In his otherwise scholarly article on the origins of The Lancet, Professor Jones has in an aside propagated the myth that George III had ‘porphyria-induced madness’.1
Recent detailed review of the 100+ volumes of the King's medical notes together with the correspondence, reports and diaries of courtiers and court officials has confirmed the fallacy of this claim first raised when the British Medical Journal unfortunately published the two articles by Drs Macalpine and Hunter in 1966–1968.2,3 It is most unlikely that The Lancet would have fallen prey to this historical temptation.
The relevant papers will appear shortly in the journal History of Psychiatry but a summary of my findings has recently been published in History Today.4 A morning in the British Library reading the relevant Willis manuscript5 would rebut the diagnostic claims of the so-called blue particulate urine (not a feature of any of the porphyrias) and shown that the diagnosis of any of the acute porphyrias cannot be substantiated.
Professor Jones is also dismissive of 18th- and 19th-century physicians; they may not have had the MRI, CT and PET scans, and other sophisticated diagnostic procedures available to today's general practitioners at the touch of a pen, but they were certainly keen observers, and in the case of Geo III knew when to call for outside help. The arrival of the Willis family of ‘mad doctors’ was followed by a remission of the King's episodes of acute mania in 1788–1789, 1801 and 1804. In doing so they helped lay the foundations of modern psychiatry, developing the recognition and approaches available today. Some CME of the history of medicine is clearly needed here.
Footnotes
Conflicting interests None declared
References
- 1.Jones R . Thomas Wakley, plagiarism, libel and the founding of The Lancet . J R Soc Med 2009. ;102 :404 –10 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Macalpine I, Hunter R. The “Insanity” of King George III: a Classic Case of Porphyria. Brit Med J 1966;1:65–71 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Macalpine I, Hunter R, Rimington C. Porphyria in the Royal Houses of Stuart, Hanover, and Prussia: A Follow-up study of George III's Illness. Brit Med J 1968;1:7–18 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Peters T. George III: a new diagnosis. History Today 2009;59:4–5 [Google Scholar]
- 5.Willis Papers (1810–11) British Library; add. MS 41,696: ff.15–77.