The Sickly Stuarts: The Medical Downfall of a Dynasty (review)

This book aims to show "exactly how disease and disability brought down the Stuart dynasty" (12). It has its origins in the intellectual curiosity and fascination with the Stuart dynasty of a Distinguished Professor of Medicine at the University of Kansas Medical Center, Frederick Holmes. Professor Holmes turned his curiosity to good effect by undertaking formal academic study in history in the 1990s, culminating in a master's degree in 1998. One offshoot of these labors was his realization that he could see and evaluate medical data in primary and secondary source material better than most historians. This, indeed, is the case, but his belief that it was poor health and medical misadventures that brought down the Stuart monarchy is much less securely based. While his detailed exploration of medical data, including that which can be culled from post-mortem examinations, renders accessible to the political historian much that would otherwise remain obscure or arcane, Professor Holmes puts an explanatory weight upon this evidence that it simply cannot bear. Few historians, for example, would be happy with the statement that "[t]he rise of parliamentary power in England during the seventeenth century was made possible by the progressive weakening of the House of Stuart by disease and disability" (3), or with the assertion that "[t]he power of the Stuarts and the English monarchy slowly faded throughout the long seventeenth century as the Stuarts were brought down by a series of medical problems and Parliament simultaneously increased in power to fill the void" (2).

This is not to deny that death and disease within the royal house had some political impact. Professor Holmes is not the only author to speculate on how the history of early seventeenth-century politics might have been different had Prince Henry, eldest son of King James VI and I, not succumbed to typhoid fever in 1612. Nor is he alone in remarking on Queen Anne's singular obstetric history, of which he provides an interesting and full account, or in examining the fact that none of her children survived beyond the age of eleven. It is helpful to have in one succinct chapter a list of Anne's seventeen pregnancies; an account of the post-mortem examination carried out on her son, William, Duke of Gloucester; and a discussion of her medical history that convincingly refutes the view that she suffered from gout and advances instead a diagnosis of systemic lupus erythematosus, a disease whose progression led to her premature death from a stroke. It is likewise useful to have reiterated that none of the Stuarts or Hanoverians suffered from porphyria.

Professor Holmes's exposition of the diseases and disability of the Stuarts is, in itself, lucid and interesting. At many points he is properly cautious in his diagnosis, and indeed he is at pains to put the medical evidence and its interpretation into a scheme of "certain, possible, doubtful or of uncertain meaning" (5). More problematic for the historian is the significance that he attaches to that evidence. Indeed, as a historian, Professor Holmes is much rasher than as a physician. One example of this is the bold assertion that he builds upon his—–much more tentatively advanced—–opinion that Charles I suffered from a delusional disorder: "Charles allowed his delusion to dwarf his kingship" (85), he states, without further analysis of the many and complex factors that made up the political, social, and religious tensions of the mid-seventeenth century. Even more sweepingly he declares at the end of his discussion of Queen Anne: "Thus, from the vascular dementia of Anne's great-grandfather, James I, to her own lupus and acute brain injury and death, the Stuart dynasty was worn down by disease and disability. Thereby [sic] Parliament won power in England, and monarchy lost it" (183).

It is a commonplace nowadays to extol the virtues of "interdisciplinarity" and to encourage the building of bridges across the scientific and humane divides. This, Professor Holmes has attempted to do...