Significant Interpretations and Depictions of George III’s Mental Health

Since the king’s death, doctors, historians and other scholars have explored the subject of his mental illness.  Their conclusions have reflected the context of their own era, including its biases but also the contemporary availability and sophistication of methods and sources. We have gathered some of the key moments in the interpretation of the king’s mental health here, with as many direct links as possible so that readers might explore for themselves. We plan to explore this tradition of historical writing more fully soon.

1855  Isaac Ray, ‘The Insanity of King George III’, American Journal of Insanity (Vol XII, July 1855).

 An America psychiatrist, early researcher in forensic psychiatry, and a superintendent of an asylum, Ray published a Medical Treatise on the Jurisprudence of Insanity in 1838.  This treatise was widely used, including in England. For his analysis of George III, Ray reported that he drew on letters and diaries of court figures including Frances Burney and Lord Malmesbury, records of Parliamentary debates discussing the king’s health, and a handful of memoirs and biographies of the period.  Ray focused on the whole of the king’s life and ‘mental disease’. He described George III as having 5 ‘attacks … of comparably short duration, none of them [except the last] continuing very obviously beyond six months’.

1941  M. S. Guttmacher, America’s Last King:  An Interpretation of the Madness of George III (New York, 1941).

Published at the height of the 2nd World War and so at first little noticed in the United Kingdom, Manfred Guttmacher’s book-length account of George III’s mental health nevertheless had an enduring impact on understandings of the topic in the mid-twentieth century before the appearance of Macalpine and Hunter’s work in the late 1960s. As a young psychiatrist trained at John Hopkins, Guttmacher somehow managed to secure unprecedented access to the Royal Archives at Windsor where he explored not just the medical records it held but a wide range of other manuscripts as he built up a psychological profile of the monarch. Guttmacher diagnosed George as suffering from ‘manic depressive illness’, to which he believed the king vulnerable not only on account of ‘neuropathic tainting’ running through his family, but from the impact of his upbringing and subsequent sexual and political frustrations, to which each of the episodes could be linked. Guttmacher went on to become a significant figure in American psychiatry, famous for his involvement in the trial of Jack Ruby.

1969  Ida Macalpine and Richard Hunter,  George III and the Mad-Business (London, 1969); link to important associated article in British Medical Journal).

Although controversial even at the time, Ida Macalpine and Richard Hunter’s assessment of King George III’s mental illness as a physiological condition — in fact, a metabolic disorder, porphyria — became enormously influential.  A mother-son team of psychiatrists, Macalpine and Hunter wrote a 300-year history of psychiatry, in the course of which they turned their attention to the famous case of King George III.  In a series of papers and this book, they argued that the king’s illness was not a form of mania, but instead a form of porphyria (they argued for one, and then a different form of porphyria, variegate porphyria).  Their evidence rested on the episodic nature and short duration of the king’s episodes, and on accounts that suggested the king’s urine was discolored.  Notably, they were able to consult some of the doctor’s reports in the Royal Archives during their research, as well as those held in Lambeth Palace Library.  A metabolic disorder, porphyria results in the build-up of toxins that can affect the nervous system.  Although disputed even at the time of publication (a review in the English Historical Review referred to medical experts’ skepticism) this interpretation became most influential with the first productions of Alan Bennett’s The Madness of George III and then the subsequent enormously popular film.  A collection of over 7,000 works in psychiatry and the history of psychiatry that Macalpine and Hunter accumulated, and that Hunter gave to Cambridge University Library, includes a large number of works related to or about George III.  A singular item in the collection is the prayerbook George III was said to have used at the 23 April 1789 service of Thanksgiving at St Paul’s.

1994 The Madness of King George adapted by Alan Bennett from his play, The Madness of George III.

Bennett’s play brought Macalpine and Hunter’s retrospective diagnosis of porphyria to audiences around the world through the film adaptation, in which Nigel Hawthorne was King George III, and Helen Mirren played Queen Charlotte.  Doctors and servants comment on the king’s discolored urine, and the porphyria diagnosis was specified in text displayed before the closing credits.

2009  Timothy Peters, ‘George III:  A New Diagnosis’, History Today.

Over the last ten years, working singly and with other authors, Timothy Peters has been extraordinarily energetic in offering new perspectives on the mental illness of George III.  In a series of papers, including one published earlier in 2019, Peters has argued that the Macalpine and Hunter thesis was absolutely wrong.  As an expert on porphyria (and the author of a general guide for physicians on porphyria), Peters was well placed to identify the errors in Macalpine and Hunter’s retrospective diagnosis.  In addition, his study of the extensive materials left by George III’s doctors, and collaborative work using computer modeling to analyze the king’s writings, led Peters to assert that King George III suffered from bipolar disorder and what was, at the end of his life, an acute mania (possibly worsened by dementia in part due to the severity of treatments over his lifetime).

2018  For the Nottingham Playhouse production of The Madness of George III, the Georgian Papers Programme supplied the programme note and content for a pre-show film which accompanied the production when broadcast by NTLive!, as well as staging a virtual exhibition.

A Bibliography of work on George III ‘s illness approached from a medical history perspective.

We have made available here a bibliography compiled by Arthur Burns of studies concerned with George III’s mental health written either by medical professionals or scholars whose interest is primarily from a medical perspective. The list consequently excludes biographies or historical works with a more general or different focus, although many of these of course include discussions of the king’s illness. Generally speaking, however, the interpretations offered in such works are dependent on those listed here. The list also includes some important responses to articles published in medical journals.

Click here to download the bibliography.