George III, king of England from 1760 to 1820, had bouts of serious illness as early as 1765, when he was twenty-seven. His symptoms included incessant ranting, agitation, sleeplessness, difficulty speaking, and physical symptoms such as incontinence, terrible itchiness and blue urine. The King seemed to have grown irrevocably insane in 1788, and then he recovered his wits in 1789. As he got older, his mental condition slowly and steadily deteriorated, and by 1811 it was universally acknowledged that he had finally lost his mind. George III's eldest son, George, the Prince of Wales, was declared Regent, or acting monarch. In 1820, George III died. He had never recovered his wits, and by that time was deaf and blind as well.
A debate has raged since the first signs of George III's illness as to what caused his condition. His doctors debated the correct diagnosis, some arguing for a palsy of the brain, some for delirium, and some for "flying gout," asserting that the gout in his legs had "flown" to his head and caused his insanity. They treated him aggressively, according to contemporary medical science, using, among other treatments: gagging; confining him in a "restraining chair"; emetics, which induce nausea and vomiting; bleeding; and "blistering" him, which involved using a small amount of acid, hot plasters, or a hot poker to burn or "blister" his skin, on his legs or head, creating a number of blisters, which were then drained.
In the 1960's, Ida Macalpine and her son Richard Hunter, both psychiatrists and amateur historians, made the case in a number of scholarly articles and a book that George III was not insane at all, that he was suffering from an illness called porphyria, a hereditary and periodic disorder that affects the nervous system. Recently medical historians have revisited the nearly 100 volumes of medical notes, diaries, letters, comments by courtiers and aides documenting the periodic manifestations of King's illness, and have argued against a diagnosis of porphyria, and instead for either late onset bipolar disorder with episodes of acute mania, and/or obsessive-compulsive disorder. The debate continues.
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