Learning Zone Fit to Rule: How Royal Illness Changed History

I'm historian Lucy Worsley.

In these short films,

I'll be investigating the physical and mental health

of our past kings and queens

and the impact it's had on our history.

I'll be reading their private letters,

studying their doctor's reports

and even examining their clothes

to help me understand the problems they faced.

In 1509,

Henry VIII came to the throne.

He looked like the ideal king -

he was young, intelligent and physically fit.

Henry was the perfect product

of the hereditary system.

His inheritance gave him great power,

but it also placed him under intolerable pressure,

because, to continue the Tudor dynasty, he had to produce an heir,

a successor who would be just as perfect and potent as Henry was.

Henry's health was of national importance,

so his doctors were leaving nothing to chance.

One of the items found here, at Hampton Court Palace,

'shows what a close watch they kept on him.'

And this is my favourite object,

practically, in the whole of the collection.

SHE GIGGLES

-Wow.

-That is what the Tudors called a piss pot,

not my word, theirs,

and this particular one was excavated in the privy garden,

just outside Henry VIII's private apartment,

and the brilliant thing about it

is that the archaeologists who analysed it in there,

when their report came back, it was great.

It said, "Contains traces of genuine Tudor piss," that were in there.

THEY LAUGH

We do know that Henry VIII used not this one, but a piss pot like this,

and his doctors closely analysed what it contained, didn't they?

They would have actually decanted it out of the piss pot

into what they would call a urinal or a jordan

and then held it up to the light,

and the badge of a physician is really the urinal,

because in every illumination,

they're always being shown at the bedside

holding up the glass to the light.

Henry's pretty closely monitored, isn't he?

We hear that every time he goes to "make water", as they call it,

he's accompanied by one of the gentlemen of the bed chamber.

He must have been under constant surveillance.

Inevitably, in such a close-knit community as this,

with everybody standing around, it was very difficult to hide anything,

so if the king wasn't well

or there was something changed in the way his urine looked,

then, it was likely to get out.

And that is, you know, potentially a political problem, isn't it?

Because if he's sick, he could die, there could be war.

If the king was not right, if there was something wrong with the king,

then, there was something wrong with the kingdom,

so there was this very straightforward equation

between the health of the king in a personal monarchy

and the state of the realm.

And the biggest problem facing the king and the country

was that Henry had been unable to produce a son.

When he inherited the throne in 1509,

he'd married the Spanish princess Catherine of Aragon,

but, after more than a decade and six pregnancies,

they had only one surviving child -

a daughter, Princess Mary.

The queen was almost 40

and all hope of a son and heir

to continue the Tudor royal line

was fading fast.

By now, Henry was desperate for a way out of his marriage,

but divorce was impossible in the Catholic Church,

so he considered doing the unthinkable

and changing his religion.

Henry broke with Rome and dissolved the monasteries

and created the Church Of England,

all to get a divorce from Catherine of Aragon

in order to marry the younger, prettier Anne Boleyn

who might, just might, give him a son.

On the one hand, Henry's divorce was a matter of high state

and international diplomacy.

On the other, though, it was an intensely personal story

about a man who was absolutely desperate for a son

and a woman who was too old to give him one.

But Henry's new wife, Anne Boleyn,

did not bear him a son.

Instead, she had another daughter,

Princess Elizabeth,

and this failure would ultimately

cost her her life.

It was Henry's third wife, Jane Seymour, who finally gave him a son.

Prince Edward was born in 1537,

28 years after Henry had come to the throne.

When he died, in 1547,

Henry was convinced that he had finally fulfilled

his most important duty as monarch,

by leaving a son to inherit his throne.

But would the future of the Tudor dynasty be secure in Edward's hands?

Edward VI became king

on the 28th of January 1547,

he was just nine years old.

On the eve of his coronation,

the young prince led a procession

from the Tower Of London to Westminster Abbey.

The streets are lined with spectators,

people hang tapestries out of the windows of their houses

and there's a great cavalcade of noblemen on horseback.

The Privy Council are there, the trumpeters are there,

but when they reach Old St Paul's Church,

the whole procession comes to a stop.

People start saying, "What's going on? Why have we stopped here?"

What had happened was that the king himself had stopped the show.

He'd had his eye caught by an acrobat.

He watched his performance on the tightrope,

he was laughing his head off, enjoying it.

He was, after all, only nine years old.

It was a really charming and amusing moment,

full of hope for the future, but there was a dark side to it.

People did remember the Old Testament saying,

"Woe upon thee, O land, when thy king is a child."

Edward was considered too young to rule by himself,

so his uncle the Duke Of Somerset was appointed as his protector

and exercised power in his place.

One unique document reveals the young king's private thoughts about his position.

We actually know what Edward was thinking and feeling

because he's the first king that we know about to have kept a diary.

It's amazing, it's here at the British Library,

and one thing it covers is his whole relationship

with his uncle, Protector Somerset.

We pick up the story in 1549,

when things are beginning to sour for Somerset.

By the age of 12, Edward had become convinced

that his uncle Somerset was abusing his position and must be deposed.

Edward summarises the charges here -

"Ambition, vain glory,

"entering into rash wars as Protector,

"enriching himself of my treasure

"and following his own opinion."

Just a couple of years later,

Edward himself signs the death warrant for his uncle's execution

and in this diary entry here, it's...it's amazing, really.

It just reads as follows -

"The Duke Of Somerset had his head cut off upon Tower Hill

"between eight and nine o'clock in the morning."

That's it. That's really cold, isn't it?

And it's from this point onwards

that observers said the young king is now to be feared.

In just three years,

the little boy who'd brought his coronation procession to a halt to watch an acrobat

had been transformed into a ruthlessly effective king.

As the 12-year-old Edward's confidence grew,

his top priority was to ensure

that England remained a Protestant country.

Edward himself is the embodiment of the Reformation.

It was for Edward that actually Henry went through

all this whole process of changing the church.

Edward is the first king who is the king

and the head of the Church Of England.

It was in Edward's reign

that, sort of, stained glass was ripped out of the churches,

saints' images were smashed, altars had to be changed,

that were the very fabric of the medieval Catholic Church,

fundamentally shifted.

How does this affect his relationship

with his half-sister Mary?

It's one of these fascinating sort of psycho-dramas, really,

the Tudor family,

that you've got all these sort of half-brothers and sisters,

Mary obviously being sort of brought up a devout Catholic,

Edward being completely on the opposite side of the scale

and then becoming ever more Protestant.

In the end,

it wasn't Mary who was the greatest obstacle to Edward's reign,

it was his own failing health.

In January 1553, the teenage king fell ill

with what was probably tuberculosis.

Even on his death bed,

Edward remained obsessed

with the country's religious future.

He plotted that his crown shouldn't pass to the Catholic Mary,

who was next in line to the throne,

but to his Protestant cousin,

Lady Jane Grey.

Yet Edward's attempt to exclude Mary from the succession would backfire

and plunge the country into political and religious turmoil.

In 1553,

Henry VIII's eldest daughter, Mary I,

became our first reigning queen.

Mary was a committed Catholic and she returned England to her faith.

But if the country was to stay Catholic,

she had to produce a successor.

She chose Prince Phillip, son of the King Of Spain, as her husband

and, she hoped, as the father of her heir.

It was now Mary's duty as the monarch, as a Catholic,

even as a woman, to reproduce.

But time was against her. She was 38 years old.

Only three months, though, after her wedding,

Mary felt something move inside her

and her doctors confirmed it - she was pregnant.

According to royal etiquette, Mary now withdrew from public life

and she locked herself away in her private chambers at Hampton Court.

Mary's pregnancy may have removed her from daily political life,

but it didn't stop her from pursuing a dedicated programme

of religious reform,

which included persecuting Protestants.

Nearly 457 years ago,

a man was brought here, to Smithfield,

to be burnt at the stake as a heretic.

His name was John Rogers,

he was the canon of St Paul's and a leading Protestant churchman.

A huge crowd had gathered to watch him being burnt.

He was offered a last chance to recant,

to say, "Yes, I give in, I am a Catholic,"

but he refused and the crowd were on his side.

As the flames rose up to consume him, some of them wept.

Others of them prayed to God to give him strength

to bear the pain and not to recant.

Over the next few days,

other leading Protestant churchmen were burnt

and the legend of Bloody Mary was born.

Mary had 284 Protestants killed in this way, leading to public outcry.

But the pregnant queen ignored these protests,

she was certain that she was carrying the heir

who would guarantee that England stayed Catholic.

As she approached the end of her pregnancy,

preparations were made for this much-anticipated arrival.

Witnesses to the royal birth were summoned and wet nurses

and the swaddling clothes of the unborn baby were laid out.

A few weeks before the baby was due,

Mary showed herself at the window of her bed chamber

so the court could all see her great belly.

She also signed pre-prepared letters announcing the birth of her heir

and one addressed to the Pope very confidently proclaimed

the happy delivery of a prince.

But, after nine months,

there was still no sign of Mary's son and heir.

It must have been a horrible feeling,

-when people started to doubt.

-Mmm.

They would have started to think,

"Hang on, this has gone on for too long. There's something not right here."

Yes, absolutely, and she would be scrutinised very closely

for the shape of her belly, for example,

and whether the roundness was descending to indicate

that the child was moving down, so it would have been a very anxious time.

A lot of modern historians talk quite glibly about this condition

as a phantom pregnancy, it was all in the mind.

What do you think may really have been going on, then?

Certainly, we've got a queen who's got a big belly,

that much is absolutely certain,

and she believes that she's pregnant, but there's never a baby.

What are the possible causes of the situation?

It could have been a tumour, it could have been a swelling,

either of air or of water,

or it could have been what they would have called a mole

or a false conception,

which was just a kind of mass of tissue

that was not a fully-formed foetus.

Tragically, what Mary had believed to be a child

was probably the cancer that would kill her.

She died three years later and her half-sister Elizabeth became queen

and made England Protestant again.

The consequences of Mary's failure to produce a successor were immense.

Had she succeeded, we might still be living in a Catholic country today.

When Charles I came to the throne in 1625,

the monarchy was a popular and stable institution.

But less than 20 years later,

the country was locked in bitter conflict.

The English Civil War had complex political, social and religious origins,

but I believe that the king's own personal shortcomings were one of its most important causes.

Many of Charles' later problems can be traced back to his childhood.

As a small boy, he had trouble walking

and I think that one of the objects in the Museum Of London store

'can shed some light on the effect this had on his character.'

What I want to show you is in here.

Have a look at them and see what you make of them.

'When Charles was three-and-a-half,'

he was given his own household and his own governess, Lady Carey,

and she seems to have paid particular attention

to this problem that he had with his legs.

We know that he had rickets and there are hints

that Lady Carey got him what you'd call orthopaedic boots,

I suppose, today.

These child's boots

are traditionally associated with Charles I

and you can see that they've got really odd metal heels

and sort of little supports here,

so the suggestion is that this is what helped him to stand upright,

and this was a real concern.

When he was made Duke Of York, they were so worried

that he wouldn't be able to stand for the whole ceremony

that a courtier was positioned each side to catch him if he fell down.

Now, this is clearly a little boy

who's suffering from physical weakness

and I don't know if it's reading too much into this

to suggest that, later on, he would overcompensate.

Charles grew up in the shadow of two men,

his father's dashing young favourite, the Duke Of Buckingham,

and Charles' charismatic elder brother Henry,

who died suddenly,

leaving Charles as the unexpected heir to the throne.

So we've got this king who's an introvert, he's sensitive,

he's a bit of a swot. Is this to do with his childhood?

I think, ultimately, yes, a lot of it goes back to his early upbringing.

I mean, he doesn't have a very satisfactory relationship

with his parents, they tend to sort of neglect him,

and, of course, his father has a series of very obvious homosexual relationships

with various royal favourites,

which I think are constantly being thrust in Charles' face.

How did Charles feel about first being the spare,

but then he becomes the heir?

He doesn't seem to have had a very satisfactory relationship

with his elder brother, who seems to have sort of bullied him.

He tends to be sort of pushed into the background

and doesn't have a great deal of sort of self-confidence.

And I think that stays with him throughout his life, really.

Despite his physical weaknesses and personal insecurities,

Charles was convinced that he really was God's representative on Earth.

Charles I absolutely believed that he was accountable only to God.

But, unlike his clever and subtle father,

he didn't have the skills to persuade other people of this.

He had to fall back on stubbornly insisting upon his divine right.

Right from the start of his reign, he made unpopular decisions,

and particularly dangerous amongst them was his choice of his closest advisor.

It was his father's great love, the Duke Of Buckingham.

I mean, I think it's very different from his father's relationship with Buckingham.

I don't think there's any element of a sexual relationship there.

I think it's much more a matter of Charles looking on Buckingham

as the elder brother that he wasn't able to relate to,

so he looks to Buckingham for worldly wisdom

and guidance and advice and does become very dependent on him.

In 1625, Buckingham led a military campaign to Spain.

But the mission was a disaster

and Parliament demanded that the king sack his favourite.

Charles was furious at this challenge to his absolute authority.

He backed his friend and dismissed Parliament instead.

The king's high-handedness and refusal to compromise with his MPs

set the tone for his future dealings with Parliament,

the institution that would ultimately overthrow him.

In 1760,

the 22-year-old George III

inherited the throne from his grandfather George II.

George III presents a paradox.

He did have one enormous weakness -

his episodes of so-called madness that have come to define his reign.

On the other hand, though, he did rule for 60 years -

one of the longest reigns of any British monarch.

When George was suffering from his episodes of madness,

he was imprisoned at Kew Palace,

isolated from his court,

even kept apart from his wife and children.

These are George's clothes that show some of the signs of his illness.

We know this shirt belonged to him,

it's got "GR" and a little crown

and it's been made extra big,

there's extra fabric under the arms,

so that his pages could dress him

when he wasn't able to do it for himself.

The waistcoat is even more poignant -

you can see how the shoulders have been enlarged

so that his servants could put it on him,

and down the front, there is food or maybe dribble.

When he couldn't feed himself,

he was fed from a cup with a spout, like a child.

For a long time, George's illness was thought to be caused

by a physical genetic blood disorder called porphyria.

But now, doctors are beginning to question this diagnosis.

Clinical neurologist Dr Peter Garrard has been studying letters

George wrote before and during his "madness"

with the same techniques he uses to diagnose his modern patients.

One of the most striking things about this letter

is the length of the sentences.

If you look at the letter that you've got in your hand,

there are maybe 400 words

and it's divided up into five or six sentences

-and that's...

-That's normal.

-..and that's the kind of way

in which you or I would divide up our letters.

But if you look at this letter, which is much longer,

it's maybe 500 or 600 words,

there are only two sentences in it.

So he's writing these massively long sentences

and that's something that seems to be a feature

of the kind of verbal verbosity

that's associated with the manic phase

of a psychiatric illness like bipolar disorder.

It's almost like he's giving out an explosion of words,

and this matches what his doctors are telling us, as well.

They describe how he suffered from "an incessant loquacity",

and he would talk and talk and talk

until the foam ran out of his mouth and he could talk no more.

It's a harrowing image. He talks himself completely out of words.

You can also look at how sophisticated the word usage is

at the individual level.

So he starts to introduce words

which attract very high sophistication scores.

Words here like "unattentive" or "the utmost".

So it's like the reading level of the language is increased?

Yes, that's a very good way of putting it.

Isn't it quite unusual

that he's using more sophisticated words when he's ill?

I would have expected the other way around.

Well, it's well-known that this kind of creativity

is a feature of the manic end of the spectrum of mood disorders.

And do you think, then, that the evidence of these letters

shows that George wasn't suffering from porphyria,

that he must have had some sort of psychiatric disturbance,

a period of mania?

I don't think there can be any doubt any more

that the porphyria hypothesis is completely dead in the water,

and that this was a psychiatric illness.

George's madness left him totally out of action

and unable to exercise his royal authority.

The king's weakness was felt by the whole nation,

who feared the consequences of a power struggle

if he failed to recover.

So the country breathed a collective sigh of relief when, in 1790,

George did unexpectedly get better.

He returned to rule for another 20 years,

until his gradual decline in 1810.

George has gone down in history as the mad king,

But his illness should not be allowed to define his reign.

In fact, he was one of the longest-serving and most successful

of all British monarchs.

It was the fundamental duty of any king or queen to produce an heir.

And no monarch suffered more in her quest for a child than Queen Anne,

the last of the Stuart dynasty,

who came to the throne in 1702.

Anne's gynaecological record was horrific and saddening.

In 16 years, she had 17 pregnancies.

12 of them ended in miscarriage or stillbirth

and of her surviving children, the oldest only lived 11 years.

Anne's friends said there was nothing more moving

than to see the Queen and her husband mourning together

as the little coffins mounted up.

Sometimes, they would weep together,

other times, they just sat in silence hand in hand.

It was unimaginably awful.

To this day, no-one really agrees on the reasons behind Anne's suffering.

What we do know is that she was obese

and even in the early 18th century,

some doctors believed that this made it harder for a woman to give birth.

Clearly there's something wrong for Anne.

What did contemporaries think it might have been?

They would have explained it in terms of her humoral constitution.

At this time, bodies were understood as made up of four humours -

blood, yellow bile, black bile and phlegm,

and they had qualities of hot, dry, cold and moist.

And, as she became progressively larger, shall we say,

they would have understood it as having an imbalance in her humours,

and so, they would have explained her constitution

as her being cold and moist.

Predominantly, she had things like watery eyes, for example,

and that would have affected her reproductive capacity.

In these sorts of books of advice, Jane Sharp's work on midwifery...

Oh, yeah.

..she says quite clearly that fat, overindulgent city women

who eat too much and have access to far too many delicacies

are far more likely to have difficult labours and a hard time childbearing

than your labouring women who were leaner and healthier as a result.

Anne's failure to produce an heir

meant that she was the last of the Stuart line,

and a century later, the survival of the next royal dynasty

again depended on one woman's ability to bear a child.

Although King George III had 15 children,

Princess Charlotte was his only legitimate grandchild

and heir to his throne.

In 1817, she was about to give birth to her first child.

The man responsible for looking after Charlotte

was Sir Richard Croft, the country's leading male midwife.

He's left us an extraordinarily detailed account

of his most important delivery.

He's talking here about a uterine discharge "of a dark green colour."

-Yes.

-That doesn't sound good.

No, this is a sign that the baby is in distress or already dead.

It means the baby has been so badly affected by the process of labour,

that it starts pooing in the womb and then swallowing this substance.

Eventually, Charlotte does give birth, after 50 hours of labour.

The baby is stillborn.

-They rub his body "with salt and mustard..."

-Yes.

"..but no animation was ever restored."

That must have been so frustrating.

He was legitimate, he'd come to term, he was the right gender,

but then, it all went wrong.

Exactly, this was the most important baby in the whole of Great Britain.

And the mother seems to have survived, doesn't she?

She's doing reasonably well. She's quite composed and says,

"Well, if this is God's will, then, that's it."

And she feels tired, she wants to rest

and, at midnight, Charlotte started complaining

about a singing in her ears and she feels unwell, she throws up.

And, very tragically, she dies at about 2:30 in the morning.

Despite the depth of the detail,

it's still not clear what actually killed Charlotte,

but it's likely that a haemorrhage caused her to bleed to death.

At a stroke, the nation had lost two heirs to the throne

and the royal family once again faced the problem

of how to secure the succession.

It was clear that childbirth remained the monarchy's greatest biological challenge.

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