Queen Victoria's Gene

Haemophilia and the Royal Family

Professor D M Potts,W T W Potts

• Publisher: The History Press
• Year: 2011
• ISBN:
  9780752471969
• Topic: History
• Subtopic: World History
• Index: History

Queen Victoria's son, Prince Leopold, died from haemophilia, but no member of the royal family before his generation had suffered from the condition. Medically, there are only two possibilities: either one of Victoria's parents had a 1 in 50, 000 random mutation, or Victoria was the illegitimate child of a haemophiliac man. However the haemophilia gene arose, it had a profound effect on history. Two of Victoria's daughters were silent carriers who passed the disease to the Spanish and Russian royal families. The disease played a role in the origin of the Spanish Civil War; and the tsarina's concern over her only son's haemophilia led to the entry of Rasputin into the royal household, contributing directly to the Russian revolution.

ONE

GOD SAVE YOU! WHERE’S THE PRINCESSE?

The story of Queen Victoria’s gene alternates between a series of intensely intimate events and a series of geopolitical movements that still affect our world. Even the domestic happenings of the monarchy come under public scrutiny and are frequently documented in considerable detail.

On the evening of Wednesday 5 November 1817 eleven officers of state, including the Archbishop of Canterbury and the Chancellor of the Exchequer, were gathered in the chilly, candlelit chambers of Claremont House, near Esher in Surrey, to observe the young Princess Charlotte deliver her first baby. Naturally, everyone hoped for a son – a son who would one day be crowned King of England.

Princess Charlotte Augusta’s place in history derives almost solely from the tragedies surrounding her short life. She was the only daughter of Prince George, the eldest son of George III, who was to become Prince Regent in 1811. The circumstances of her conception had been gross, even by Regency standards. Concerned at the failure of any of the king’s fifteen children to produce even one legitimate heir, though they had nearly a dozen recorded illegitimate ones, parliament offered to meet the Prince Regent’s debts if he were to marry. The prince had already contracted a morganatic marriage with a Mrs Fitzherbert. His debts by this time exceeded £200,000, and he reluctantly agreed to marry but unwisely delegated the task of finding a suitable bride to his current mistress, the Countess of Jersey. The countess astutely calculated that if the bride were sufficiently unattractive she would be able to retain the prince’s affection. The prince was a close friend of Beau Brummell, who had revolutionized personal habits of cleanliness and was himself unusually fastidious; the prince set fashion and determined taste. The countess therefore chose Caroline of Brunswick, a first cousin of her lover, who was short, gauche and not noted for bathing. In a further attempt to sabotage the match she appointed herself the bride’s dresser; she then covered Caroline’s hair in a foul-smelling concoction and added a beaver hat and bright red cheeks to the bridal array. Her final touch was to lace the bride’s supper with a large dose of Epsom salts. How many of these tricks were noticed by the prince is uncertain because he came to the wedding ceremony drunk and by nightfall he was so intoxicated that he fell over the fender in the bedroom and spent the night in the hearth. However, he had recovered sufficiently by the morning to justify the taxpayers’ investment of £200,000; it was the only time the husband and wife ever had intercourse. Years later in 1820, when the Prince Regent had become George IV, he attempted to divorce Caroline on the grounds of adultery. During the notorious trial of Caroline, Lady Cooper recorded: ‘She says it is true she did commit adultery once but it was with the husband of Mrs Fitzherbert. She is a drôle woman.’ Luckily for the Prince Regent the bride conceived and nine months later Caroline delivered a large baby, following a twelve-hour labour. The infant was named after her paternal grandmother, Queen Charlotte.

The Prince Regent had been thirteen when the American colonies declared their Independence, twenty-three when he married Mrs Fitzherbert and thirty-three when he married Princess Caroline. His first marriage had been without the consent or knowledge of his father King George III; it had also been illegal because Mrs Fitzherbert was Roman Catholic. She was somewhat older than George, and he certainly loved her, although this did not prevent him accumulating additional mistresses such as the Countess of Jersey. Three days after Charlotte’s birth the Prince Regent willed his now solvent estate to Mrs Fitzherbert while to Princess Caroline he left a derogatory ‘one shilling’. In his will he described Mrs Fitzherbert as, ‘my wife in the eyes of God and who is and ever will be such in mine’, and from the moment of her birth, it was apparent to the Court and to the nation that Charlotte would be his only legitimate heir.

When Charlotte was growing up her father took little interest in her and forbade her mother to see her. As an adolescent she suffered from recurrent bouts of abdominal pain, insomnia and alternating excitement and depression. It is likely that she suffered from the hereditary disease porphyria, which was the probable cause of her grandfather, George III’s, episodes of excitability. Porphyria is due to a defect in a single enzyme. The victim is unusually sensitive to sunlight and has episodes of abdominal pain and of excreting very dark urine. The condition causes partial paralysis of the autonomic nervous system which controls the guts and womb. It may therefore cause indigestion, flatulence and difficulties in labour.

In 1814, when she was eighteen, Charlotte was courted by and fell in love with a handsome European aristocrat, Leopold of Coburg, a junior member of a minor German ducal family. The Prince Regent disapproved of the match and it was only with the assistance of Charlotte’s uncle, the Duke of Kent, that the young couple managed to keep up a secret correspondence. Unlike her mother’s courtship, Charlotte’s relationship with Leopold seems to have been genuinely loving and romantic and after two years the Prince Regent relented. The country was delighted and Mr Wilberforce described the union to the House of Commons as ‘a marriage of the heart’, and her marriage to Leopold, who was created Prince of Great Britain for the occasion, appears to have been very happy. The couple were married in May 1816. Charlotte was twenty-one years old, a well-nourished woman with a long, slightly bent nose and golden-brown hair which she wore in ringlets. Fanny Burney the novelist described her as ‘quite beautiful’, adding that it ‘was impossible not to be struck with her personal attraction, her youth and splendour’.

Charlotte conceived in the month of her marriage but miscarried in July. She may have had a second spontaneous abortion but became pregnant again early in 1817. At 7 p.m. on Monday 3 November, after forty-two weeks of pregnancy, her waters broke and Princess Charlotte had ‘sharp, acute and distressing’ labour pains. Sir Richard Croft, the 55-year-old royal accoucheur, had moved into Claremont three weeks earlier. He occupied Prince Leopold’s dressing room which connected with Princess Charlotte’s bedroom in one corner of the house. Mrs Griffiths, who had been wet-nurse to Charlotte’s uncle Edward Duke of Kent, had also moved in as the royal midwife. At 11 p.m., Croft conducted a vaginal examination and found the neck of the womb dilated to the size of a halfpenny. The examination was of course carried out without any asepsis or washing of hands and with Sir Richard wearing the cravat and high collar of Regency London. Labour was proceeding slowly but in a not untoward way. Charlotte remained in strong labour and at 3 a.m. vomited. Throughout history obstetricians have watched and waited, and in the early years of the nineteenth century their options for intervention were few. Croft did the only positive thing he could and summoned the officers of state.

The tradition of senior officials attending at the birth of an heir to the throne was intended to prevent anyone substituting another infant. It was not very effective. In 1688 when James II’s Catholic wife Mary gave birth to a son she was accused by Mary, her Protestant stepdaughter and wife of William of Orange, of smuggling another infant into the birth chamber. It was said the royal midwife brought the substitute infant concealed in a warming-pan. The baby was indeed Mary’s and his birth had been witnessed by sixty-seven people, including the Lord Chancellor, Lord Privy Seal, numerous male members of the aristocracy and many ladies-in-waiting.¹

During Charlotte’s labour the officers of state crowded into the breakfast room which, like Leopold’s dressing room, also opened directly into Charlotte’s chamber. By 8 a.m. on the Tuesday morning quite a crowd was assembled, including the two archbishops, Mr Vansittart, the Chancellor of the Exchequer, the Earl Bathurst, Minister of War and the Colonies, and other aristocrats and political leaders. Naturally, the midwife, Mrs Griffiths, and several ladies of the court were also in attendance. By Tuesday morning Charlotte’s pains had begun to get weaker and Sir Richard sent for a second obstetrician, Dr Baillie, who was his brother-in-law. Charlotte herself was stoical, keeping a promise to Mrs Griffiths not to ‘bawl or shriek’.

A second vaginal examination was performed at 11 a.m., but the cervix had only dilated slightly, in readiness for the expulsion of the baby. Sir Richard Croft drafted a letter to be carried by hand to a third royal physician, Dr John Simms, a 69-year-old botanist with an uncertain interest in obstetrics. Then vacillating, Croft held the letter back. The officers of state and the bystanders continued their wait. Finally at 9 p.m. on the Tuesday, another examination showed the neck of the womb to be fully open, but by this time Charlotte had been in labour for twenty-six hours and she was almost too weak to push out the baby.

To add to Charlotte’s problems she was probably also very anaemic. The diet recommended for aristocratic women who were pregnant had little meat and was especially light in vegetables, the two best sources of iron available. In addition she had been bled several times. Three months earlier Charlotte had written to Croft, ‘I am certainly feeling much better for the bleeding’. One month before delivery a press statement announced that, ‘Her Royal Highness submitted to four incisions in the arm without effect in consequence of the veins being deeply buried . . . [therefore] blood was ordered to be drawn from the back of the hand where the operation has been several times successfully performed . . . with great relief to her Royal Highness.’

The practice of ‘therapeutic’ bleeding was virtually universal until well into the nineteenth century. If, for example, a woman’s periods were too heavy or too light or didn’t come at all, she was bled. Blood was removed either by leeches or by opening a vein. European obstetricians recommended a woman ‘be bled at least three times, in the fifth, the seventh and last month in order to avoid haemorrhage and to prevent the child from growing too large’. If a woman haemorrhaged at delivery more blood was taken from her veins.²

The labour pains during the second night of Charlotte’s ordeal were irregular and weak. Croft and Baillie had attended enough labours to know that things were going wrong, but it may have been their very familiarity with the dangers of childbirth that made Croft dither. Eventually, Croft sent the letter he had written earlier to Simms, who arrived well after midnight. The doctors consulted in Leopold’s dressing room but Simms still did not see Charlotte directly.

Obstetric forceps had been in use for well over one hundred years and consisted of two separate blades, much like modern forceps, and a pair had been taken to Claremont in case of a difficult delivery. Each blade could be passed around the baby’s head and then slotted into each other like a pair of tongs. The blades applied traction to the head while protecting it.³ Medicine, however, is a cautious profession, and those who advise royalty are usually particularly conservative. Predictably, Croft did not use the forceps he had brought along. At noon on 5 November some meconium from the baby dribbled from the vagina. Meconium is the greenish-yellowish contents of an infant’s gut and it is an important sign that the foetus is distressed.

Fifty hours after her ill-fated labour began, at 9 p.m. on Wednesday 5 November Charlotte delivered a stillborn child. The distress after so harrowing an experience must have been doubly painful when it was realized that the baby was the boy every princess yearns for. For one hour, heroic efforts were made to resuscitate the child. Its lungs were inflated and everything possible attempted, from ‘rubbing salt and mustard’ and ‘putting brandy in its mouth’. In retrospect, it seems likely the child had been dead for some hours, perhaps since the middle of the day.

Although the stillbirth was a great tragedy, Charlotte was young and there was no reason why she should not conceive many more times. Mrs Griffiths, the midwife, wept bitterly and it was the bereaved Charlotte who comforted her, saying it was the ‘will of God’. The officers of state, having been shown the dead body, retired after their long sad vigil.

Uterine contractions were now too weak to expel the placenta and once again the three obstetricians consulted. It was agreed that Sir Richard Croft should remove the placenta by hand. He wrote afterwards, ‘In passing my hand I met some blood in the uterus but no difficulty, until got to the contracted part [of the uterus]. . . . I afterwards peeled off nearly two thirds of the adhering placenta with considerable facility.’

The operation, no doubt, added to Charlotte’s already considerable distress. When it was completed, she felt a final labour pain. Croft speaks of the loss of ‘very little fluid blood or coagulum’. As was the contemporary practice, a broad bandage was then placed round Charlotte’s abdomen, probably by Mrs Griffiths. The princess’s pulse was steady after the removal of the placenta and she showed great courage and stamina; ‘talked cheerfully and took frequently of mild nourishment’ – chicken broth, hot wine, toast and brandy. At one point Charlotte joked that her attendants were trying to make her tipsy. The obstetricians retired to bed but around midnight the princess began to show signs of blood loss, complaining of ringing in her ears. She vomited once and showed ‘extreme restlessness and great difficulty breathing’. Almost certainly Charlotte was bleeding into her uterus but the bandage would have made it difficult to detect any enlargement. If, as we have seen, she was already anaemic due to an inadequate diet and two or more episodes of blood-letting during pregnancy, then her extreme state is easy to understand. Croft was called and noted her pulse had passed the hundred mark and was feeble and irregular.

Other likely diagnoses have been suggested, including a pulmonary embolus or an attack of porphyria. In the case of an embolus a clot of blood forms in the veins of the pelvis or legs and then breaks off to lodge in the lungs and bring about death. We have noted that Charlotte may have shown symptoms of porphyria earlier in her life and a fatal attack can develop after an otherwise normal delivery. The record of excitement and difficulty in breathing would fit with such a diagnosis. A later writer claimed Charlotte put her hands over her abdomen and cried, ‘Oh, what a pain!’, but this may well be an embellishment to already dramatic events.

Whatever the correct diagnosis, at 2.30 a.m. on the morning of Thursday 6 November 1817 Princess Charlotte died. Her husband, Leopold, was by her side. Her father the Prince Regent received news of his daughter’s labour and travelled to London from Suffolk, but did not arrive until after her death. Her mother was in Italy and even by December did not really know what had happened. Queen Charlotte was in Bath and heard of her granddaughter’s death late the same day. The old king, George III, now senile and confined to Windsor Castle, never knew of the death of both direct heirs to his throne.

In keeping with the British royal tradition the corpses were embalmed the next day. Already there was controversy over the cause of death and Sir Everard Home, the king’s sergeant-surgeon, turned the embalmings into post-mortems. ‘The child was well formed and weighed nine pounds. Every part of its internal structure was quite sound.’ The brain and lungs of the mother were normal but, ‘The uterus contained a considerable quantity of coagulated blood and extended as high as the navel and the hour glass contraction was still apparent.’ The stomach and intestines were dilated.⁴

The princess and her child were buried at Windsor on 19 November, amid widespread and sincere national mourning. The harvest had been bad, and the victory at Waterloo two years earlier seemed less glorious against rising unemployment and depression. On the day after Charlotte’s death, The Times reported, ‘we never recollect as strong and general an expression and indication of sorrow’. Later it was said, ‘It was really as if every household throughout Great Britain had lost a favourite child’. The Duke of Wellington called the tragedy, ‘one of the most serious misfortunes the country has ever met with’. Lord Byron heard about the death while he was in Venice and wrote, ‘The death of the Princess Charlotte has been a shock even here and must have been an earthquake at home’. Even Napoleon, exiled to the remote island of St Helena after his defeat at Waterloo, commented, ‘What has happened to the English that they have not stoned her accoucheurs?’

In fact, Prince Leopold, the Prince Regent, and Baron Stockmar, the prince’s personal physician from Coburg, all wrote to Sir Richard Croft commending his ‘zealous care and indefatigable attention’. Looking back with today’s knowledge, then if Charlotte died from blood loss, her life might have been saved on two occasions; first, by forceps delivery some time earlier on the Wednesday, and second, by more careful management after the manual removal of the placenta. The risk of intra-uterine bleeding following delivery, with few or no external signs, was understood at the time. Unfortunately, the habit of binding the abdomen after delivery interfered with Croft’s ability to follow what was happening.⁵

Sir Richard was deeply burdened by a sense of total failure and inadequacy. The press and the coffee gossips of London were less kind than Prince Leopold and the Prince Regent, and Croft remained depressed, sleeping poorly. However, he was still sought after as an obstetrician and in February 1818 attended the wife of one of the king’s chaplains, Revd Dr Thackeray. In a reversal of roles, Thackeray noticed the physician’s depression and entreated him to rest. ‘What is your agitation compared to mine?’ snapped back Croft. A few days earlier, a fellow surgeon said Sir Richard was ‘so melancholy, that it was quite distressing’, adding, ‘his mind was so absorbed that he would not give answers to questions’.

On the night of 13 February 1818 Croft retired to his rooms in Wimpole Street. The Revd Thackeray and his wife were also sleeping overnight in his house. At about 2 a.m. they heard a noise, like someone falling off a chair, but took no notice of it. A little later a servant girl found Sir Richard ‘on his back, with a pistol in each hand; the muzzles of both were at either side of his head. He was quite dead.’ A post-mortem was held the same day and the jury returned a verdict of ‘Died by his own act, being, at the time he committed it, in a state of mental derangement’. They commented on the fact that just prior to his death he had been reading Shakespeare’s Love’s Labours Lost and had reached the page with the words, ‘God save you! Where’s the Princesse?’ The twentieth-century obstetrician, Sir Eardley Holland, who wrote at length about Charlotte’s death, aptly described the whole sad episode as a ‘triple obstetric tragedy’.

With the death of Princess Charlotte there was once again no British heir to the throne. The old demented George III was still alive but senile and he died three years later. His son, the Prince Regent, was fifty-eight years old and the death of Charlotte and her stillborn son had eliminated his only legitimate grandchild. His numerous sisters and sisters-in-law were all past child-bearing age. George III and his wife Queen Charlotte had had fifteen live born children – the largest brood born to any British monarch – and thirteen of them survived to be adults. The next generation had produced eleven illegitimate children; even one of the royal princesses, Sophia, contributed her quota, but there were now no legitimate grandchildren. With Charlotte’s unexpected death, the succession stakes were in disarray.

TWO

DYNASTIC CLIMBERS

Leopold married Princess Charlotte in 1816. His family dukedom took its name from Coburg in what is now northern Bavaria in Germany. Its ancient and picturesque buildings survived the Second World War and it is still dominated by the Veste Coburg castle, with steep pitched roofs and battlements, on the hill above the town and the later Ehrenburg Palace below. Leopold’s ancestors had a long history in this small picture-postcard town, and thanks to his ambitions and abilities, his descendants and collaterals were to rule, for a while, half the world.

Like the Habsburgs, the family of Coburg gained more by mating and parenthood than Napoleon or Charlemagne ever did by the sword. In medieval times the lands that are now Germany were divided into numerous small principalities loosely joined together as the Holy Roman Empire, which historians hasten to point out was not in any way an Empire, could hardly claim to be Roman and certainly wasn’...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Preface
• Introduction
• 1. God Save You! Where’s the Princesse?
• 2. Dynastic Climbers
• 3. Victoire and Victoria
• 4. The Ugly Duckling
• 5. The Bleeders
• 6. Mutation or Bastard?
• 7. Crowns Rolling about the Floor
• 8. The Pretenders
• 9. The Coburgs and Haemophilia in Iberia
• 10. Later Generations
• 11. A Breed Apart
• Notes
• Bibliography