Saturday, February 17, 2007

Book Review : Sickly Stuarts - The Medical Downfall of a Dynasty by Frederick Holmes (Sutton Publishing 2003)

Frederick Holmes is a practicing Doctor of Medicine with an interest in history, which is probably why this unusual book appears so fresh and interesting. His thesis is that the Stuart dynasty was brought down by the medical disorders of successive monarchs, his evidence the medical notes and autopsies carried out on the six Stuart monarchs who ruled Scotland and England from 1603 to 1714.

It must be said that his thesis is overplayed. Like most families, the Stuarts succumbed to a variety of diseases and mishaps and unlike, for instance, the Spanish Habsburgs, constant intermarrying did not contribute to a weakened genetic inheritance. Prior to their accession to the English throne, the Scottish Stewart monarchs can best be described as unlucky - after the first Stewart Robert II, not one died of old age. Battle, murder, execution or grief finished them all off prematurely - life in medieval Scotland was certainly nasty, brutish and short.

But the British Stuarts died from a variety of causes. Ironically, the only one to die violently was Charles I, who, despite his size and his stammer was very healthy - Holmes ventures a tentative diagnosis of delusional disorder which contributed to his death. Charles' father James I had been a vigorous ruler until his later years, when vascular dementia started to cloud his significant intellect. He finally died from a series of strokes.

Holmes makes a more radical diagnosis in the case of Charles II, who died prematurely at the age of 55 from a kidney infection. Holmes notes that Charles was a keen alchemist, who spent many hours in his private laboratory with mercury compounds. He puts forward the theory that Charles died as a result of acute mercury poisoning, backed up by clinical diagnosis and an analysis of hair purporting to come from the head of Charles which shows it to contain 10 times the normal level of mercury.

Had he lived, Holmes notes, then it is less likely that his brother James would have succeeded him and tried to force the country unwillingly towards Catholicism. As it was, his ability to resist the army of William III was hampered by a 3-day long nosebleed. Despite not being a Stuart, Holmes notes how the velvet-suited gentleman caused the downfall of William III, several years after his wife Mary had succumbed to a virulent strain of Smallpox. Finally, the chequered obstetric history and progressive disablement of Queen Anne is explained by systemic lupus erythematosus.

Not having a medical background, I am unable to comment on the validity of the claims of Professor Holmes. But the book is a fascinating insight into, not only the clinical methods of the 17th - 18th Century and the forms of royal autopsy, but how modern medical knowledge can be brought to bear on our understanding of events which happened hundreds of years ago. And all this is written in fluent style that is perfectly accessible for a complete layman such as myself, with all complex medical terms fully explained. It is a very fascinating book.

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