monarch of Babylon Nebuchadnezzar exhibited symptoms of a disorder known as boanthropy where an individual believes they might be a cow! Now it’s hard to know if this was propaganda used against him or the truth. But the condition certainly exists.

The Roman Empire threw up an extraordinary number of mentally unstable emperors almost from the start. The second emperor, Tiberius, retreated to the island of Capri where he reportedly tortured people in some pretty horribly ways.

He was then succeeded by Caligula whose madness is disputed by some historians but accepted by most. One of his oddest acts was to announce the appointment of a new consul, which turned out to be a horse called Incitatus.

In the 6th century CE, the Byzantine Empire was ruled by Justin II. A chronicler called John of Ephesus described how he was possessed by an evil angel that made him impersonate animals!

For suddenly it destroyed his reason, and his mind was agitated and darkened, and his body given over both to secret and open tortures and cruel agonies, so that he even uttered the cries of various animals, and barked like a dog, and bleated like a goat; and then he would mew like a cat, and then again crow like a cock: and many such things were done by him, contrary to human reason, being the workings of the prince of darkness…

Ecclesiastical History – John of Ephesus – Book 3

The only way to calm Justin down was to have organ music played all day and night, which must have driven his courtiers round the bend. He also had to be pulled through the palace in what’s described as a throne but I think a baby cart would present a truer picture.

And then no blog post on mad monarchs could leave out the maddest of them all – King George III. The king of England who lost America and his mind. Experts are still debating what the nature of his disorder was and views seem to change every year.

But the poor man was completely incapacitated for periods and would do things like greeting trees and shaking their branches as if they were human. You will all be familiar with the famous stage play and movie on this life story.

C’mon America – was King George really a tyrant?

It wasn’t just American colonists who though King George III of England was a tyrant. Many English radicals thought he was too. And that’s before we canvass the opinion of the French!

King George the tyrant – in American eyes!

I’ve now been to see the musical Hamilton twice and what’s not to like. Alexander Hamilton as a morally compromised hero. Thomas Jefferson as a vicious piece of work. And then there’s the hilarious figure of King George III – who prances on to the stage to rile the audience.

He loathes democracy. Thinks America won’t be able to handle everyday life once he’s forced from their stage. They’ll be crying to have him back soon – he jibes at the theatregoers. And we love it of course. Everybody adores a villain. Especially a villain with a big crown and velvet breeches.

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King George – not such a tyrant

I appeared as a contributor on the TV series Private Lives of the Monarchs presented by the co-curator of the Royal Palaces, Tracy Borman. We did one programme looking at King George III and posing the question – was he really THAT bad?

He was certainly a lot more complex than he’s given credit for. His correspondence points to a man who took kingship terribly seriously. In fact, he was very keen to be seen as a “good king” and a constitutional monarch.

Compared to monarchs in continental Europe, he was fairly benign. He had to work with a democratically elected parliament (well, elected by property owners at that time) and couldn’t make arbitrary judgments in the way that kings were able to in France – or the Tsar in Russia.

His Prime Minister imposed a stamp tax on the American colonies. The reason was to pay for the war that had just been fought against France in the Americas. Not only the cost of that war but also the continued stationing of troops in the colonies had to be paid for. Not that the English expected to see all that tax revenue as America had a shaky record on actually coughing up its taxes due to the British crown.

Well, as we know, Americans of an independent spirit saw things differently. They rebelled and achieved their independence. So how did King George the tyrant react to the loss of the United States?

George wrote a long letter on the subject full of remorse and sadness. Interestingly, his main point was a warning to British politicians that no overseas possession could be retained if those living there didn’t support British rule.

Americans had clearly turned their back on the king and Mother Country. But George wrote that he hoped they could remain friends – if for no other reason than mutual trading benefits.

I’m not going to completely whitewash King George III here or let him off the tyrant hook completely. But we’re all grown ups here and capable of a bit of nuance and acceptance of shades of grey in history.

George III’s main claim to fame was the onset of madness. Now we wouldn’t mock the insane today. Yet George’s mental illness was treated with hilarity at the time in a way that would make most of you squirm. For example, he was referred to by one English satirist as “Your Mad-jesty”.

The tyrant King George did end up talking to plants and addressing Lords as peacocks. The man’s condition was made worse by being treated with toxic substances like arsenic. Still, he did have an unusually long reign from 1760 to 1820 and very much shaped the era in which he ruled.