The Madness of King George: The Regency Crisis

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18th Century England, 18th Century Europe, Alan Bennett, George III, George IV, Helen Mirren, Kings and Queens, Nigel Hawthorne, Rupert Everett, The Madness of King George

Last week I looked at the illness of King George III as it is depicted in The Madness of King George (1994, dir. Nicholas Hytner, based on Alan Bennett’s play The Madness of George III, adapted by Bennett for the film). (Incidentally, there is a myth that the title change was due to Americans thinking that the film was a sequel. In reality, the producers worried that the audiences wouldn’t understand that this film was about a king.) But I only touched on the film’s other half, which examines the Regency Crisis that broke out around the king and his son Prince George.(Because there are two Georges here, I’ll capitalize ‘King’ and ‘Prince’ to help the reader tell them apart.)

In my discussion of The Duchess I talked about the Regency Crisis, but it’s worth going over again. The British Government of the period was conceived of as The Crown in Parliament, meaning that the King ran the government, but that Parliament played a dominant role in the legislative process, so that the king had to operate through his ministers in Parliament rather than just issuing decrees on his own. Thus the king was a vitally important figure, unlike in modern England, where the monarch mostly plays a ceremonial role. The king had considerable control over which ministers served in government, he controlled appointments to many lucrative positions in government and within the royal household, and he had to assent to the laws passed by Parliament in order for them to take effect.

English politics was divided into two broad political parties, the Tories and the Whigs. The Tories favored a strong monarchy that operated by its own rights, as well as a traditional Anglicanism that included privileged political status for Anglicans and a degree of hostility toward Catholics. The Whigs favored a weaker monarchy that operated within limits set by Parliament, significant political reforms to what they saw as a corrupt political system, and toleration of religious minorities, including political rights for Catholics. Although they were generally opposed to the king’s power, only a minority of them were Republicans. The Whigs had been in political ascendency for much of the early 18^th century, but when George III came to the throne, he quickly threw his political support to the Tories, which pushed the Whigs out of power and fractured them into several factions based around different politicians.

George was a loving husband and father, but very strict and pious. He expected his children to be disciplined and virtuous, and he grew increasingly disappointed with his oldest son, George Prince of Wales, as he reached adulthood and proved to be a rather dissolute young man. Prince George favored a lavish lifestyle (later on as king, he was an important patron of art, architecture, and fashion), and indulged in heavy drinking, excessive gambling, and wild parties, and so he quickly fell deeply into debt, despite the very substantial income he received from both his father and Parliament. The Prince’s behavior disgusted the King, who was very critical of his son’s ways and refused to pay his debts. The Prince, for his part, felt his father was excessively strict and was frustrated by the King’s failure to give him any significant duties. The father-son hostility that developed between the two men was a replay of the conflicts between previous generations; George I had disliked George II, and George II and his wife had loathed their son Frederick, being somewhat relieved when he died young, leaving the future George III as his heir. The Prince’s quarrels with his father meant that he supported the Whigs, many of whom clustered around the Prince as the inevitable future ruler of the kingdom.

George IV

When, in the fall of 1788 it was realized that George III was mentally incompetent, the initial assumption was that he was about to die, and thus the Prince would become king soon. But after a few weeks it became clear that the king was not physically in decline and a messier problem emerged, which historians call the Regency Crisis. The British system required a monarch who could actually perform his duties, and so it was necessary for Parliament to appoint a regent, who realistically would have to be Prince George. But the question was on what terms would he become regent?

The question had political as well as constitutional significance. Since the Prince clearly favored the Whigs, he could be expected to demand the resignation of the Prime Minister, William Pitt the Younger (so named to distinguish him from his father, who had previously served as Prime Minister as well, but also a nod to the fact that he was the youngest man ever to serve as Prime Minister, an office he took over at 24). Pitt governed by a decent majority in Parliament, but his position was dependent on the Whigs being disunited and on the support of the king. If Prince George took over as regent, he could be expected to offer the Prime Ministry to Charles James Fox, one of the leading Whig politicians. The Whigs hoped that the Prince would appoint them to lucrative government offices and support their desires for political and legal reforms.

So the Whigs dearly wanted the Prince to receive a strong regency, while the Tories wanted him to receive a limited regency. This led to a bizarre inversion of the normal Tory and Whig positions. The Whigs who normally championed the power of Parliament to limit the Crown suddenly began insisting that the Prince automatically had full authority by his own rights, while the Tories, who normally championed royal rights argued that Parliament had the power to dictate the terms on which Parliament granted the regency. The Whig position was that George III would not recover his wits and was therefore functionally dead; so the Prince was legally king in all but name already and therefore deserved all the powers the king enjoyed. In contrast, Pitt asserted that the king was only temporarily indisposed and would recover, so Parliament had the legal right to decide which royal powers would be delegated to the Prince of Wales.

William Pitt, looking decidedly younger

A key figure in this was Edward Thurlow, the Lord Chancellor. This was a key office in government; the Chancellor acted as the presiding officer in the House of Lords, the controller of the Great Seal, and the leader of the Supreme Court of England and Wales. Thurlow was a Tory, but he disliked Pitt, and so the Whigs hatched a plan to win his support for their cause by promising that he would continue as Lord Chancellor during the Regency, an offer that Thurlow appeared receptive to. His defection from the Tory cause could well have fatally undermined Pitt’s position.

Fortunately for Pitt, the Whigs proved incapable of taking effective advantage of their window of opportunity. By coincidence, Fox was in Italy when the Regency Crisis broke out, and when he finally returned, he was slowed by illness. This bought time for one of his allies, Richard Brinsley Sheridan, to insinuate himself with the Prince of Wales and shape the Prince’s ideas of what he would do; ultimately this meant that Fox had little control over the Whig strategy, despite being its most prominent leader in the House of Commons. Sheridan disliked Charles Grey, another of the leading Whigs, and persuaded the Prince to promise Grey an insultingly minor office, which alienated Grey. The political philosopher Edmund Burke, an important Whip MP, initially supported Fox, but later on became disgusted by his willingness to compromise on principles and alienated many other Whigs. Behind th scenes, Georgiana, the Duchess of Devonshire, struggled to organize her party but was unable to get them to overlook their personal rivalries and disputes. When Fox finally appeared in Parliament, he gave a very ill-advised speech in which he declared that Parliament had no right to impose limits on the regency. Pitt immediately attacked this as contradicting nearly a century of political practice. This proved the critical turning point in the Crisis, because after these speeches, it was clear that Pitt had gotten the upper hand and Parliament would dictate the terms of the regency. Soon after, Pitt persuaded Thurlow to continue supporting him.

Charles James Fox

Throughout this whole affair, the Prince of Wales had been a central figure, but he handled the situation increasingly poorly. Initially he had shown a great deal of concern for his father’s well-being, weeping so much his doctors decided that he needed to be bled to restore his emotional balance. But as Whig politicians like Sheridan and Grey courted him, the Prince, who had almost no real experience with politics, let the attention go to his head and became impatient to receive what he felt were his legal rights. Despite Sheridan’s advice, he began staying out late, drinking and gambling scandalously. At one card game, he announced, “I will play the fool”, when he threw down one of the kings. One evening, he drove his carriage through the city so wildly that he broke several street lamps. These actions helped increase public support for the King, who was already quite popular, and made it harder for the Whigs to demand the Prince’s rights.

Pitt wisely recognized that he needed to play for time, so he stretched out the negotiations for the Regency Bill. The Bill would have granted the Prince a very limited regency, according him a veto over the making of peers and the granting of life-time offices, and awarding complete control over the king, the royal family, the king’s property, and the offices of the royal household not to the Prince but to Queen Charlotte, who firmly supported Pitt. The Prince protested that denying him control over his father was an insult to his character, since it implied that he could not be trusted with the king’s life and health. The Whigs fought the Bill the whole way, thus foolishly playing into Pitt’s strategy of delay when it was clear that Pitt had a solid majority that the Whigs could not hope to overcome. Then, on February 20^th, a few days before the Bill would have been presented to the House of Lords and been passed, it was abandoned. The King had recovered from his illness and the Regency Crisis had passed.

The Regency Crisis in The Madness

The film presents the Regency Crisis somewhat differently. It establishes early on that the King (Nigel Hawthorne) and the Prince of Wales (Rupert Everett) dislike each other. The King calls his son “The Fat One” (a somewhat unfair charge, since the Prince only became corpulent in later life), and the Prince ridicules his father. At one point he tells his mother that he would have thought she would be glad to take a break from bearing so many children. She accuses him of laziness, to which he retorts that he is given nothing to do.

Nigel Hawthorne and Helen Mirren as George III and Charlotte

The film presents Prince George as the central villain of the film. He loathes his father for what seem like minor reasons, and he schemes to push his father into a public breakdown so that he can become Regent. The film downplays his father’s physical assault on him to make it less serious, and it assumes that the Prince’s shows of concern for his father are an act rather than a genuine expression of filial concern. While it is not impossible that the Prince’s public concern was faked, it seems more likely that his initial concern was genuine but the political situation wore down his somewhat weak character.

Rupert Everett as Prince George, with his largely useless younger brother Frederick

The film also shows the Prince taking control of the king’s person and using that to isolate him from the queen, who is denied access to her husband until finally one of her attendants, Lady Pembroke (Amanda Donohoe), seduces the king’s equerry, Greville (Rupert Graves), so that the queen can get last minute access to the king to warn him of the impending regency bill. The film suggests that the king’s separation from his wife was emotionally traumatic and harmful to him. The Prince gives his physician, Dr. Warren, control of the king’s treatment, with the understanding that it is Warren’s best interests if the king doesn’t recover. In reality, the situation was the opposite. Throughout the Crisis, Pitt and the queen controlled access to the king. It was the Prince who was denied access during the illness, except for one brief meeting rather late in the crisis. It was the queen who arranged for Dr. Willis to treat the king. So the film is clearly demonizing the Prince as a way to increase the tension in the film.

The Parliamentary situation is also mis-represented. Pitt, Fox, and Thurlow are shown as the key figures in Parliament; Sheridan, Grey, and Burke are entirely absent from the film, and Fox is shown as being in London throughout the whole process. That’s a minor detail, but a more serious problem is the film’s depiction of the Whigs as being largely unified, plotting effectively, and gradually increasing the pressure on Pitt by winning Thurlow over to their cause.

The Regency Bill is fundamentally misrepresented. The film presents the political debate as revolving around whether or not there will be a Regency at all; Fox and the Prince are pushing for a Regency, and Pitt is fighting a slowly losing battle against one. Initially he wins a vote on Regency by 30 votes, but later on Fox wins a vote to demand a Regency Bill by 3 votes. At this point, the desperate Queen Charlotte (Helen Mirren) hurries to Kew and gets access to George, warning him that he is about to be pushed aside by his son. The king recovers and Thurlow, having seen that the king is well, changes sides and frantically races back to London as Parliament debates the Regency Bill. He hurriedly tells Pitt that the King has recovered, and Parliament abruptly ends its debate (during a speech by a member of Parliament played by Alan Bennett) and rushes outside in time to see George getting out of a carriage, obviously well. The Prince signifies his defeat by fainting.

Thurlow presenting King George to the members of Parliament

The film’s vision of the Regency Bill is that it would have inaugurated a permanent shift in government. It would have perpetuated Prince George’s control over the king’s person, which would have enabled the Prince to keep the King locked up in perpetuity, thus effectively making the Prince Regent a functional king. This is false; the Regency Bill would have had effect only as long as the King was incapable of fulfilling his duties, and the regency would have ended as soon as the King was well again.

The film  suggests that the Regency Bill represented everything the Whigs wanted, when in fact the Bill represented exactly what they didn’t want. The film offers no suggestion that Pitt has any alternative to a full regency and that he was on the losing side in the debate. The actual political issues are presented wrong. And, in true cinematic fashion, the defeat of the Regency Bill is a matter of high drama and a narrowly-timed victory that would have failed if a flock of sheep had taken more time to get out of the way of Thurlow’s carriage.

So while the very basic scenario of the Regency Crisis is true (the King’s illness had political ramifications, the Whigs and the Prince schemed to get the Regency, a Regency Bill was presented to Parliament for a vote), almost all the details are wrong and the historical situation is almost entirely inverted; early in the Crisis, the Whigs and the Prince lost their opportunity to get what they wanted, largely through Fox’ disastrous speech, and Pitt had the upper hand from that point on.

Julian Wadham as Pitt the Younger

If the film has a deeper message, it is about political cynicism. The Prince and Fox have no political principles whatsoever beyond a lust for power. Lady Pembroke seduces Greville not because she is actually attracted to him but because it is the only way to get the queen in to see the king; when Greville later makes an advance on her, she shoots him down. When the king haltingly apologizes for his inappropriate behavior toward Pembroke, Pembroke offers the polite lie that she has no memory of anything inappropriate and that his behavior was always proper.

Throughout the crisis Greville has been loyal and supportive to the king, while another equerry, Fitzroy, has betrayed the king by passing information to the Whigs. At the end of the film, Greville is ordered to fire the king’s loyal attendants, and then he himself is dismissed, while Fitzroy is promoted. This is untrue; Greville remained in service as an equerry until 1797; after his dismissal, he was eventually promoted to the more prestigious position of Groom of the Bedchamber. The message here that kings have no loyalty to those who see their weaknesses, while treachery like Fitzroy’s can get one advancement.

This all fits in with the film’s rather negative view of court protocol. The film emphasizes a variety of what to modern eyes are rather bizarre and nonsensical rules. People are not supposed to look directly at the King, and even his personal physician is not allowed to ask questions directly to the king or examine his body. People sit only when the King grants permission for them to, and he rarely does. During one scene, the King and Queen sit to listen to a concert, while the rest of the court struggles to keep standing. The King denies a pregnant woman the right to sit down, and the court quietly groans when George declares he wants to hear the concert a second time. When the king and queen leave, the whole court immediately collapses into every available seat.

These rules are presented as part of the cause of George’s problems, and what he needs a dose of being treated like everyone else, being forcibly restrained until he can learn to control himself again. So the re-establishment of these protocols when the King apologizes to Lady Pembroke and she lies to him signals a return to a morally corrosive situation.

What the film doesn’t want to admit is that its criticism of the Crown has a lot in common with the Whigs’ opposition to the Crown. The Whigs generally championed the power of Parliament over the hereditary rights of the king, and felt that the system of patronage that the Crown used to win support was legalized corruption, and they wanted to restrict it. Fox was an advocate for the abolition of slavery and the establishment of religious toleration. Fox’ branch of the Whigs gradually laid the foundation for the reform-minded Liberal Party of the 19^th Century. In 1832, Charles Grey was finally able to introduce a Reform Bill that dramatically expanded the voting franchise, abolished rotten boroughs (which were essentially the private ownership of a seat in the House of Commons), and generally restricted legal opportunities for bribery. So while the film quietly ridicules the system that the Tories supported and the Whigs opposed, it makes the Whigs the bad guys by simply never explaining what the deeper political issues of the day were.

Obviously explaining 200-year-old political debates to an audience that no longer sees the relevance of the issues is a tough act, and it’s easy to understand why Bennett chose to simplify the political issues. King George is his hero, and that makes the decision to cast the Prince and the Whigs as the bad guys rather obvious. The real problem is Bennett’s decision to moralize the king’s illness and emphasize it by showing the monarchy as governed by corrupt protocols, because not only is it false to the facts of the time, but it also undermines the film’s point that the king’s illness wasn’t psychological but rather metabolic. The film’s triumphant return of the King to mental health and political power is undermined by the emphasis on the resumption of court protocols that were supposedly responsible for the king’s illness in the first place.

Perhaps that’s Bennett’s way of hinting to the audience that the King eventually went mad again in 1810, after the death of his youngest daughter Amelia. Already virtually blind, he never recovered his wits and died blind, deaf, and insane in 1820, after years of wandering Windsor Castle, talking to angels like some deranged Biblical patriarch. The Prince got his regency and eventually the throne. The Whigs eventually got their political reforms. But the film doesn’t acknowledge any of that in its epilogue text. Instead it settles for the short-term happy ending of the King’s recovery in 1789, rather than revealing the true complexity of the overall situation. But as Peter S. Beagle once wrote, “There are no happy endings, because nothing ends.”

By the Way

A Royal Affair is about George’s sister Carolina Matilda, who became Queen of Denmark.

Want to Know More?

The Madness of King Georgeis available on Amazon. The screenplay, The Madness of King George,is also available.

If you want something on the Regency Crisis, you don’t have a lot of options. John Derry’s The Regency Crisis and the Whigs 1788-9is about half a century old, but still a good study of the fracturing of the Whig Party. E.A. Smith’s George IV (The English Monarchs Series) seeks to rehabilitate the reputation of this poorly-regarded king. I found his brief section on the Regency Crisis to be quite helpful in writing this post. Finally, you might take a look at Amanda Foreman’s Georgiana – Duchess Of Devonshire (available in paperback and Kindle edition). She examines the duchess’ behind the scenes role in the Crisis quite nicely.

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The Madness of King George: Blue Urine and Bondage Chairs!

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18th Century England, 18th Century Europe, Alan Bennett, George III, Helen Mirren, Ian Holm, Kings and Queens, Macalpine and Hunter, Medical Stuff, Nigel Hawthorne, Porphyria, The Madness of King George

Viewing Dragon Knight while I was sick left me a little mentally imbalanced, and I needed something to help me recover. So I turned to a film about another man seeking help with mental illness, The Madness of King George (1994, dir. Nicholas Hytner, based on Alan Bennett’s play The Madness of George III, adapted by Bennett for the film). Fortunately, the film proved to be the right treatment, because by the end of it, I felt my wits returning just like King George’s.

What Was the Madness of King George?

The film examines an important incident in English history generally known as the Regency Crisis. The Crisis happened in 1788, when King George III experienced a bout of insanity. George’s symptoms were varied: a brief stomach ache at the start, obstructive jaundice, hypomania (euphoric or irritable moods, physically energetic behavior, extreme talkativeness, and bursts of creative ideas), howling like a dog, hearing voices, and, most unusually, blue urine. His speech bordered on totally incoherent, he became violent toward members of his family, including his wife Queen Charlotte and his oldest son Prince George, and it was necessary to physically restrain him on numerous occasions.

Exactly what was wrong with George has been a subject of debate among both historians and medical specialists. At the time, the consensus was manic depression, although one physician diagnosed it as “flying gout”, suggesting I think that George’s gout had gone from his leg to his brain. Historians for the next 150 years followed the consensus and suggested that his mental illness stemmed from his dissatisfaction with his marriage. He had never particularly wanted to marry Queen Charlotte (a German princess he met for the first time on his wedding day) and while the marriage was a happy one, it was clear that George was a much more highly-sexed man than his wife was. His religious nature meant that he was unwilling to take a mistress, so historians suggest that his sexual frustrations eventually led to his mental breakdown.

George III

But in the later 1960s, a mother/son pair of psychiatrists, Ida Macalpine and Richard Hunter, put forward a very different diagnosis, porphyria. Porphyria is a very rare metabolic disorder that produces various neurological symptoms including abdominal pain, vomiting, hypertension, tachycardia (elevated heart rate), and muscle weakness; it can also produce psychiatric symptoms including anxiety, confusion, and hallucinations. It also often causes the feces and urine to turn purple (hence the name, which is Greek for “purple”). Macalpine and Hunter suggested that the key to understanding George’s symptoms lay in his blue urine, and that his madness was not psychological at all but rather metabolic.

Macalpine and Hunter’s claims provoked considerable debate in the medical community, which seems to have focused entirely on whether the symptoms they had focused on would constitute porphyria rather than on whether the historical record supported such a diagnosis in all details. Over the course of the 1970s and 80s, the Porphyria Theory pushed out the earlier diagnosis of manic depression to the point that many historical organizations, such as the National Gallery and Kew Palace (where George was treated), asserted the veracity of the diagnosis. As a result, it’s come to be accepted as a ‘fact’. By the 1980s, professional historians had generally accepted the diagnosis. Alan Bennett, who studied and taught history before turning to writing plays, assumed the diagnosis of porphyria when he wrote the play.

However, the Porphyria Theory has never actually been proven, and in fact it has some significant problems. First, not all in the medical community had agreed with Macalpine and Hunter in the first place. Second, porphyria is hereditary, and since George III was the grandfather of Queen Victoria, there are numerous generations of the royal family (not to mention other descendants of his 15 children—I told you he was highly-sexed) who might have shown signs of porphyria; but no solid evidence of the disease has shown up among them.

More seriously, Macalpine and Hunter have been accused of cherry-picking their evidence from across George’s lifetime. The claim that he suffered from muscle weakness is contradicted by the reports of his energetic physical exertions and by the violence with which he assaulted his attendants on some occasions. Macalpine and Hunter exaggerated the extent of his abdominal pain, and failed to mention that his vomiting had been induced with a medication.

Most importantly, George’s urine was not consistently reddish-purple (more properly blue, in George’s case) at all. There are only four times when blue color was reported in his urine; on one occasion Macalpine and Hunter point to a report of blue urine, but fail to mention that on six occasions in the previous weeks, his urine was reported to be clear or yellow. Even more importantly, three days before the blue urine was reported, his doctor gave him a medication containing gentian extract, which is known to cause blue urine. So in the opinion of one scholar, Macalpine and Hunter did not just get the diagnosis wrong, they intentionally misrepresented the facts to make their case.

Urine from a porphyriac

Finally, recent analysis of George III’s numerous letters by Peter Gerrard and Vassiliki Rentoumi has suggested that his vocabulary and writing style during his attack mirror patterns seen in modern patients suffering from bipolar disorder (as manic depression is termed nowadays). During his attacks, his sentences may contain 400 words and 8 verbs, for example.

There are serious problems with trying to diagnose medical and psychological conditions in historical figures. Historians are rarely qualified physicians and I doubt more than one or two of them have ever been skilled at differential diagnosis (what House does in every episode of his tv show). Conversely, physicians are rarely skilled at historical research or aware of all the relevant documents (which seems to be the reason why Macalpine and Hunter’s argument persuaded some physicians).

Furthermore, historical diagnosis relies very heavily on the observations of people from the historical figure’s own time; George’s physicians may have failed to notice or failed to remark on certain symptoms that modern scholars might spot (such as the shift in his vocabulary that Gerrard and Rentoumi found) or may spot symptoms that they failed to make sense of (such as failing to recognize that George’s blue urine might have been caused by gentian extract).

Unless a historical figure’s body is available for forensic analysis, it is impossible for there to be any sort of examination by a modern medical specialist. In cases where this is possible, medical analysis can help scholars sort out legitimate clues in historical sources from lies and gossip. A good example here is the recent discovery of King Richard III’s body, which enabled scholars to confirm that he was in fact a hunchback, while disproving the not-very-serious gossip that he had a tail.

What this means is that modern historians have to move very carefully when they attempt to answer a question like what George III suffered from. The Porphyria Theory seems very shaky, and Gerrard and Rentoumi’s work would support a diagnosis of bipolar disorder, but it cannot conclusively prove it, especially given the notorious issue of psychologists trying to diagnose patients they have not spoken with. But bipolar disorder was essentially the diagnosis made by George’s own physicians, and since it seems to fit with the available facts more readily than porphyria does, that’s the one I’m going with in my look at the film.

 

How the Film Deals with the Symptoms

Bennett wrote his play in 1991, when the Porphyria Theory had become dominant. I have no information about how Bennett researched the play, so I don’t know if he looked at genuine historical documents about the king’s illness or if he relied on Macalpine and Hunter’s papers on the subject. Nor do I know how substantially Bennett revised the medical details in his original script for the film. But the film works to establish many of the symptoms of porphyria.

The first medical symptoms George (Nigel Hawthorne, reprising his performance from the debut of the play) has are an inability to fart followed by an intense abdominal pain that causes Queen Charlotte (Helen Mirren) to call for help. The film suggests that he continued to have fits of pain at the height of his illness, but once he begins to recover they are not shown again. This would seem to follow Macalpine and Hunter’s misleading claims that he suffered from abdominal pain almost continuously, when in fact he suffered only one attack right before his more dramatic symptoms appeared.

In the film his mood shifts erratically from enthusiastic to angry to overwhelmed and miserable. His violence toward the queen is not shown, but his infamous physical assault on Prince George is shown, although the film presents it as an assault intentionally triggered by the power-hungry prince in which he chases the prince around a room beating him with his hat; in fact it was a spontaneous outburst in which he choked the prince into near-unconsciousness. Since Prince George is the villain of the play, the facts have to be massaged a little to keep the audience from accidentally sympathizing with him.

George (Hawthorne) chased by his attendants early one morning

The film makes repeated references to his urine and feces. Early on, one attendant points out that the urine is blue, but the king’s physicians insist it is a meaningless symptom. Dr Pepys (Cyril Shaps) is obsessed with the quality of the king’s stools, but Dr. Warren (Geoffrey Palmer), the prince’s physician, ridicules this. At the end of the film, one attendant notices that the king’s urine has turned normal again and comments that the urine was blue throughout the whole episode. This is the film’s way of suggesting that the king’s doctors had all missed the central symptom that should have told them it was porphyria (which was first diagnosed more than 2,000 years earlier). This claim is completely false; as I’ve mentioned, it relies on Macalpine and Hunter’s apparently deliberate misrepresentation of the actual facts.

There is also some discussion of the king’s pulse, which is extremely high. Dr. Warren comments that it’s irrelevant because his pulse varies too much. This is obviously the tachycardia associated with porphyria. Nothing I’ve read on the king’s illness has mentioned tachycardia at all, so I’m unsure if this was actually one of the king’s symptoms or if it was added by Bennett to strength the case for porphyria.

The two major symptoms mentioned by Macalpine and Hunter that the film omits are the king’s blindness (which only happened many years later and so is irrelevant in this film), and his muscle weakness. Muscle weakness plays a major role in Macalpine and Hunter’s argument, and I suspect that Bennett omitted it for the same reason that I’ve already mentioned; it doesn’t fit with the reports of the king’s physical struggles with his attendants. Those struggles are important moments; they dramatize the king’s problems and often serve to generate sympathy for him as we see him being humiliatingly manhandled by Dr. Willis’ orderlies. So the struggles have to stay, and that would make muscle weakness almost impossible to present in a coherent fashion.

 

Isn’t Modern Medicine Wonderful?

A central theme of the film is the comparatively primitive medical knowledge of the time. In the first portion of the film three doctors attend George, Drs Warren, Pepys, and Baker (Roger Hammond). They spend much of the film arguing about which of his symptoms are important and which are incidental. Warren, as already noted, insists that neither his pulse nor his urine are important, while Pepys is obsessed with the quality of his stools. This is played for mild humor; the audience is intended to be amused by Warren’s inability to realize that the pulse and urine matter, and Pepys’ interest in George’s stools is almost farcical. But Warren’s disinterest in these symptoms is quite unrealistic. Taking the pulse was an important procedure from before the time of the Greeks, just as it is today. Physicians of the day routinely examined both urine and stools (as is evident from the fact that George’s doctors noted the quality of his urine quite a lot).

At the same time that Warren ‘s skepticism represents modern amusement about 18th century medical practice, he also represents what today would be considered barbaric medical treatment. He insists on blistering the king (applying heated glass cups to the skin to draw fluids to the surface and then lancing the resulting blister to drain the fluid). It was an extremely painful process, as the film shows, and serves to horrify the audience and increase their sympathy for George.

Blistering cups

Baker is dithering and ineffectual. At the start of the crisis, rather than examining the king directly, he questions the king’s equerry, because protocol forbids speaking to the king about his symptoms. Again, we’re supposed to be amused and appalled by the poor quality of the medical treatment given to George.

When Dr. Willis (Ian Holm, reprising his role from the debut of the play) arrives, he is presented as being a different kind of doctor. Indeed, Warren sniffs that he isn’t actually a legitimate doctor (although the real Willis had his medical degree from Oxford). He approaches George’s problems from a completely different direction. He takes the position that George’s inability to restrain his speech and actions are caused by the fact that George has never actually had to restrain himself, because the court indulges his whims and cossets him at every turn. In other words, George’s sickness is moral rather than medical. What George needs is to learn restraint through a process of being restrained whenever he misbehaves. George is immediately tied down to what today would be considered a bondage chair and gagged with a leather strap. He is also kept in a straight jacket. As he shows self-control, he is increasingly permitted to live more comfortably, but whenever he acts out, Willis immediately forces him into the chair. Gradually, George learns to go into the chair voluntarily when he misbehaves, and then learns to self-correct whenever Willis says something or even just looks at him. By the end of the film, George has returned to his old demeanor and no longer needs Willis standing in a corner clearing his throat as a reminder.

Holm as Willis

There is some truth to all this. Willis did employ restraints in alternation with more gentle treatment. But he also employed blistering, which the film associates with Warren instead. He also employed manual labor, which isn’t shown either.

 

The Problem with the Film

The film sets up Baker, Warren, and Pepys to represent ‘old’ medicine as quackery and ineffective, and Willis as ‘new’ medicine, which is both more effective and more humane. It encourages the audience to be both amused and horrified by how terrible medicine was in the past, and thus implicitly glad that we have come so far from those ‘bad old days’.

In an epilogue text, the film tells us the color of the king’s urine suggests he was suffering from porphyria, thus explaining the significance of the references to the king’s urine. So it asserts that we now know what was wrong with the king, even if they didn’t know it back then, and we are encouraged to assume that if George III were alive today, he would receive much better treatment. The film is flattering us for being so much smarter and more enlightened than our ancestors were in the late 18th century.

This is a common problem with historical movies, which often operate by establishing an implicit position of moral and intellectual superiority toward the past. Such films often tell us that we are smarter than or morally superior to our ancestors because we no longer do X, with X being whatever the film is about. (See my thoughts on Gladiator and its depiction of gladiatorial combat for another variation of this.)

The problem is, as I frequently tell my students, we are no smarter than our historical ancestors were. We know more and we have better technology, but we’re not actually smarter than they are. What looks to us as stupidity and barbarity is actually just a different culture acting on different assumptions and different bodies of knowledge than we use. In 200 years, I have no doubt that film audiences will be told to marvel at how ignorant and barbaric 21st century Americans were because they still believed something that 23rd century science has disproven. Who knows, maybe 23rd century epigenetics will disprove the ridiculous notion that bacteria cause disease. So someday a film make will show moronic, hidebound 21st century physicians –gasp!—giving syphilis patients antibiotics rather than gene therapy. My point is that we have no way of knowing what facets of current society our descendants will be embarrassed or horrified by. So it would be best to get out of the habit of gawking at our ancestors like they were a freak show before we ourselves get trundled out as the next exhibit by our great-grandchildren.

And, in fact, The Madness of King George demonstrates this problem quite well. Bennett relied on the Porphyria Theory when he wrote the play and revised it for the screen. But as I’ve already noted, the Porphyria Theory is probably wrong. The king’s urine was probably occasionally blue because of a medication he was taking, and his other symptoms have to be aggressively manipulated and misrepresented to fit such a diagnosis. If the actual problem was bipolar disorder, then the modern film is wrong and George’s doctors were actually right. The consensus at the time was that George was suffering from a mental illness, not a physical one, So they probably got it right and Macalpine, Hunter, Bennett, and the film got it wrong.

 

The Deeper Problem with the Film

Bennett’s story does a wonderful job of dramatizing George’s plight, and the film itself is loaded with great performances, especially Hawthorne and Holm’s. But the film doesn’t realize that there is a major problem with its presentation of the medical issues.

The foundation of the play medically is that George was suffering from a metabolic disorder. Even though that’s probably wrong historically, it’s a valid approach, especially since at the time the play and the film were produced, many scholars had accepted the Porphyria Theory. So we can’t blame Bennett for following the roughly accepting thinking of the day on the issue.

But Bennett doesn’t actually approach George’s cure as a question of treating a metabolic disorder. Willis’ treatment is entirely in the realm of morality. He adopts a moral theory of what is wrong with George, proposes a course of treatment based on moral re-education, and achieves results. This would be as problematic as if George’s underlying medical problem were a brain tumor. No amount of teaching George self-restraint could possibly cure his porphyria, because good manners don’t qualify as an effective treatment for metabolic disorders.

Hawthorne and Mirren as the king and queen right at the end of the film

The film hints at this in the epilogue text when it says that porphyria is “periodic, unpredictable—and hereditary”. The film essentially says “oh yeah, the story we just depicted is bullshit because what helped George was actually his disease going dormant, not anything that we just showed you.” So the film is trying eat its cake and have it too. We get a heartwarming story of how modern democratic values (as represented by Willis’ refusal to abide by court protocols) help cure a king whose problem is that no one will tell him anything he doesn’t want to hear, and then the film winks at us and tells us to disregard what it just showed us. The film unfortunately perpetuates the myth that mental illness is mostly a matter of lack of self-control. In doing this, it falls right in line with people who tell someone suffering from depression to “just snap out of it” or who condemn alcoholics for their lack of self-control. Even as it wants us to sympathize with George III’s sufferings, it’s also blaming him for his turmoil because he was too weak to keep himself in line. So in an odd way, the film too is suffering from its own mental disorder, schizophrenically saying mutually contradictory things and expecting us to believe both of them at once.

Want to Know More?

The Madness of King Georgeis available on Amazon. The screenplay, The Madness of King George,is also available.

Janice Hadlow’s A Royal Experiment: The Private Life of King George IIIis a well-received study of George’s private life that examines his rather unpleasant childhood, his relationship with his wife and children, and his mental illness. She’s not a professional historian, though, so read it with a bit of caution. It’s only available in hardcover or Kindle editions.