Madness of King George III may have been his doctors' fault - The Boston Globe Madness of King George III may have been his doctors' fault By Carolyn Y. Johnson, Globe Staff | August 1, 2005 Nearly two centuries after King George III famously mistook a large tree for a Prussian king, peed red- and blue-tinged urine, and died blind, deaf, and mad, scientists are still finalizing his diagnosis. In 1969, a mother-and-son team of psychiatrists with a penchant for diagnosing deranged, dead celebrities suggested that the king suffered from a hereditary disorder called porphyria. The diagnosis stuck, and the British king's legacy brought fame to the rare metabolic disease -- though it remained hotly contested. Other possibilities have been floated over the years, too: the king who sat on the throne when the United States earned its independence could have had manic-depressive psychosis, or even pent-up sexual frustration -- the theory is that after being forced to marry an ugly German princess, the king, as a ''God-fearing man, had to remain faithful . . . and that put him over the edge," said Martin Warren, a biochemist at Queen Mary, University of London.

Now, using modern forensic techniques on a two-inch lock of the king's hair and retracing the royal family tree, Warren and his colleagues have uncovered further evidence that the king likely suffered from porphyria, which even today is frequently mistaken for mental illness -- and a possible explanation for his unusually long, severe episodes of madness. Their analysis, published late last month in the British medical journal, The Lancet, implicates arsenic -- a heavy metal known to aggravate and even trigger episodes of the disease. The arsenic, researchers wrote, was probably a contaminant in his medications, meaning that as the royal physicians attempted to cure the king of his porphyria -- they may have been making him much worse. ''Of course, postulates such as this one are of the armchair variety," and not provable, but the paper is ''provocative," said Dr. Peter Tishler, a professor at Harvard Medical School, and a member of the advisory board of the American Porphyria Foundation. He has long been skeptical of King George's diagnosis. Porphyria is a complicated diagnosis: Even today, the disease is nicknamed ''the little imitator" because it looks like dozens of other diseases on first examination.

The genetic disorder interferes with metabolism, causing acute abdominal pain, muscle weakness, confusion, and red-tinged urine, which seems to have affected several of the king's offspring and relatives. To support their diagnosis, researchers drew on the royal physicians' reports from the 1780s until the king's death in 1820: They were giving the king medications that -- unbeknownst to them -- commonly contained arsenic. ''His Majesty's medicine was given him by force at seven o'clock and this has certainly contributed to his irritation and irascibility which has prevailed ever since," one note from 1811 reads. Nonetheless, controversy continues. Wilfred Niels Arnold, a biochemistry professor at the University of Kansas Medical Center who has written several papers suggesting that the impressionist painter Vincent Van Gogh had porphyria, said he is skeptical of the new claims. He believes the arsenic found in the hair may have been an external preservative and that several of the king's medications could have triggered episodes of porphyria.

In an e-mail, he called the paper ''one of the worst so far in this field," because many of the king's medicines contained different compounds that could have triggered attacks of porphyria. Like other subjects of ''pathography," a field of science that reconstructs illness long after a person has died (posthumous medical diagnoses have been offered in books whose titles include ''The Health of Presidents," ''The Madness of Kings," and ''Medical Biographies: The Ailments of Thirty-three Famous Persons") King George III has long excited both medical and historical curiosity -- although researchers cheerfully agree that such medical mysteries are ultimately unsolvable. The king's madness often overshadows his most important achievements and his great failure: the expansion of the British empire, the defeat of Napoleonic France, mastery of the oceans, and the loss of the American colonies. Despite efforts to put one of the king's sons in power during a particularly debilitating episode of madness in 1788, King George was able to recover from the early episodes of derangement, and was one of Britain's longest serving monarchs. His oldest son, later King George IV, served as regent during his father's last nine years on the throne.

Disagreements over what felled long-dead celebrities may seem pointless, since such belated diagnoses aren't likely to illuminate much about how diseases work, and the dead can't campaign on behalf of their illness as Michael J. Fox has done for Parkinson's disease and Lance Armstrong for cancer. But their influence on modern medicine can't be discounted. ''It's interesting and instructive, and perhaps it explains something of where we're from," Tishler said, who sees patients who suffer the same fate as King George: given a wrong treatment that actually triggers a debilitating attack. ''Like a lot of history, we'd rather not repeat the mistakes of yesterday." Carolyn Y. Johnson can be reached at cjohnson@globe.com . © Copyright 2007 Globe Newspaper Company. More: King James medical mystery unraveled – USATODAY.com Portrait of James I by Paul van Somer in 1620 . Sponsored Links Best known from the 1994 movie, The Madness of King George , the bouts of insanity afflicting George III , the bad guy in the American Revolution , have long been blamed on his predecessor, James.

James was a bit odd, and porphyria , an inherited affliction of the nervous system and skin linked to unusual behavior in some cases, has long been suspected as the culprit . But historians and porphyria experts who have looked through the medical letters surrounding King James have run the monarch's symptoms through diagnostic software and suggest another syndrome better explains the oddness of King James I. "He certainly was an unusual chap," says archaeologist-physician Timothy Peters of the United Kingdom's University of Birmingham. He's the lead author on the History of Psychiatry journal report that takes a closer look at the "recurrent disputes" surrounding the afflictions, possibly inherited, of an "interesting but enigmatic king." James I ascended the Scottish throne in 1567 and the English one in 1603, the age of Shakespeare, Galileo and Sir Walter Raleigh . Interesting times , and King James survived the execution of his mother, Mary, Queen of Scots , the murder or execution of at least three of the aristocrats appointed to raise him as a child, and a thwarted plot to blow him up along with Parliament, still celebrated with fireworks in England.

He inveighed against tobacco (" this vile custom "), wrote poetry and in 1606 chartered England's first permanent North American colony, Jamestown . What finally ended his reign was a stroke in 1625. "It is generally agreed that the last five years of his life were accompanied by intellectual deterioration," says the History of Psychiatry study . Born prematurely, James rarely impressed his contemporaries as a physical specimen, who saw him as feeble, "clumsy in riding and hunting," according to one historian, suffering from itchy skin, gout and abdominal pain. English psychiatrist Ida Macalpine, concluded in 1968 that all those symptoms added up to a mild case of porphyria — a rare family of inherited afflictions that affects about 200,000 people in the U.S. today caused by a buildup of compounds called "porphyrins" in the bloodstream. Macalpine's diagnosis of James I, and a similar one she made for Mary, Queen of Scots, along with her determination of a severe case affecting King George III, inspired the 1994 movie.

She also swayed popular thinking about "Porphyria — A Royal Malady," as she titled one of her books . The only problem is that royal diagnosis seems a bit odd itself. "To our surprise, the more we look the less we see any signs of porphyria," says Peters, who regularly treated porphyria patients in his career as a physician. Looking at James I, the "very outstanding medical notes" of the royal physician written in 1623 detail a series of kidney problems, and his autopsy ("they suspected he was poisoned," Peters says) reports kidney stones in his shriveled left kidney, the site of recurrent abdominal pain that had been key to the porphyria diagnosis. Kidney stones aren't a porphyria symptom. Popping James I's symptoms into a diagnostic computer program called SimulConsult , Peters and his colleagues report no mention of porphyria. Instead, it yields a diagnosis of an even rarer disorder called mild Lesch-Nyhan syndrome , inherited from a maternal genetic defect. The diagnosis seems reasonable, says physician Hyder Jinnah of the Emory University School of Medicine , an expert on the rare disorder, who was not part of the study.

"Problems related to gout and kidney stones may emerge later in life, because they take time to develop," he says by e-mail, in mild cases of the syndrome. More likely, mild Lesch-Nyhan syndrome along with more mundane problems of a man who was separated from his mother at 11 months and drank too much besides, could better explain the odd behavior of James I in his declining years. (His problems were nothing like George III's, who at some points ran around his palace naked attempting outrages against the ladies of the court, according to a physician's notes.) If true, and only genetic testing of some sort of remains would confirm mild Lesch-Nyhan syndrome, a genetic ailment passed down by maternal genes would rule James I out as the source, six generations removed, of the celebrated madness of his distant descendant, King George III. "Most people in medicine now accept that porphyria wasn't likely the culprit for King George's troubles," Peters says. "But it has become a popular view, where King James' diagnosis just further argues against it." For more information about reprints & permissions , visit our FAQ's. To report corrections and clarifications, contact Standards Editor Brent Jones.

For publication consideration in the newspaper, send comments to letters@usatoday.com . Include name, phone number, city and state for verification. To view our corrections, go to corrections.usatoday.com . Posted | Updated USA TODAY is now using Facebook Comments on our stories and blog posts to provide an enhanced user experience. To post a comment, log into Facebook and then "Add" your comment. To report spam or abuse, click the "X" in the upper right corner of the comment box. To find out more, read the FAQ and Conversation Guidelines . Top viewed stories, photo galleries and community posts of the day Most popular right now: One Minute History: The Madness of King George: A Misunderstood King The Madness of King George: A Misunderstood King George III in his coronation robes. His Royal Highness the Prince of Wales, George William Frederick (June 4, 1738-January 29, 1820) became King of the Great Britain and Ireland as George III on October 25, 1760 when his grandfather, King George II , died after passing out unceremoniously and unfortunately while using the toilet early in the morning.

The former king had lived to the age of 77, longer than any recorded English monarch up to that point. The new monarch was only 22 years old when he took the title King and 23 at his coronation but he had extensive schooling from his tutors and, unlike the previous two British kings of the House of Hanover, spoke English as a first language (instead of German), never visited the Electorate/Kingdom of Hanover in Germany which he became king of eventually, and was wholeheartedly British. However, the king had a dreadful problem. He suffered from several episodes of serious physical and mental illness throughout his life that were well-documented thanks to his high station. It is widely believed now that the king had a hematological disease called acute intermittent porphyria (AIP). First of all, unlike other royal afflictions such as mandibular prognathism in the Hapsburg family (more on that another day), porphyria is not the result of marriage between close relatives (inbreeding) . Rather, AIP is a hereditary disease that is autosomal dominant, meaning that someone affected by it has a 50% chance of passing it on to each of his children.

The disease can lay dormant for one's whole life and often needs a trigger (like a change in medicine, stress, diet, etc.) to bring out an acute attack, explaining why neither of George III's parents had notable symptoms. One of King George's descendants, Prince William of Gloucester (December 18, 1941–August 28, 1972) was diagnosed with variegate porphyria (VP), a similar porphyria with hepatic and cutaneous symptoms and autosomal dominant inheritance pattern. Prince William suffered from porphyria too. An attack of acute intermittent porphyria is manifested by a wide range of symptoms. The actual cause of the attack is the absence of an enzyme, porphobilinogen deaminase, that converts a chemical called a porphyrin into heme, a component of hemoglobin, the iron-based chemical in red blood cells that carries oxygen around the body. Porphyrins are toxic to the body in high doses and attacks occur when stress, diet, or something else causes the body to not be able to filter the excess porphyrins.

Pain is severe and most often located in the abdomen and the hands and feet (peripheral neuropathy). Often pain needs to be treated with IV morphine or other equally strong narcotics. Insomnia is common. Nausea, vomiting, constipation, and diarrhea all can occur. Muscle weakness, seizures, headaches, forgetfulness and confusion are often the neurological symptoms. The heart races and tachycardia (high heart rate) and hypertension (high blood pressure) are not uncommon even when an attack is not occurring. Psychiatric problems can occur and can sometimes be the only manifestation of the disease. Often individuals afflicted with porphyria are simply depressed and have anxiety issues but in more severe attacks serious cases of paranoia and psychosis can occur. Finally, AIP is often marked by a distinct purple color in urine and stool during an attack, hence it's name which is related to the Greek word for "purple" (a book about George III's porphyria is titled Purple Secret ). There can often be other symptoms. There is no cure and the treatment is usually just of symptoms.

One medicine, called Panhematin is available to treat the cause of porphyria but requires an IV and is difficult to find as most hospital pharmacies do not carry it and only one company in the United States makes it. Other than Panhematin, IV glucose (sugar) is used sometimes because carbohydrates are known to help stop attacks. Opiates are used for pain, phenothiazines are used for nausea, and benzodiazepines are, very cautiously, used for seizures. Barbiturates and many other drugs are known to be porphyrogenic, i.e., trigger attacks of AIP. Arsenic, now known to be poisonous in any individual, is one of the most dangerous substances to ingest for someone with any porphyria. In 2003, samples of George III's hair and wigs were analyzed and arsenic was found in them, most likely a medication given to him for his illness that in a cruel twist of fate actually made his condition worse.

George III is often remembered as "Mad King George." In fact, the playwright Alan Bennett wrote a play called The Madness of George III in 1991 which was adapted as a movie, The Madness of King George in 1994.The play and movie focus on the unfortunate king's mental illness rather than his successful military campaigns during the Napoleonic Wars and his warm welcome of the United States to the international scene after the defeat of Britain in the American War of Independence. Rather, he is also remember often as the king who lost the American colonies (the United States was founded during his reign). Some bloggers have even asserted that if it weren't for porphyria, the United States wouldn't exist and we'd all be drinking tea and singing God Save the Queen today (presumably on the assumption that the king was crazy due to the disease and mishandled the colonies and the war). However, a lot of scholarship now has a more positive outlook on George III's reign, the longest in British history up to that point. Let us try to look at George III like unbiased historians rather than Americans who are most familiar with the king as the despot who ruled with "absolute tyranny" to whom the Declaration of Independence was addressed.

George III was actually quick to respect the United States as a new country, welcoming John Adams as the de facto ambassador from the US (his title was Minister Plenipotentiary to the Court of St. James's). John Adams did not stay at the court for long, however. According to US Department of State Historians , John Adams "became so frustrated with the cool reception [from George III's court] that he closed the legation in 1788 and the post remained vacant for four years." It seems from his dealings with the infant United States that King George III was in fact a rather honorable man. He also enjoyed some simple pleasures. Sometimes remembered as " Farmer George ," the King had somewhat of a green thumb, liked to tend to his garden, and was very interested in agriculture in general. He loved spending time at what is now called the Royal Botanic Gardens in Kew. He was also a skilled equestrian. George III in 1820, the year he died. However, with regards to the king's disease acute intermittent porphyria, George III suffered attacks often.

His most notable episodes occurred in the early 1780s, 1804, and 1810. He was immensely popular in 1810 but his deteriorating condition caused parliament to pass the Regency Act of 1811, officially titled the "Care of King During his Illness, etc. Act of 1811," of which this year is the 200th anniversary . The law passed control of the monarchy to his son, the future King George IV . Suffering all the typical symptoms of AIP, the king also was almost totally blind and in chronic pain. It is rumored that he would speak for hours on end about nothing and sometimes would wander around nearly or entirely naked. He never learned of the death of his son Prince Edward, the Duke of Kent, Queen Victoria's father. He never knew that he was proclaimed King of Hanover and the Electorate of Hanover was elevated to a Kingdom.

He died with his favorite son, Prince Frederick, the Duke of York, by his side on January 29, 1820 around 8:30 PM, in incredible pain, grief-stricken over the death of his youngest and favorite daughter Princess Amelia, and most likely conscious but psychotic until the bitter end. If ever there was a "tyrant" that one can feel sympathy for, it is the misunderstood King George III. As a side note, I have a particularly strong interest in George III and porphyria. My grandmother suffered from acute intermittent porphyria and it is likely that my mother, my sister, and I all have inherited it. For more information on porphyria, or to help promote awareness of the rare but serious hematological disease, check out the American Porphyria Foundation and learn about the different porphyrias to become more aware. Here's an interesting tidbit to pique your interest: porphyria is sometimes cited as a cause or contributor to vampire and werewolf myths.

Posted by George III - British History - HISTORY.com Google George III: Birth and Education The Georgian era (1714-1830) spanned the combined reigns of the five British monarchs from the Electorate of Hanover, a member state of the Holy Roman Empire. George III was the first Hanoverian king born in England rather than Germany. His parents were Frederick, prince of Wales, and Augusta of Saxe-Gotha. Did You Know? The planet Uranus was originally named "Georgium sidus," the Georgian Star, after King George III of England, who had funded the 40-foot telescope William Herschel used in its discovery. On his father’s death in 1751, the 12-year-old George became prince of Wales. He was cared for in relative isolation by his mother and tutored by the Scottish nobleman Lord Bute. George III: Early Reign George III became king of Great Britain and Ireland in 1760 following his grandfather George II’s death. In his accession speech to Parliament, the 22-year-old monarch played down his Hanoverian connections.

“Born and educated in this country,” he said, “I glory in the name of Britain.” A year after his coronation, George was married to Charlotte of Mecklenburg-Strelitz, the daughter of a German duke. It was a political union—the two met for the first time on their wedding day—but a fruitful one, producing 15 children. George III worked for an expedited end to the Seven Years’ War (1756-63), taking a position that forced his influential war minister William Pitt the Elder (who wanted to broaden the conflict) to resign in 1761. The next year George appointed Lord Bute as his prime minister, the first in a quick succession of five ineffective ministers. In 1764 Prime Minister George Grenville introduced the Stamp Act as a way of raising revenue in British America. The act was fervently opposed in America, especially by the pamphleteers whose paper would be taxed. Parliament would repeal the act two years later, but mistrust persisted in the colonies. George III: The American Revolution In 1770 Lord North became prime minister, beginning a 12-year period of parliamentary stability.

In 1773 he passed an act taxing tea in the colonies. The Americans complained of taxation without representation (and staged the Boston Tea Party ), but North held firm with George’s backing. The American Revolution began on April 19, 1775, with the Battles of Lexington and Concord . The next year, the Declaration of Independence laid out the Americans’ case for freedom, portraying George III as an inflexible tyrant who had squandered his right to govern the colonies. In reality the situation was more complex: Parliamentary ministers, not the crown, were responsible for colonial policies, though George still had means of direct and indirect influence. The king was reluctant to come to terms with his army’s defeat at Yorktown in 1781. He drafted an abdication speech but in the end decided to defer to Parliament’s peace negotiations. The 1783 Treaty of Paris recognized the United States and ceded Florida to Spain. George III: Later Rule and Mental Illness At the end of 1783, Lord North’s coalition was forced out by William Pitt the Younger, who would be prime minister for more than 17 years.

In 1778 George lapsed into a months-long period of violent insanity. He was restrained with a straitjacket and suffered various treatments as crisis of rule unfolded around him. He recovered the next year and reigned for the next 12 as a newly beloved monarch and symbol of stability in the era of France’s revolutionary chaos. George’s support of England’s role in the French Revolutionary Wars of the late 1790s offered early resistance against the Napoleonic juggernaut. George suffered a second major bout of insanity in 1804 and recovered, but in 1810 he slipped into his final illness. A year later his son, the future George IV, became prince regent, giving him effective rule for the War of 1812 and Napoleon’s final defeat at Waterloo in 1815. George III died blind, deaf and mad on January 29, 1820. His illnesses may have been caused by porphyria, an inherited metabolic disorder, though a 2005 analysis of hair samples suggested arsenic poisoning (from medicines and cosmetics) as a possible cause.

Tags The Madness of King George Reviews & Ratings - IMDb IMDb 17 January 2017 8:34 AM, PST NEWS 51 out of 62 people found the following review useful: The King Who Talked To The Trees - And Claimed They Talked Back from United States 21 May 2005 He was our last King, and the one we are raised to hate the memory of. And he was actually a hard working monarch, wrong headed at times, who had the longest reign (for any monarch - until Queen Victoria) in English history. He was George III (reigned 1760 - 1820 - the last nine years incapacitated by insanity and blindness). It was while he was ruling Great Britain that the American Revolution occurred, the French Revolution occurred, Napoleon rose and fell, and the industrial revolution hit Western Europe and the Americas. His is a key reign of modern history. We are taught he was a tyrant. Actually he was a conscientious supporter of the British Constitution, but he believed the colonists were disobedient children who should have been punished for their own good.

Once it was obvious that they had won on the battlefield, George offered to abdicate. He was talked out of it, and eventually faced up to accepting the papers of the new Minister from the United States, Mr. John Adams. But he never really fully accepted it, and in his last decade the two countries fought a second war (the War of 1812). George III was a good, but strict family man. He and his wife Charlotte had seven sons and six daughters. But his sons were disappointments (the best one, Frederick, Duke of York, was a second-rate army commander who got involved in a scandal when his mistress, Mrs. Clarke, sold army commissions "in the name of the Duke of York" to undeserving men). The German Georges had a tradition of hatred between the Kings and their sons and heirs. George I was hated by George II because the former had imprisoned his wife (George II's mother) for life for infidelity (see SARABAND FOR DEAD LOVERS). George II was hated by his son, Frederick, Prince of Wales, and kicked the son out of the royal palace.

Frederick died prematurely in 1758, so his son George III succeeded in 1760. His son, known as Florizel or "Prinny", had a long standing relationship with Mrs. Fitzherbert, a popular actress who happened to be Catholic. It was actually known by King George III that Prinny had an illegal marriage with Mrs. Fitzherbert. As head of the Church of England, George III resented this act. He also disliked Prinny's support of Whig politicians Charles James Fox and Richard Sheridan (and sometimes Edmund Burke). The King was a good Tory - he never realized that Prinny's politics were a way of annoying him, and Prinny was even more reactionary than the King was. Prinny's gambling and drinking debts also annoyed the King. George was able to support the wise government (to 1789 anyway) of William Pitt the Younger. So supportive was he, that Pitt would reciprocate. For one day, in 1788, King George got out of his carriage in a forest, walked over to a tree, and had a long conversation with it.

The tree, you see, was not a tree, but actually the now dead King Frederick the Great of Prussia. George III was showing signs of dementia. He was the first really certifiable monarch since Henry VI back in the 15th Century. George's son Prinny was ready to back a bill to remove his father and lock him away. Pitt saw Fox ready to replace him, and fought a long delaying action on the Regency bill. It worked, as Dr. Wills managed to bring the dementia under control. It would only be in 1811, when Pitt was dead for five years (and Fox for four) that a Tory Government passed a Regency bill, but by then Prinny was openly anti-Whig. It was politically allowable for the Percival Ministry to chance Prinny as Regent by then. After George III died he would become George IV and reign until 1830. This film has followed the tragic illness that incapacity (and eventually) destroyed George III, but only to the conclusion of it's first appearance in 1789. Nigel Hawthorne had performed the role to international acclaim on stage.

He repeats it here, showing a thoughtful monarch (witness why he is upset about the errant colonies gaining independence - the valuable natural resources are lost, and he is aware of this). He is puritanical when normal, but with a son like Prinny who could blame him for being sorely disappointed. From the start you find yourself rooting for Hawthorne's monarch, who was not the evil tyrant that Thomas Paine and Thomas Jefferson painted. Rupert Everett shows the callousness of the Prince of Wales, who is so selfish that at one point (when safely alone) Pitt and Fox wonder if their American cousins were right about abolishing the monarchy. Ian Holm, as Dr. Wills, is properly a mixture of early pioneer of psychology and tyrant. A wonderful film of how a national crisis was met and overcome peacefully. And timely too. Within weeks of the recovery of George III in 1789 the Bastille fell in Paris. Was the above review useful to you?

32 out of 35 people found the following review useful: "I have you in my eye, Sir" from San Jose, CA 22 September 2002 A great performance from Nigel Hawthorne makes this movie very enjoyable. His portrayal of the 'Mad King' is in turns entertaining, poignant, sharp, and commanding. The rest of the cast back him up well. The conversion from stage play to screen works well here... the production design is excellent, and the direction is dynamic enough to ensure that the movie never drags. Best of all though is Alan Bennett's script which is full of wonderfully comic and intelligent soundbites. This is a sumptuous period drama which is never too intense, but at the same time never too pithy, and it makes for very pleasant viewing. The film never takes itself too seriously or gets bogged down - after all, what other 18th century costume drama can boast such lengthy discourse regarding the constitution of a British monarch's fetid stools? Was the above review useful to you?

28 out of 32 people found the following review useful: Faultless from Bracknell, England 14 December 2005 Watched this again yesterday & once more was enraged at the injustice of Nigel Hawthorne missing out on the Oscar to Tom Hank's Forrest Gump that year. An absolutely masterful performance from Hawthorne, matched by Ian Holm's doctor. The scene where the two of them meet for the first time is one of my favourites of all I have ever seen & always moves me. The film never takes itself too seriously, and the cast is a veritable who's who of great British actors that Hollywood largely ignored. If you haven't seen this film, then I'd urge you to do so. Not many of you will fail to be impressed....... Was the above review useful to you? 25 out of 28 people found the following review useful: A great fun story full of colourful characters and performances from United Kingdom 27 February 2004 Already upset by the loss of America to independence, King George III of England's position is made more difficult by the onset of an illness that causes him to act wildly and babble uncontrollably.

While the Prime Minister places him in the hands of Dr Willis to keep him in power, The Prince of Wales and the leader of the opposition both plan to replace the king with the prince by way of a parliamentary bill. Based on the great little play that is historically based, this film went down very well with the awards season since it is very English and well acted. The plot is well written, I'm not sure if it is totally accurate but it is surely based on facts even if it has been coloured for artistic and entertainment reasons. The film embraces both the internal workings of the royal family and the politics of parliament really well; again, it may not be totally true but it is colourful, dissenting and enjoyably. The film is involving but yet still manages to be enjoyable and funny. It is a great story and it is lavishly brought to the big screen in this great production. The sets and costumes are really good and establish the period and setting of the story very well, but it is the performances that really make it work. Hawthorne is wonderfully cast and delivers a great performance in the lead - both as the cruel monarch or the madman.

He is totally believable all the way and never lets his performance become comical or silly even when it is amusing in delivery. Mirren and Donohoe both have less to do but make impacts in their scenes. Everett, Holm, Wadham and Graves support the film to great effect, their performances are colourful, impacting and very enjoyable. Overall, historical films will quite often be viewed as lifeless, dull and overlong. Here this film goes against all those old clichés and is lively, colourful and enjoyable. The rich sets and costumes add value to some great performances in an engaging story that is very enjoyable. Was the above review useful to you? 26 out of 30 people found the following review useful: Satisfyingly sharp and funny from USA 3 July 2000 THE MADNESS OF GEORGE III (called MADNESS OF KING GEORGE in the States because of reported studio concern, probably not apocryphal, that most Americans would wonder why they missed MADNESS I and II) begins with an act of lese majesty, a look behind the scenes as the family and ministers of George III prepare for the ceremony to open Parliament in 1788.

We see the confusion of an equerry who has no idea of what his duties are, a royal attendant hurriedly spit on and cuff-polish a jewel on the kingly crown, the boredom of the king's eldest sons who would rather be just about anywhere else than waiting for their father in the chilly anteroom. ("Colder in here than a greyhound's nostril," mutters the Lord Chancellor.) It's a theme that will carry through the entire film. Kingship and royalty are shams, it seems - magic acts that require faith on the part of the audience. A peek behind the curtain of noblesse oblige and it's all likely to fall to pieces. The story remains fairly true to the facts. Late in 1788, George III is taken by a mysterious illness (lately surmised to be porphyria) that strongly resembles the then-popular conception of madness.

Chaos ensues, mainly in the desperate efforts of the Government (headed by William Pitt - Julian Wadham) to hush the whole matter up lest the forces of the Whig Opposition (led by Charles James Fox - Jim Carter) use the power vacuum to place the king's eldest son, the Prince of Wales, at the head of a regency sympathetic to their political cause. But Alan Bennett, who originally wrote the script for the theatre, is wise enough to treat the potentially tragic story as essentially comic even while raising the question of the basic insanity behind all pretensions to royalty. ("Some of my lunatics fancy themselves kings," notes the "mad doctor" who undertakes the case. "But he IS the king. Where shall his fancy take refuge?") The power of the film radiates from neither history nor comedy but from performances, and Nigel Hawthorne, who sharpened his characterization of George III over months of playing it on stage, dominates a roster of top-notch actors. Whether brow-beating his older children with admonitions of "Do not be fat, Sir! Fight it!

Fight it!" or, freed from his self-imposed strictures of kingship by illness, slipping the reins and pawing under the stays of Lady Pembroke (Amanda Donahoe), Hawthorne is both maddeningly and appealingly autocratic. Perhaps his Farmer George, England's prime example of husbandry both in his knowledge of horticulture and in his brood of 15 children, is more sympathetic than the historical personage, but in the end that matters little. It's a superbly nuanced performance. And he's given able support by Helen Mirren as his faithful Queen Charlotte, who's devoted her life to supporting the man who rescued her from the obscurity of a small Germanic kingdom and married her despite her rather spectacular lack of good looks. Mirren's accent is variable; her etching of Charlotte's desperate groping at every straw in order to see her husband cured is not. The rest of the cast is impeccable as well. Ian Holm is all steely religious conviction turned to medical practice as Dr. Willis, who undertakes to treat the king.

Rupert Everett, despite the double handicap of an obviously false stomach and the silliest wig in the film, does a creditable turn as the Prince of Wales, though the script treats Prinny unfairly, mainly for the comic potential of doing so. Ministers of state and Parliamentarians Wadham, Carter and John Wood handle their lines with a panache and wit that would do credit to any authentic 18th-century gentleman. Some of the best lines go to Wood, who as usual gives his unsurpassable style and timing, as when he growls out in church, "I'm praying, goddammit!" The costumes are both faithful and sumptuous, the cinematography is luminous and the sets, borrowed at low cost from various castles and colleges, are lovingly handled. Of special note is the music of Handel, adapted so cleverly by George Fenton that one would swear the old boy in the knee breeches wrote the score himself for every scene. Was the above review useful to you?

14 out of 15 people found the following review useful: Singular outstanding acting job in a most complex role from United States 19 January 2011 I'm writing these comments about "The Madness of King George" because of the singular outstanding performance by Nigel Hawthorne. This is one of the most versatile roles in films in decades. It surely ranks among the very best of all time. As King George, Hawthorne covers a range of emotions, personalities and temperaments not often found in film roles. His character is a study in transition from the serious to the serene to the silly. It's a role of drama, of hilarity, of ego and stuffiness, of pathos, of sorrow and regret, and of gentleness and kindness. What an exceptional acting job. Most often I watch a movie for the whole experience, taking in the plot, characters, acting, scenes and scenery, location, action, intrigue, comedy, tragedy, as a blend of the whole product. All of these weigh in and affect how much I enjoy the film. But half way through this film, I became aware that I was more engrossed in the lead character himself, and the great diversity and excellence of acting on display.

Others have commented that Hawthorne should have won the Best Actor Academy Award for his role in 1994. While I like Tom Hanks as an actor, I agree that his role in Forrest Gump wasn't anything exceptional. Certainly not on the order of "Mr. King" in "The Madness of King George." Indeed, Hawthorne must have had to work on his role -- even as a consummate actor, if not for the variations of mood and portrayals, at least for the vast amount of lines he had to speak in the film. By comparison, the Forrest Gump role had a very small amount of lines, and those were far less taxing to an actor. Hanks' was a role that seemed more fun and easygoing than a challenge or demand. I'm not one to complain about Hollywood (except for the low quality and volume of attempts at humor in the past 20 years), but once in a while I think that many others who make the same observation are right on. Hollywood flops big time in its Oscar choice of an actor, actress or film once in a while. It seems to me that the California-based Academy at times doesn't look as objectively and honestly at films produced outside the U.S.

Nothing else produced in 1994 even came close to the outstanding acting by Hawthorne in this first rate film. Was the above review useful to you? 11 out of 12 people found the following review useful: Nigel Hawthorne's Crowning Achievement. from United States 4 August 2002 The late Nigel Hawthorne received his only Oscar nomination for his outstanding role of King George III of England who developed a mental disorder that created chaos for the the nation's leader in the 1700s. His wife (Helen Mirren in an Oscar-nominated role) cannot cope and it turns out that no one can really help the king as the medical profession just lacked the modernism necessary to assist. Ian Holm is a genuine scene-stealer as the physician who uses some unorthodox methods to try and cure the titled character. Nigel Hawthorne, who sadly passed away recently, was one of the truly great actors of his time and this was his finest role. 4 stars out of 5. Was the above review useful to you?

11 out of 13 people found the following review useful: A darkly film, not quite your Three Musketeers "history" piece from Mad City, WI 5 June 2000 I positively loved Hawthorne in this movie, thanks to him King's madness is quite palpable, emotional rather then clinical. Ian Holm charms as always - this time as a rather driven/bordering on sadism "doctor", whose elaborate system of punishment was impressed on King George by sadistic and yet so well meaning party of the King. Nice thing about this movie is the absense of the clear-cut villains - even the Prince ain't that bad. It's rather a story of one's power slipping away from everywhere but the very surface, a fable of the King in no more than the name, driven to the edge of misery by intrusive politicians and abusive doctors. As such it has it's depressing moments - don't expect a Hollywoodish romp of the Iron Mask or Musketeers. Was the above review useful to you? 12 out of 15 people found the following review useful: "It's 4 O'clock!

Six hours of sleep is enough for a man, seven for a woman, and eight for a fool." <George III to his attendants> from Houston, Tx, USA, Earth 17 December 2001 *** This review may contain spoilers *** According to the history books, George III of England went hopelessly mad by 1811. This film, which appears largely historical to this non-Brit, begins in 1788, and King George (Nigel Hawthorne) is still indignant over losing the "colonies", now known as The United States. He has already begun to display unbalanced behavior, and his oldest son, Prince of Wales (Rupert Everett)is plotting, along with his cronies, to have a bill passed which makes him Regent, basically acting as king without being king. The tagline at the end of the film asserts that George III was suffering from a particular illness, as evidenced by references to blue urine in the script. In the film, a doctor who has established some reknown as a healer of "mad" people is retained, and forceably takes the King to his compound.

There, every time the King acts unseemly, he is bound to a chair and gagged. Eventually, right before the bill is to be passed, he returns to his subjects, and exhibits normal behavior. He begins adding "what-what" to the end of his sentences, as he had done before he became incapacitated. I wonder if that is where it came from for the movie, "Chicken Run?" A very good movie, done in good style with appropriate humor. Nigel Hawthorne and Rupert Everett are both great in their roles. Was the above review useful to you? 9 out of 10 people found the following review useful: Wonderful, entertaining Britflick from London, UK 18 February 2004 I've recently revisited the third Blackadder series. Nigel Hawthorne doesn't play his George III quite as spoony as that of the Curtis/Elton BBC series who wants his son to marry a pot plant, but it's close. The film works because of three things. First - always first - is Alan Bennett's screenplay which is succinct and hilariously funny. It is also unbearably sad at choice moments.

The actors - the second success story of the project - throw themselves at the pathos as furiously as at the comedy. There's camp and potty humour (literally) juxtaposed with the bare quoting of King Lear and it all works. Thirdly, there is an attention to the detail which goes beyond costume and design. Hytner has got his cast to play out humans inside 18th century character roles - there's no false reverence or mannered acting. Nigel Hawthorne is brilliant, playing out a human despite the vastly inflated ego he has to inhabit either side of sanity. All others aspire to this lead, with only Ian Holm (naturally, as his temporarily domineering doctor) matching it. 7/10 Was the above review useful to you? Page 1 of 6: The Madness of King George: the only insanity is Nigel Hawthorne losing out on the Oscar to Forrest Gump | Reel history | Film | The Guardian Reel history The Madness of King George: the only insanity is Nigel Hawthorne losing out on the Oscar to Forrest Gump The 1994 film of the play by Alan Bennett is a model of historical accuracy and psychological tact.

Only an error involving a curate leaves director Nicholas Hytner with egg on his face Nigel Hawthorne's King George runs riot. All photographs: The Ronald Grant Archive Thursday 18 February 2010 03.54 EST First published on Thursday 18 February 2010 03.54 EST Entertainment grade: A– History grade: A– In 1788, not long after losing his American colonies, King George III of Great Britain and Ireland lost his sanity. Politics To play the king … George gets the hang of the crown King George III (Nigel Hawthorne) is opening parliament, and prime minister William Pitt the Younger is sparring with Whig leader Charles James Fox. "Do you enjoy all this flummery, Mr Pitt?" "No, Mr Fox." "Do you enjoy anything, Mr Pitt?" "A balance-sheet, Mr Fox." Pitt did make himself somewhat unpopular by raising taxes to pay the national debt, but since everyone's doing that these days we may judge him less harshly now than they did back in 1994.

In addition to balance-sheets, a thing Pitt enjoyed was a bottle of port (sometimes two) a day, which may have contributed to his death, possibly from cirrhosis, aged 46. Health Wigging out … Helen Mirren consoles Hawthorne The king crashes children's cricket matches, pretends a shrubbery is the Americans and wallops it with his stick, runs around in his pyjamas, and launches himself upon ladies-in-waiting. These seem like the sort of things a lot of people might do were they king for a day. But in the film, and in real life, they were taken to indicate that George III was going mad. The famous story that he mistook an oak tree for the King of Prussia does not make it to the screen: correctly, because it was almost certainly not true. The film doesn't mention porphyria as a likely cause of the king's condition until the closing title cards. This, too, is quite correct. The diagnosis is a modern one, suggested by some historians, but not provable.

It does, however, lay into George's doctors, depicting them as a bunch of wackos obsessed with scrutinising his effluvia and inflicting blistering, cupping and purgatives. Unfortunately, this is accurate. Scandal 'The fat one?' … Rupert Everett as the then Prince of Wales The Prince of Wales (Rupert Everett) prances around in a shantung dressing-gown and conspires to have his father declared mad, so he can become Prince Regent. But he has compromised himself by his secret marriage to Maria Fitzherbert. This was illegal because he didn't have his father's consent, and because she was a Catholic. "You performed an illegal marriage!" says the king's agent to the guilty curate. "And he only gave me £10," moans the curate. Robert Burt, the curate who really married the pair, got £500 and a never-fulfilled promise of appointment as a royal chaplain. Medicine Giving me the Willis … George is treated by the good doctors The mean Dr Willis turns up to torture the king.

(In fact, there were two Doctors Willis – father and son.) "Get away from me, you scabby bumsucker!" bellows his majesty. But Willis won't go away. Instead, he straps the king into a restraint chair, while the king struggles and howls. In a stroke ­of cinematic genius, while George III is being forced on to this horrible parody of a throne, the soundtrack fires up Handel's Zadok the Priest – the music usually played at the anointing of a British monarch. "I hate all the physicians, but most the Willises," complained the king in real life. Regency I know a shortcut … the final reel dash Parliament is having a ding-dong over the regency, and it looks like the Prince of Wales ("The fat one?" exclaims the king, crossly) may get his way. But the king regains his senses and, in a frantic carriage-ride, just manages to get himself there in time to scupper his son's ploy. There's a touch of dramatic licence here – the king didn't actually have to race to parliament at the 11th hour – but it is true that his recovery sank the bill.

It was temporary, and the Prince of Wales would become regent in 1811. Verdict They gave it to Forrest Gump? Really? A triumph. Shockingly, Nigel Hawthorne lost the Oscar to Tom Hanks for Forrest Gump. Since that makes even less sense than mistaking an oak tree for the King of Prussia, perhaps it was a final act of revenge by what the film calls those "ramshackle colonists in America" on their last and unlamented king. The Madness of King George (1994) Starring: Nigel Hawthorne, Helen Mirren, Ian Holm - Three Movie Buffs Review The Madness of King George "His Majesty was all powerful and all knowing. But he wasn't quite all there." Reviewed on: May 5th, 2015 Nigel Hawthorne and Helen Mirren in The Madness of King George. The Madness of King George is a dark comedy, adapted by Alan Bennett from his hit play The Madness of George III. The reason for the title change is that outside of England, George III is not universally known as a king, and also perhaps because they feared American audiences might mistake this movie for a sequel.

This is the story of King George III's mental health issues and the archaic medical procedures he endured. It is set around the historical backdrop of the Regency Crisis of 1788 during which the King's son, George IV - also known as the Prince of Wales, plotted to have himself declared Regent in his father's stead. Still reeling from the loss of the colonies during the American Revolution, King George III begins having bouts of mental distress. He becomes violent and prone to vulgar outbursts, “Push off, you fat turd.” He also experiences periods of forgetfulness. His doctors attempt various painful remedies including blistering and purges. One of them obsessively studies the king's stools and urine (which has a blue tint) for any signs or symptoms. “One may produce a copious, regular evacuation every day of the week and still be a stranger to reason.” As it turns out this guy was on to something, modern medicine now suggests that George III suffered from a metabolic imbalance caused by porphyria, that also happens to turn urine a shade of blue. As the King's mental condition continues to deteriorate, his political enemies hatch plans to supplant him.

A different doctor shows up with newfangled ideas using elements of psychoanalysis. The King is put in restraints and is made to follow a strict routine. In one great sequence the King is strapped down to a chair but it's shot as if it's his coronation ceremony. Handel's “Zartok the Priest” underscores the scene and the musical climax comes just as the king's head is placed in a leather strap, thus representing his crown. The cast, led by the glorious Nigel Hawthorne, is universally terrific. Helen Mirren, once again playing royalty, is underused but still memorable as Queen Charlotte. Rupert Everett (in a fat suit) plays the indolent and gluttonous Prince of Wales. Ian Holm plays Doctor Willis, the physician with modern ideas who matches wills with the King. Rupert Graves has a few good scenes as one of the King's most trusted attendants and Jim Carter of Downton Abbey fame plays Charles James Fox, leader of the opposition. But it is Hawthorne who carries the entire movie. He is a delight from start to finish as the mentally unstable monarch. It's a juicy role and he relishes every outburst and over-the-top moment.

The Madness of King George is beautiful to look at. Shot at many famous historical locations around England, it vividly recreates its time period and won the Oscar for Best Art Direction. It was also nominated for Actor (Hawthorne), Supporting Actress (Mirren) and Adapted Screenplay. In 1999 it was ranked at #42 on the BFI's list of the 100 Best British Films of the 20th Century. Did you enjoy Patrick's review? +11 Reviewed on: May 6th, 2015 Rupert Everett and Nigel Hawthorne in The Madness of King George The Madness of King George tells the sad tale of a man suffering from an illness that could not be accurately diagnosed or treated properly and efficiently at the time. As he is the leader of a country, many people are concerned for his wellbeing and his mental state. Some are personally invested, such as the Queen and Robert Fulke Greville, whose personal diary was the primary source for the play, The Madness of George III. The King's suffering and how it affects those he loves is tragic as no one knows exactly what to do to help.

Hawthorne breaks your heart as he shows just how frustrated the king was wrestling with emotions and thoughts he had so little control over. At one point he wakes up his servants, “Six hours of sleep is enough for a man, seven for a woman, and eight for a fool.” He then runs outside, pursued by the servants, still dressed in night wear, who are clueless of what is wrong or how to help. At another point he carries a child to the castle roof with the Queen in pursuit, fearing what his intentions are. Had George been a mere British subject, he would have been dismissed as simply insane and likely locked away. When the doctor has him strapped in a chair, George bellows, “I am the King of England!” The doctor stands his ground, “No sir! You are the patient.” Although much is invested in his recovery, some are not so excited to see it through. The King’s son, George IV, the Prince of Wales, is such a lazy and unlikable person that we wonder how much he truly wants to see his father recover. If George III dies or is considered incompetent, George IV could become King but that is an awful lot of work for such a sloth.

Rupert Everett is hilariously horrible when the Queen, upset by having the King taken away from her, storms in and tells him that he should support the King as she has, doing such things as giving birth to his fifteen children. George IV, thinking he is being witty, smirks and responds, “Then you should be grateful for giving you breathing space…No, “breeding” space.” Everett then lets out the worst laugh I have heard in a long time. There are some light moments such as when Greville gets seduced in the hall and when George and his servants play like children throughout the mansion. Of course, there are also the many running jokes, intentional or not, about the King's urine and excrement. This is however, a historical costumed drama and as such may not appeal to everyone. Some of the wigs alone are worth a smile, and how many of us can truly relate to people of such positions. If you like Merchant and Ivory films you are probably this film’s target audience. The cast is very solid and the production value is impeccable. Patrick mentioned the many recognizable names in the cast and it certainly helps to be an anglophile to enjoy The Madness of King George.

I also agree with my brother that it is Hawthorne’s performance that carries the entire movie. He plays the gamut of emotions and is never anything less than perfect. Did you enjoy Eric's review? +6 Reviewed on: May 20th, 2015 Nigel Hawthorne and Helen Mirren in The Madness of King George. The name change and the reason for it Patrick referred to from The Madness of George III to The Madness of King George has become something of an urban myth and an inside Hollywood joke that supposedly pokes fun at the idea that audiences, and Americans in particular, would have mistaken the original title as meaning that this was the third film in the The Madness of George series. However, it's something the producers have denied and indeed the name was changed universally, including inside the United Kingdom where presumably they would know better. Their stated reason is closer to what Patrick said, which is that they wanted to make it plain to audiences that this was about a King and not just a plain old George from a family without much imagination when it came to naming their sons. Shakespeare is referenced several times during the film, including a topic appropriate reading of King Lear in one scene.

It brought to mind another Shakespeare quote, but from Hamlet, "Madness in great ones must not unwatch'd go." As Eric wrote, if George were just another George, he'd have been locked up somewhere or sent, if very lucky, to Dr. Willis's farm. As inhumane and archaic his treatment seems at times, compared to what any of his subjects would have been subjected to, it is the finest care then available. Although the film refers to porphyria as the cause of the King's madness, more modern theories tend to dismiss this idea. A 2013 study by St. George's University of London posited, after studying thousands of the King's personal letters, that the cause was indeed mental rather than the result of a disease, and concluded that were he diagnosed today, he would probably be deemed a manic-depressive. Their research also revealed that the King was given medicine derived from the plant gentian, one of the side effects of which is turning the patient's urine blue. Although the causes of his madness will probably continue to be debated by scholars. As Patrick said, Hawthorne carries this movie and he carries it brilliantly.

He brings such humanity to the part that you can not help but feel for his plight. You never lose sight of the man behind the madness as he often times struggles to maintain control over himself. He moves between arrogant monarch to cowed child, often in the same scene. He more than earned his Academy Award nomination. The rest of the cast (filled with a who's who of British character actors as my brothers wrote) all do good work, but this is in reality a one man show and Hawthorne is nothing short of perfection. There are several running jokes, which are clearly intentional, but I would stop short of calling it a comedy. A tragedy with jokes is how I would describe it. Bennett wisely slips in a few laughs when the tone becomes too dark and depressing. He also ends the story on a positive note with the King seemingly recovered. The truth is that the king was plagued by such episodes for the rest of his life until eventually he was forced to hand over power to his son in 1810. With its high production values, this is historical spectacle on a grand scale. There's definitely plenty for an Anglophile or lover of Masterpiece Theater to enjoy. Did you enjoy Scott's review? +5

Question: What is considered to be the most likely cause of "The madness of King George"?
Answer: Porphyria