page_title: Frederick III, German Emperor
section_title: Illness and decline
hierarchical_section_title: Frederick III, German Emperor / Illness and decline
caption_attribution_description: Morell Mackenzie
context_page_description: Frederick III was German Emperor and King of Prussia for ninety-nine days in 1888, the Year of the Three Emperors. Known informally as "Fritz", he was the only son of Emperor Wilhelm I and was raised in his family's tradition of military service. Although celebrated as a young man for his leadership and successes during the Second Schleswig, Austro-Prussian and Franco-Prussian wars, he nevertheless professed a hatred of warfare and was praised by friends and enemies alike for his humane conduct. Following the unification of Germany in 1871 his father, then King of Prussia, became the German Emperor. Upon Wilhelm's death at the age of ninety on 9 March 1888, the thrones passed to Frederick, who had by then been German Crown Prince for seventeen years and Crown Prince of Prussia for twenty-seven years. Frederick was suffering from cancer of the larynx when he died, aged fifty-six, following unsuccessful medical treatments for his condition.
  Frederick married Victoria, Princess Royal, eldest daughter of Queen Victoria of the United Kingdom. The couple were well-matched; their shared liberal ideology led them to seek greater representation for commoners in the government.
context_section_description: Frederick had been a heavy smoker for many years. At a ball held by William on 31 January 1887, a guest reported the Crown Prince "was so hoarse that he could hardly say a word." His hoarseness continued through February, and was diagnosed as a thickening of the mucous membrane over the vocal cords, caused by "a chronic laryngeal catarrh." On 7 February, Frederick consulted a doctor, Karl Gerhardt, who scraped a wire across the membrane for 10 days in an attempt to remove thickened tissue. After the procedure proved unsuccessful, Gerhardt cauterised the left vocal cord with an electric wire on 15 March in an attempt to remove what was then thought to be a vocal fold nodule. Due to Frederick's highly inflamed throat, Gerhardt was unable to remove the entire growth. After several cauterisations, and with no signs of improvement, Frederick and his wife went to the spa of Bad Ems, where he drank the mineral waters and underwent a regimen of gargles and inhaling fresh air, with no effect.
  On 17 May, Gerhardt and other doctors, including Ernst von Bergmann, diagnosed the growth as laryngeal cancer. Bergmann recommended consulting a leading British cancer specialist, Morell Mackenzie; he also recommended a thyrotomy to gain better access to the inside of the larynx, followed by the complete removal of the larynx – a total laryngectomy – if the situation proved serious. While Victoria was informed of the need for an immediate operation, Frederick was not told. Despite the tentative diagnosis of cancer, the doctors hoped the growth would prove to be a benign epithelioma. A room on the top floor of the Crown Prince's palace was then equipped as an operating theatre, but Bergmann elected to put the operation on hold until Mackenzie could provide his assessment. Mackenzie arrived in Berlin on 20 May, but after examining Frederick recommended a biopsy of the growth to determine whether or not it was malignant. He conducted the biopsy the following morning, after which he sent tissue samples to the distinguished pathologist Rudolf Virchow for microscopic examination. When Virchow was unable to detect any cancerous cells despite several separate analyses, Mackenzie declared his opposition to a laryngectomy being performed, as he felt it would be invariably fatal, and said he would assume charge of the case. He gave his assurance that Frederick would fully recover "in a few months." While Gerhardt and Physician-General August Wegner concurred with Mackenzie, Bergmann and his colleague Adalbert Tobold held to their original diagnosis of cancer. In addition to Mackenzie's opinion, Bismarck strongly opposed any major operation on Frederick's throat, and pressed the Kaiser to veto it. On 9 June, Mackenzie again biopsied the growth and sent the samples to Virchow, who reported the following day that he was again unable to detect any signs of cancer.
  On 13 June, the Crown Prince left Potsdam for London to attend his mother-in-law's Golden Jubilee and to consult Mackenzie. He never saw his father alive again. He was accompanied by Victoria and their three younger daughters, along with Gerhardt; on 29 June, Mackenzie reported that he had successfully operated at his Harley Street clinic, and had removed "nearly the entire growth." Frederick spent July with his family at Norris Castle on the Isle of Wight. However, when Frederick visited Mackenzie's office on 2 August for a follow-up examination, the growth had reappeared, necessitating its cauterisation the same day, and again on 8 August – an ominous indication that it was indeed malignant. Felix Semon, a distinguished German throat specialist with a practice in England, and who had been closely following Frederick's case, submitted a report to the German Foreign Secretary in which he strongly criticised Mackenzie's cauterisations, and gave his opinion that the growth, if not malignant, was suspect, and should continue to be biopsied and examined. On 9 August, Frederick travelled to Braemar in the Scottish Highlands with Dr. Mark Hovell, a senior surgeon at the Throat Hospital in London. Altho
caption: Morell Mackenzie, whose treatment of Frederick caused controversy
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