madness of George III; porphyria???
Richard B Gorrie (rgorrie@uoguelph.ca)
Wed, 3 May 1995 17:53:39 -0400
Please do not believe that "we know" that George III or any other
members of the British royal family suffered from porphyria. Porphyria does
indeed have modern standard diagnostic numbers. That does not mean, of
course, that we can clearly determine whether George III had it. According
to modern diagnostic procedures, to determine that a patient has porphyria,
one must show that s/he has excessive amounts of porphyrine (a chemical) in
the bloodstream or urine. We cannot now (obviously) determine that for
George III. Therefore, any retrospective diagnosis must be made according
to symptoms reported in the sources at a time when the various symptoms had
not yet been grouped together as "porphyria". That must make one very
critical of the sources. The symptoms reported of George III might OR MIGHT
NOT have something to do with the disease.
It was Ida Macalpine and Richard Hunter who first proposed the
retrospective diagnosis of porphyria in King George, beginning with an
article in the Brit. Med. Journal in Jan. 1966 and followed up in other
articles. They expanded their theory (it is, to repeat, only a conjecture)
in their book of 1969 on George III and the Mad Business. BUT it should be
noted that a number of physicians who dealt with patients who suffered from
porphyria wrote critical replies in the medical journals to the Macalpine
and Hunter theory, raising many doubts about the soundess of their view.
That includes Geoffrey Dean, who included his doubts in his 1971 edition of
his book, The Porphyrias.
No problem if a playwright wants to use this hypothesis to account
for George's madness (although personally I thought it rather undercut the
case also made in the film for the departure of the American colonies being
the cause of the unbalancing of George's mind). And no problem if you want
to believe that everything is in our genes (or biology). Art, faith, and
science are worth discussion. But just because porphyria is a current
diagnostic category does not mean that we KNOW that George had it. Maybe.
Maybe not.
Harold J. Cook
Dept. History of Medicine
University of Wisconsin-Madison
hjcook@facstaff.wisc.edu