The Madness of King George III and the

Use of Primitive Medicine in the Eighteenth Century


By Miles Nye

The Madness of King George was a British work that made its theatrical debut in 1994 and was directed by Nicholas Hytner. However, this movie was adapted to the motion picture screen by the English playwright Alan Bennett whose widely popular play entitled “The Madness of King George III” generated great support for the idea of a film version. As the titles suggest, the film portrays the King of England as he would have been observed by courtiers and friends alike at the time of his mysterious illness in the late eighteenth century. That strange illness, which so greatly devastated the king’s physical and mental state, is now believed to be attributable to acute intermittent porphyria by most medical professionals of the modern era.

King George III lived a very long life, yet the movie focuses heavily on the time of the Regency Crisis in 1788, which is when George III’s manic outbursts were at an all-time high in frequency and his illness severely threatened his ability to function as the ruler of the United Kingdom of Great Britain and Ireland. His estranged and spoiled son, George, the Prince of Wales, was attempting to gain legal authority from Parliament to act as head of the state in his father’s place as a result. What unfolds is a fair and accurate display of the lack of understanding and development in the field of modern medical practices in eighteenth century England (and the world, for that matter). Being a noble sovereign, King George III had plenty of scholars and renowned physicians to serve his every need and to ensure that he received top-quality medical care by the standards of the day. Unfortunately, the methods of even the greatest physicians in London could not cure the King’s ailment, causing the viewer readily to begin to empathize with the deranged King. As George III undergoes physically exhausting and ineffective medical treatments performed by his doctors, the viewer will most assuredly gain a greater respect for the advancements in the practice of modern medicine. Moreover, the royal palaces and the city of London in the backdrop of the eighteenth century time frame make this Academy Award-winning (Best Art Direction) a must-see for European and medical history buffs alike.

King George III, played by Nigel Hawthorne, held the title of the King of the United Kingdom and Hanover from October 25, 1760 until his death on January 29, 1820. This movie concentrates on George III’s life during the so-called Regency Crisis in 1788-1789 that became a central issue in British political life. It was during this time period that George III’s behavior became increasingly erratic. As a result, the unpredictable behavior of the ruling monarch gave powerful statesmen, such as Charles James Fox, acted by Jim Carter, an excuse to try to forcibly remove the King from authority in favor of his heir, the Prince of Wales. The persistence of Fox and the Prince of Wales, played by Rupert Everett, to usurp executive power so that the young prince could be appointed regent becomes an important element of suspense and drama within the movie. With this in mind, the viewer’s sympathy for the feeble king will grow greater in the hopes of seeing him fully recovered by the end of the motion picture.

One of the best features of this film is that it goes through a historical timeline of King George III’s later life and illness while not sacrificing the interest of the audience in royal pomp and the conspiracy in the plot. As George III’s symptoms of porphyria become more severe, the viewer becomes acquainted with his many royal physicians who desperately try to quell his unexplained fits of madness, but to no avail. The recurrent lapses in King George III’s mental stability within the movie are largely suggestive of the failure of the outdated eighteenth century medical practices being performed, and perhaps serve as a metaphor for the decline of royal power. Certainly the outdated eighteenth century medical practices were still closer in methodology and scholarly knowledge to earlier medieval times as opposed to the great modern practices of modern medicine that are widely taken for granted today.

At the earliest stage of his symptoms of porphyria, (a rare autosomal dominant metabolic disorder that affects the bloodstream within the human body), the king was subject to a number of curious medical treatments. In the beginning of the film, the King can be seen undergoing several harmful medical treatments upon his person, such as the process of “blistering” a patient. Practices such as this (one among many primitive methods) will have the viewers cringing in their seats as they watch the finest doctors available to the King of England scorching glass jars in order to press them against the miserable monarch’s body in hopes of curing his bouts of insanity. Adding to this horrendous display of ineptitude by doctors of that era comes purging patients of impurities. Unlike the process of “blistering,” purging is the act of drawing blood from a patient in order to remove supposed impurities within the body. It was a very old method, which dated back at least to the late medieval era. It is surprising to note that this movie received a rating of PG-13, considering that the blistering and blood-letting of King George III on screen becomes eerily reminiscent of the torture-genre of horror films such as Hostel or the Saw series. Regardless of the movie’s official rating, it is not for those who are deterred by the sight of blood or screams of agony- especially when that person undergoing such horrors is the dignified and kindly King of England.

Although many of the King’s physicians still clung to primitive tools and scholarly misconceptions, the appearance of Dr. Pepys (Cyril Shaps) and Dr. Willis (Ian Holm) on to the screen offers viewers a glimmer of hope within a movie filled with intellectual darkness. These two men, using two very different methods of treatment, became symbolic of medical advancement in the understanding and treatment of serious mental and genetic disorders. Their fusion of ideas and observations can be seen as a cornerstone for modern medical theory and application in a world that still lacked much of the knowledge that modern physicians take for granted.

Dr. Pepys plays the role of the inquisitive and observant physician in this movie. His meticulous documentation of the King’s purple-colored urine and irregular stool samples throughout the film are dismissed as nonsensical ramblings by many of the other doctors, pointing out an inherent flaw within the medical community of that time period. Pepys’ need to closely monitor every aspect of the King’s condition irritated many but represented the growing necessity for observation of the human body in diagnosing medical illnesses and recognizing their symptoms. Today, the observation of a patient’s overall well-being relies heavily on the examination of bodily waste and other factors that were often overlooked during this time period. Although it was unknown to almost all medical practitioners of the late eighteenth century, the purple discoloration of urine, such as that of King George III, is highly symptomatic of a serious medical illness such as porphyria. Pepys, in a sense, becomes the metaphorical bridge between the scientific methods of the eighteenth century and the improved standard for scientific study of the human body in the nineteenth and early twentieth centuries. Moreover, Dr. Pepys’s character was further marginalized by his peers beyond by his own “oddball” personality being displayed on screen. The indifference to Dr. Pepys’s finding by other royal physicians reflects the inability of the contemporary medical community to expand intellectually as the century is coming to a close.

In the role of Dr. Willis, Ian Holm (better known to Americans for his role of Bilbow Baggins in The Lord of the Ring trilogy), the viewer will recognize the initial development of psychiatric treatments in the modern era. Recommended to the Queen Consort by an Equerry’s spouse, Dr. Willis was a “man of the cloth” who was known for his unusual methods of treating mentally unstable patients.

As Dr. Willis enters the center of the drama that was unfolding in London during the year of 1788, he is labeled by other court physicians as a quack, unworthy of the King’s consideration and as an outsider to the royal circle. The competition amongst the physicians makes the viewer feel compelled to “cheer” for one of the many schools of medical thought being presented in the film. Willis presents the character of a strong, puritanical man. He has little tolerance for King George III’s bouts of insanity, something that separates him from the other physicians in the film who treat the king as though he were still in his right frame of mind.

The methods being used by Dr. Willis included physical restraint of the patient, blistering of the skin, and the harsh treatment of the king that many others rejected. Many of the practices used by Willis were not unusual for the time, yet it was the way that he handled the social aspect of dealing with the king that made his role in the film memorable. First, Dr. Willis would not allow the king to have his way in all matters, which makes for a good bit of comedy as the King relapses into harsh tirades against the doctor for disrespecting the honor of the monarch.

Another strikingly different method used to combat the illness of King George III by Dr. Willis was his ability to allow the king to have “free time” as a reward for good behavior. After undergoing treatment and physical labor (the latter was thought to combat disease effectively) the king was rewarded with a walk in the countryside. However, this reward for good behavior in the film turns in to a dark comedy as the King soon relapses into his manic ramblings and must be restrained by a straight jacket or by his servants once again.

The understanding of the illness and the way to prevent the episodes were touched upon lightly within the film, but at times, the film mostly focused upon the political drama caused by the King’s bizarre behavior. At times he mistakes his Prime Minister, William Pitt (Julian Wadham), for his political rival Mr. Fox. The morally chaste king’s lewd conduct towards the court’s ladies-in-waiting and his speaking with a tree which he thinks to be another monarch, provide comic relief during the film and help to explain the near hysteria that gripped the country during the Regency Crisis of 1788-1789.

The film itself is a treasure in many aspects of the motion picture. On the one hand, the viewers have the issue of the “madness” of the King to contend with, yet, on the other hand, they have the beautiful scenery of the royal palaces and splendor of London to lighten the seriousness of the film’s topics. The beauty of eighteenth century England is portrayed in such a majestic manner, it is no wonder that it won an Academy Award for Best Art Direction in 1994. If viewers do not desire to see the film for fear of gruesome medical practice as well as scenes of agony and gore, they can at least be somewhat persuaded to see it for the sheer magnificence and beauty being displayed in the film. Director Nicholas Hynter does a superb job of making eighteenth century courtly life comprehensible to modern viewers.

In conclusion, The Madness of King George is a remarkably entertaining adaptation of Alan Bennett’s popular play. The extensive amount of work and attention to detail, in regards to both the contemporary practice of medicine and politics at that time, make this film a must-see for fans of history and according to one critic, “The viewers will be happily entertained through a series of dramatic scenes, comedic flare-ups, and breath-taking views of London during the eighteenth century.”