King George III and Porphyria

The madness of King George III: a psychiatric re-assessment

“…Following similar studies on his relatives, they altered the diagnosis to one of variegate porphyria, a milder disease (Macalpine, Hunter and Rimington, 1968). In spite of the well-argued objections at the time by acknowledged experts in porphyria (Dean, 1968a(Dean, , 1968bDent, 1968aDent, , 1968bEales and Dowdle, 1968), Macalpine and Hunter persuaded historians (Brooke, 1968;Röhl, Warren and Hunt, 1998;Trevor-Roper, 1968) and not a few medical scientists (Goldberg, 1968;Krebs, 1968;Rimington, 1968;Roth, 1967) that their case was proven and stated that The Royal Malady was variegate porphyria (Macalpine and Hunter, 1969). Their views have proved very influential and, surprisingly, the claim has been widely accepted and is re-iterated without reservation in most books on porphyria and Georgian history, both academic and popular; Alan Bennett developed it into a highly successful play and film script.…”

George III: A revised view of the royal malady*

“…While bark (quinine) and tartar emetic (an antimony compound) may have continued to be favorite medicines given to the King in 1804, when he appeared to look markedly physically ill, we can only speculate about how they were possibly implicated in the pathogenesis of the King's blindness, which was noticed in Downloaded by [Erciyes University] at 15:36 27 December 2014 While quinine is toxic to the retina and may cause optic atrophy (Bateman & Dyson, 1986), the King may in fact have had bilateral lenticular opacities as his physicians believed (Guttmacher, 1941, pp 342-347). Antimony, mercury, and quinine Roth, 1967) were used to treat the King but no discussion fully stresses the toxic qualities of these substances. Antimony potassium tartrate (tartar emetic and James' powder), a colorless water soluble crystalline trivalent antimony compound, was very widely used as an emetic, purgative and diaphoretic.…”