by Lucy Worsley
There were actually very good reasons for the king to maintain even a ‘ridiculous farce of health’. If the news of an illness leaked out, it would ‘disquiet the minds of his subjects, hurt public credit, and diminish the regard and duty which they owe him’.11
Earlier in 1737, George II had suffered horribly from haemorrhoids, and he’d eventually undergone the painful operation to have them cut out. He had endured ‘violent inflammation and swelling’, and ‘his surgeon was forced to attend him with alternate applications of lancets and fomentations’.12 The king could not bear to speak of his humiliating illness. He dismissed his solicitous servants as ‘troublesome, inquisitive puppies’ who were ‘always plaguing him with asking impertinent, silly questions about his health like so many old nurses’.13
Caroline also suffered from the necessity of having to be present and correct in the drawing room whatever the circumstances. In the past her health had often given cause for concern. At one court occasion, ‘she found herself so near swooning’ that she had to send a message ‘to the King to beg he would retire, for she was unable to stand any longer’. That night he nevertheless made her go to a ball, and kept her there until eleven.14
Peter Wentworth, standing and watching from the sidelines as usual, frequently found his heart smarting with concern for Caroline’s heroic fortitude. He described how he was ‘often in great pain for my good Queen, but it is not the fashion to show any [weakness] at Court’. After another, earlier illness, he overheard her telling another courtier ‘that she had really been very bad and dangerously ill’. It was her own fault, Caroline said, for she’d kept her fever a secret and soldiered on with her social duties. ‘She owned she did wrong,’ Wentworth recalled, and she promised that ‘she would do so no more, upon which I made her a bow, as much as to say, I hoped she would do as she then said. I believe she understood me for she smiled upon me.’15
The pain that Caroline felt in her new library, though, was too severe for her to deceive anyone: a vicious cramp in her stomach accompanied by ‘violent vomiting’. Her doctors eventually resorted to Sir Walter Raleigh’s Cordial. This powerful sedative made from alcohol and a compound of forty different roots and herbs ‘gave her some ease, and was the only thing stayed with her … She continued all night so ill that the King, the Duke and Princesses sat up with her.’16
Like Peter Wentworth, Sir Robert Walpole hoped that Caroline’s collapse would force her to begin to take better care of herself. The day after her attack in the library, he spent an anxious hour begging her to be careful, saying, ‘Madam, your life is of such consequence to your husband, to your children, to this country, and indeed to many other countries, that any neglect of your health is really the greatest immorality you can be guilty of.’
Only she could control the king, Walpole said, she alone held the reins ‘by which it is possible to restrain the natural violences of his temper’.
‘Should any accident happen to Your Majesty,’ Sir Robert concluded, ‘who can tell what would become of him, of your children, and of us all?’17
*
As the queen’s battle against this mysterious stomach ailment commenced, she had the comfort of knowing herself to be a brave, if bloodied, warrior in the field of medicine, and she had previously won some fabulous victories against the ignorance and conservatism of contemporary doctors. She is most renowned, medically speaking, as a strong supporter of the practice of inoculating children against smallpox.
The mild discomfort of a few days of artificially induced illness was well worth it to avoid the full-blown version of a disease which had such a high risk of death. Smallpox first appeared as a red rash, then liquid-filled pustules gradually covered the sufferer’s entire body. The mouth, eyes and even the sexual organs became so swollen that the patient couldn’t be recognised and fought for breath as his or her throat and nose narrowed. After a week or so, the liquid in the pustules turned to yellow pus, and feverish delirium set in.
When the pustules burst they filled a sickroom with ‘a stink so intolerable, that a thousand old rotten ulcers, with their united stench of Midsummer, could not equal it’. One medic reported that he’d put a vinegar-soaked sponge in his mouth as protection against the putrid smell, but even that was inadequate: ‘as if struck with a thunder-bolt, I was instantly seiz’d with a trembling over my whole body’.18
If the patient survived the bursting of the pustules, the prognosis was good, for then they formed incredibly itchy but harmless scabs. These slowly flaked away, leaving behind brown and finally white permanent pits in the skin. The scarred survivors known to Caroline included her own daughter Princess Anne and Lady Mary Wortley Montagu (who’d lost her eyelashes to the disease).19 And Caroline herself had suffered in her youth. It was said that she ‘was esteemed handsome before she had the small-pox, and became too corpulent’.20
Meanwhile, far away in Asia, the secret to surviving smallpox safely had been discovered. Lady Mary Wortley Montagu, a former drawing-room regular, had travelled to the East as the wife of Britain’s ambassador to the Turks. In Constantinople she’d learnt how to introduce a tiny amount of smallpox pus into a child’s body to bring on a mild form of the disease, with the intention of immunising the adult against more virulent strains. The method to be followed was to
take a child of any age under ten years old, the younger the better … and find out a person that is sick of a favourable sort. When the pustules are ripe … lance some of them, and receive the matter into a nut-shell, and carry it to the place where the child is. Then with a needle, that hath been dipt into this pocky-poison … prick the fleshy part of each arm and each thigh, deep enough to fetch blood. In a little time each of these punctures begins to inflame, and rises up into a great boil, which ripens, breaks, and discharges abundance of matter. About the seventh day the symptoms of the small-pox begin to appear [but] neither the life nor the beauty of the patient is in any danger.21
This technique – so completely counterintuitive – would never have caught on in England without the support of George II and, especially, of Caroline. It was probably Sir Hans Sloane, the royal doctor, who drew their attention to this remarkable new way of saving lives. At Caroline’s request, George II allowed Sloane to try out inoculation on a group of prisoners awaiting execution in Newgate Jail. They were promised freedom if they survived the experiment.
The positive results convinced Caroline that the treatment was good enough for her to give it the ultimate seal of approval: she had her own children – Princesses Amelia, Caroline, Mary and Louisa – inoculated.22
This news was widely publicised, and the same edition of the newspaper announcing Peter the Wild Boy’s arrival at court in 1726 also informed its readers that ‘last Saturday night the Princess Mary was inoculated for the small pox’.23 Other court mothers including Mrs Titchborne followed Caroline’s example and had their children treated too.24 Sarah Osborn described her own son’s intense misery during the experience: ‘his swelling under his arm is still open’.25
Inoculation was, and remained, deeply controversial. In Paris, the Duchess of Orléans confessed that she was ‘worried a great deal’ by Caroline’s proceedings. ‘If my children were quite well I couldn’t possibly steel myself to make them ill,’ she admitted. ‘My doctor doesn’t think this remedy is safe, he says he doesn’t understand it.’26
Nevertheless, it was soon reported at the British court that ‘the three young Princesses’ were seen dancing, ‘which is a sign they got over their inoculating very well’.27 A doctor was dispatched to Hanover, where the young Prince Frederick was still living, in order to inject the heir to the throne. He complained heartily about the ‘soreness all over his skin’ from the 500 pustules he developed. Yet he was still able to crack jokes and to eat baked rice pudding with a good appetite.28
These events, widely reported in the press, sent out a powerful message about the modern, enlightened nature of the Georgian monarchy. Opponents of inoculation often took the
line that it was bound to fail, associated as it was with foreigners (the Turks) and females (Lady Mary Wortley Montagu). Indeed, one senior doctor thought it extraordinary that ‘an experiment practiced only by a few ignorant women, amongst an illiterate and unthinking people’ should suddenly be ‘receiv’d into the Royal Palace’.29 And its adoption or rejection by doctors tended to follow political lines: Dr Arbuthnot, Peter the Wild Boy’s tutor, was the single exception to the rule that all Tory doctors were against inoculation.30
Their support of medical science differentiated George II and Caroline from the exiled Stuart claimants to the throne. The Stuarts, as mystical, divinely appointed monarchs, believed that the power to heal lay in the very touch of their hands. Sufferers of the illness called scrofula, a disorder of the glands, had queued for hours to be ‘touched’ by the seventeenth-century Stuart kings and queens in hope of relief.
While the Stuarts had claimed to cure through a kind of magic, the Georgian kings trusted science instead. Unlike the Pretender, George II would never be found ‘touching’ victims of scrofula. This was of incalculable significance. In the seventeenth century, people used simply to hope that divine providence would cure their ills; now they began to place themselves in the hands of doctors and scientists.31
Despite these steps forward, eighteenth-century doctors could still be violent and misguided, doing more harm than good. Many of them continued to think that sickness was the result of an imbalance in the body’s four constituent ‘humours’ – black bile, choler, phlegm and blood – so purges of the digestive system, morphine-based drugs and bleeding to restore a supposedly lost equilibrium remained the commonest medical treatments.
In reality, bleeding sapped the body of strength and much-needed oxygen. Caroline herself was drained of no less than ‘thirty ounces of blood’ during the first twenty-four hours of her illness.32 And the treatments she was given would continue to suggest that Georgian doctors could do more harm than good.
*
Caroline fell ill on Wednesday 9 November, but it wasn’t until 4 o’clock in the morning of the following Saturday that her doctors finally worked out what was wrong with her. Until then they could come up with no better explanation of her illness than ‘gout in the stomach’. Diagnosis was made all the more difficult because of their customary lack of permission to examine her body, and they were doubly confounded by a conspiracy of silence about a dread secret.
No one had seen Caroline naked for over ten years. Part of the reason for this was the eighteenth-century habit of wearing a shift practically all the time, even in the bath. Yet Caroline also had a grotesque problem with her stomach that she’d taken care to keep to herself and only a very few others.
It was her husband who finally gathered the strength to be honest with the royal doctors, breaking a promise he had made to his wife and overcoming his scruples about invading her privacy.
Now, because ‘the King absolutely insisted upon it’, she admitted that for many years she’d had ‘a rupture under her navel’.33
*
This rupture, or hernia, was caused by Caroline’s last pregnancy, and her whole medical history was full of the frightening incidents attendant upon the need to secure the future of the dynasty by providing heirs.
Her obstetric troubles had begun more than thirty years previously, soon after her marriage in 1705. Following the wedding, her husband had revealed a desire to go to war, but it was reported that the ‘Court is against it, and will not give their consent to let him go into the field till he has children’.34
From the very beginning of her married life, Caroline’s duty to provide a son had been made more than clear.
Yet, in the early years, she had difficulty in fulfilling it. In January 1707, some sixteen over-long months after her marriage, Caroline finally appeared to be pregnant. But the court of Hanover had ‘for some time past almost despaired’ of her ever ‘being brought to bed’. They feared that the bulge in her stomach was ‘an effect of a distemper’ rather than an unborn child. However, Caroline was finally ‘taken ill’ one dinner time, and subsequently ‘delivered of a son’.35 This was Prince Frederick, who would cause so much trouble.
William Hunter’s engraving of an unborn baby, 1752
Working women found that breastfeeding their children for up to two years had a contraceptive effect that allowed them to space out their pregnancies. But no one had the slightest notion that Caroline should breastfeed her children. Aristocratic or royal women, constantly under pressure to produce heirs, used wet nurses instead. As a result, they could find themselves almost continually pregnant. John Hervey’s mother, the Countess of Bristol, had seventeen children, of whom only eleven survived beyond babyhood.
Princess Anne followed Frederick two years later, and Caroline’s husband was greatly relieved that she’d made a second safe passage through the dangers of childbirth. ‘The peace of my life’, he wrote to her, ‘depends upon knowing you in good health, and upon the conviction of your continued love for me. I shall endeavour to attract it by all imaginable passion.’36 Princesses Amelia and Caroline followed in due course in 1711 and 1713 respectively.
In 1716, after she’d come to live in London, Caroline found the last stages of a difficult pregnancy made worse by the customary disputes about personnel and presence at the birth. For nine months she had been ‘mightily out of order’, ‘extremely weak and subject to continual faintings’.37 Endless streams of worriers came to wish her well. The back-stairs to her room were ‘always so crowded’ that it was hard to get through, and her Ladies of the Bed-chamber were worn out with answering questions.
But even Caroline’s precarious state of health had no effect upon the bickering German and English factions among her courtiers.38
When labour seemed imminent, the English ladies took against Caroline’s German midwife. They ‘all pressed to have the Princess laid by Sir David Hamilton’ instead, but Caroline ‘would not hear of it’.39 The German midwife herself persuaded Caroline to keep the doctor at a distance and, significantly, encouraged ‘the aversion of the Princess to have any man about her’.40 It would be many years until the male accoucheur with his iron tongs was a fixture at babies’ births.
Eventually, though, the German midwife lost her nerve. Daunted by her responsibilities, she ‘refused to touch the Princess unless she and the Prince would stand by her against the English’. She said they were ‘high dames, and had threatened to hang her if the Princess miscarried’.
Prince George Augustus, naturally enough, fell into such a frenzy at all this silly squabbling that he threatened to throw them all out of the window. But it was only several days later, with Caroline clearly ‘in ye utmost danger’, that the courtiers became frightened enough to quell their quarrels. A new and sombre tone emerged, with nothing ‘talked of but the Princess’s good labour and safety’.41 The Ladies of the Bedchamber transformed their attitude towards the German midwife, ‘squeezed her by the hand, and made kind faces at her: for she understood no language but German’.
But it was too late, and the labour went badly wrong. ‘The poor Princess continued in a languishing condition till Friday night, when she was delivered of a dead Prince.’42 The Duchess of Orléans was vastly relieved that Caroline at least had survived: ‘I was very shocked that our dear Princess of Wales had such an unhappy lying-in, and cried bitterly, but God be praised that she is still alive and out of danger.’43
Only a year after her miscarriage of 1716, Caroline was ready to give birth again. On 2 November 1717, ‘a little before six a clock in the evening’ was born the short-lived baby, George William, whose christening had caused the disastrous division between George I and his son. On this occasion there was a considerable crowd present in the room:
His Royal Highness the Prince of Wales
The Lord Archbishop of Canterbury
The Duchesses of St Albans, Mountague and Shrewsbury
The Countess of Dorset
The Lady Inc
hinbroke
The Lady Cowper, being the Ladies of Her Royal Highness’s Bed-Chamber
The Duchess of Monmouth
The Countess of Grantham
The Countess of Picbourg
The Governess of their Highnesses the young Princesses
All the Women of her Royal Highness’s Bed-Chamber
Sir David Hamilton
and Dr Steigerdahl, physician to His Majesty.
That evening ‘a universal joy was seen’ among ‘all sorts of people throughout London and Westminster, of which the greatest demonstrations were shown by ringing of bells, illuminations and bonfires’.44
When William Augustus, Duke of Cumberland was born in 1721, Caroline took the trouble to consult the authorities about who really had the right of admittance to her bed-chamber. She was delighted to discover – despite rumour to the contrary – that ‘neither the law, nor any rule or custom’ decreed anything definite upon the subject of witnesses. The Lord Chancellor told her that she was ‘at her perfect liberty to choose who she pleases to have present’.45
Prince William Augustus was followed by Princess Mary, and the arrival of Caroline’s last daughter, Princess Louisa, in 1724 was accompanied by relief all round: ‘we think it such a blessing her being safe & well that we don’t repine at our not having a Prince’.46 Each pregnancy was a major threat to life, and indeed in 1736 Caroline’s own eldest daughter, Princess Anne, was ‘so ill in labour that the midwife was forced to squeeze the child extremely to deliver her, which kill’d it’.47
Following the birth of Louisa, her last child, Caroline had suffered an umbilical rupture, or hernia. There’s a natural weakness around the belly button in anyone’s ‘rectus sheath’, or stomach muscles. In Caroline’s case, repeated pregnancies had placed great pressure upon her stomach. As she grew older, and fatter, the muscles got weaker and a painful hernia, or hole, appeared.
