His Majesty’s Psychosis: the Case of Emperor Joshua Norton

Abstract

Case studies are a cornerstone of medical education and have been shown to be effective teaching tools. When teaching is entertaining, learning is enhanced and, therefore, strange and unusual cases present the opportunity to illustrate issues of disorder and illness in an engaging manner. The author illustrates this concept by presenting the life and character of Joshua Norton, who declared himself Emperor of the USA in 1859 and "reigned" until his death in 1880. Although grandiose claims are not rare among patients, Norton is unlike most self-proclaimed royalty in that his community embraced him and joined in with his fantasy. No psychiatrist or psychologist has ever opined on the matter of whether or not Norton's claims stemmed from mental disorder, and the author therefore presents Emperor Norton as a unique case in psychiatric history to explore first what diagnosis best explains his story and, second, whether he merits a diagnosis at all.