For many years George III was known as the “mad” king of England. But as attitudes and science have progressed, historians and doctors alike have tried to diagnose the illness which haunted George from 1788 to the end of his life.
It is extremely difficult to determine whether he suffered from a psychological disorder, or a disease that caused mental disturbances as part of a larger problem. A recent theory is that George had acute porphyria, a rare inherited condition affecting the enzymes that produce porphyrins and heme. Porphyria has an acute impact on the nervous system causing abdominal pain, vomiting, muscle weakness, seizures, hallucination and paranoia. A high heart rate may also develop. You may have seen the film The Madness of King George, in which the King’s urine is reported to be blue. This was certainly the case through some of his illness, and blue urine can be another sign of porphyria.
However, we cannot lay too much store by this one symptom, as some of the medicines the King was prescribed could well have changed the colour of his urine.The first hint of the King’s condition came in 1765, just five years into his reign. He was feverishness with stitches in the chest and a pulse rate of 120. For a time his life was feared of. The strange episode was referred to merely as a fever, and perhaps it was, but similar symptoms appeared in the onset of George’s great illness twenty three years later.
Before the mental delirium, George experienced violent stomach pains which seized him in the night and rendered him speechless. When under an attack, he found it difficult to breathe. At one time he showed his third daughter, Elizabeth, a rash that had appeared on his arm. She said it looked as if he had been scoured.
These were not the only physical symptoms. Doctors’ reports show shooting pains from side to side in the King’s back, cramp and swelling in the legs, which was thought to be gout. Indeed, for some time the doctors believed George’s manic episodes were caused by gout “travelling up to the brain”.
Visual disturbance also troubled the King. He felt he had a floating mist before his eyes and feared he would go blind. But more curious is the changing colour of the King’s eyes. The whites became yellow and Queen Charlotte described his pupils as “blackcurrant jelly”. In terms of behaviour, George’s illness shows similarity to bipolar syndrome. During manic episodes, he barely slept, speaking continually until the foam ran from his mouth. Sometimes crying, sometimes violent, it was impossible to predict the King’s mood. However, before his illness George was always eccentric, fast-talking and painfully blunt. This makes it hard to decide whether he was truly displaying alternating mania and depression. On the recent BBC documentary Fit to Rule, a leading doctor examined George’s handwriting and found significant changes during bouts of illness. He believes there is enough evidence to prove George was bipolar. Unfortunately, he makes no mention of the physical symptoms such as the mottled skin and swelled veins in George’s face, let alone the bodily cramps.
With a life dominated by duty, an over-bearing mother and the death of his father at a young age, George does seem a likely victim of psychological damage. It is certainly true that the methods used by Doctor Willis – the keeper of an asylum– were the only ones that had an impact on the King’s behaviour. But whether this was science or coincidence, we will perhaps never know.