Madness of King George

[ Suspenseful music plays ] -Winter, 1788.

The British king, George III, is hallucinating, violent, and abusive.

-Out of my sight!

♪♪ -He's losing control -- of himself and the country.

At a time of upheaval, Britain can't have a mentally ill king.

♪♪ As a last resort, a medical maverick, who runs an asylum, is summoned.

♪♪ Can he save the king?

-[ Shuddering ] ♪♪ In this series, I'm reinvestigating some of the most dramatic and brutal chapters in British history.

♪♪ It wasn't just one generation.

It was three generations losing their lives, bam, bam, bam.

These stories are epic and legendary and they all have fascinating mysteries at their heart.

It's chilling to think that this could actually be evidence in a murder investigation.

♪♪ I want to look at them from a fresh and modern perspective to try and unlock their secrets.

♪♪ It's a horrible psychosexual form of torture, this, isn't it?

-Absolutely.

♪♪ -By uncovering forgotten witnesses, reexamining old evidence, and following new clues, can I get closer to the truth?

-It is one of the great British mysteries.

-It was one of those moments, I'm afraid, for a historian, that makes the hair stand up on the back of your neck.

[ Cawing ] ♪♪ -"Lucy Worsley Investigates" was made possible in part by contributions to your PBS station from viewers like you.

♪♪ ♪♪ -I'd say I know a fair bit about George III, but, I don't know nearly enough about his mental health and now's the perfect time to take a look at it because new evidence has come to light.

Just a few years ago, the royal family granted unprecedented access to his personal papers.

This treasure trove of documents is stored at Windsor Castle.

A residence of the British royal family for more than 1,000 years.

So far, 225,000 documents -- diaries, letters, medical notes -- have been published online.

But there are still more secrets to be revealed.

♪♪ I've been here to the Royal Archives before, but this is the first time I hope to get my hands on documents that will take me behind the scenes, into 1788, when the king fell ill.

I've asked the royal archivist to bring out a unique private diary.

It's an eyewitness account of George III's illness as it escalated.

-There we are.

-Thank you ever so much.

This is great, thanks.

This is an amazing thing to get to see.

It's the diary of Robert Greville, "Journal of His Majesty's most serious and afflicting illness."

He was one of the king's equerries, which means he spent a lot of time with the king.

And, on Sunday, the 9th of November, he's writing about, "Great agitation & much incoherence in thought & expressions."

It's fascinating that he's actually with the king.

This is like a frontline report from the king's bedside.

What else are we going to learn?

Oh, finally, he goes to sleep, after having "talked for 19 hours without scarce any intermission."

♪♪ Poor man.

What's happening on November the 24th?

"We found the king violently agitated and very angry, but more particularly with Dr Warren,' one of the medical advisors.

"The king advanced up to him and pushed him."

♪♪ So, Greville's getting pretty upset, actually.

He says that, "the general conduct of the physicians has not been...decided or firm."

They simply don't know what to do.

"They appear to shrink from responsibility."

Greville says here that, "a report has been sent to Mr Pitt," the prime minister, "stating that [His Majesty] had passed a quiet night, but that he was entirely deranged."

♪♪ George had at least five personal doctors and they were all mystified.

In the 1780s in Britain, the medical profession still clung to a centuries-old notion about mental illness.

♪♪ When George fell ill in 1788, his doctors, at first, still believed they needed to get this disease out of his body.

They gave him drugs to make him vomit.

They used blisters to draw out what they thought was bad blood from his body.

And they used these little suckers.

Got these off the Internet.

I love the way they're actually called...

These are leeches!

Look at them wiggle.

They're just like tiny, little monsters.

Ooh!

He's sucking the side there.

And the idea was that these would be applied to George's temples and that they would suck the madness out of his brain.

♪♪ The king is bled, blistered, and purged.

Nothing works.

♪♪ His baffling illness could not have struck at a worse time.

♪♪ In the 1780s, Europe is a tinderbox.

Peter III of Russia has been murdered, France is on the brink of revolution, and the American colonies have all but won the war for independence.

[ Thud ] ♪♪ George was ill at such a crucial time in history.

Then, and since, there's been a keen interest in working out what was wrong with him.

♪♪ And it seems to me that George's illness wasn't just misunderstood in his own lifetime.

♪♪ This essay was published in the British Medical Journal in 1966.

It's by a couple of psychiatrists, Macalpine and Hunter.

They looked at George's medical records and argued that he had a rare genetic blood disorder called porphyria.

This idea really stuck, notably, in the stage play by Alan Bennett.

When this was turned into a film, there was actually a caption onscreen suggesting that George had porphyria.

But, historians have been divided about this and now, there's a rival diagnosis.

♪♪ I'm going to speak to one of the UK's most eminent psychiatrists, to see if he can shed some light.

He's also been examining the papers from the Royal Archives.

♪♪ Can the new evidence settle the question of what was wrong with George, once and for all?

♪♪ Simon, how do you feel about "diagnosing" dead people?

There are some concerns here, aren't there?

-Oh yeah, very much so.

In medicine, in general, and psychiatry, it's a very dangerous thing to do.

The only reason that we can do this with George is because the documentation's so extraordinary.

-Why do you think that porphyria was so warmly welcomed as a theory in the 1960s?

-Macalpine and Hunter were, it now turns out, ardent monarchists, and they wanted, really, to remove the taint and the stigma of mental illness from the royal family.

And porphyria did run in the royal houses of Europe, by the way, it just didn't affect George.

But they wanted to kind of help the queen out by taking away the taint of mental illness.

-What was really the king's condition, do you think?

-The best evidence we have from George is the observations of his behavior.

We've had, for some time now, what we call diagnostic criteria, in which you can fill in a computer program and that will then tell you what is the most likely diagnosis.

-So, you have your computer program and you can put George into it and see what comes out?

-You can, indeed.

-Employment: king.

-Employment: king.

[ Laughter ] Residence: Windsor Castle.

Grandiosity.

Bit difficult, in a king, to diagnose that, actually.

-Excessive self-reproach.

He was a great one for beating himself up.

-Poor sleep -- very, very common.

Reduced need for sleep, reduced appetite.

-He's having hallucinations.

-Yes, there we are, he's having some hallucinations, which is common in very severe mania, the times when he had to be restrained, for example.

There was also a lot of violence and things like that.

And so, now, they've ticked what the diagnosis is and it comes up as the most probable diagnosis is what we now call bipolar disorder.

♪♪ Not a concept they had.

-At the time.

-No, not at all.

Any doctor reading that now, it would just shout "bipolar" at you, it really would.

-I'm convinced.

-[ Laughs ] Yes.

-But can you tell me what causes it?

-I wish I knew.

I don't.

-Yeah.

-Nobody knows.

What we do know is there's very compelling evidence that what we call life events, major traumas in your life -- bereavement or being a victim of crime or, you know, divorcing, something like that -- it doesn't cause bipolar disorder, but what it does do, it will then trigger an episode and you'll have a full-blown illness.

So, it's sensitive to what's going on in our environment.

♪♪ -If episodes of bipolar disorder can be triggered by traumatic events or extreme stress, what was happening in George's personal life in the run-up to '88?

♪♪ There's something I want to see at the Royal Academy, an art school and gallery founded by George III in London.

♪♪ By 1783, George had 15 children.

The older ones, particularly, the Prince of Wales, were causing him all sorts of trouble with their overspending and their womanizing, but he really doted on the two littlest boys.

[ Melancholy tune plays ] Tragically, George's toddler, two-year-old Alfred, died suddenly.

♪♪ Then, eight months later, four-year-old Octavius died, too.

♪♪ Infant death was common, so you might think parents were used to dealing with this kind of loss.

♪♪ This is such a poignant image.

♪♪ It's an engraved copy of a painting George had done to commemorate his two lost little boys.

This is Prince Alfred, who died first, and he's in heaven already, and he's welcoming in his brother Prince Octavius.

Octavius dies, and this angel's here to look after them both.

George had the original of this on the wall of his bedchamber, so that, when he woke up in the morning, the first thing he'd see were his lost sons.

That, alone, I think, speaks volumes about what this loss meant to him.

♪♪ ♪♪ It seems to me that this could have been a trigger for his breakdown in 1788, but to prove it, I need a window into George's mind.

[ Suspenseful music plays ] ♪♪ You might think that's impossible, but I've come to the Royal Botanic Gardens at Kew, where Octavius and Alfred once played, to meet a professor who's doing something unique -- he's examining George's hallucinations and delusions.

How do you know what the king's delusions were?

-Well, we have very few direct records of what the king said, but we do have what the pages, the attendants, who were looking after the king when he was asleep or in the night told the doctors the next morning.

From those, you get these often very brief references to things that he is said to have believed or imagined, but which, when you put them all together, is quite a substantial body of material that just lets you see inside the king's mind, really.

-And do you think you can see evidence of specific trauma, bad things that happened to him in his life, that you see sort of being processed through these delusions?

-Well, there are particular instances relating to his children.

He was a very devoted father and, when they were lost, at different stages of his life, they then reappear to him in his delusions, in, really, very moving ways, actually.

-What sort of delusions is he having about his lost children?

-There's a very particularly moving instant that takes place on Christmas Eve 1788.

On this particular night, what the king records is thinking that the pillow of his bed is Octavius, -Oh!

-who's come back and... -This is so awfully sad.

-...it's all then described here.

-It says, "He had the pillow in the bed with him, which he called Prince Octavius, who he said was to be new born this day."

The reason this is so upsetting is because you just have the image of him holding the pillow like it was the baby.

Oh.

-That's the recurring trope, actually, for the king because, when his daughter Amelia dies from TB, after she's dead, he begins to imagine having conversations with her and that she's had holes drilled in her coffin and, in fact, survived burial and has come back to talk to him after that.

That's a very strange delusion, which, again, echoes this earlier incident with Octavius.

The fact that this comes up in his delusions, not only in this illness, but in his later illness, too, suggests that that's the trigger.

-Arthur, do you feel that this research is giving you a really extraordinary insight into the mind of a king?

-There's a sense in which one of the things that's happening to him in his illness is he becomes disinhibited and will actually, perhaps, articulate things that he otherwise has been suppressing or repressing in his mind.

-And, in a way, it's his illness, it's his so-called madness, that allows us to know him.

-Absolutely.

We don't get to those bits of his mind otherwise.

-Hm.

♪♪ I've been left feeling really sad about what Arthur had to say about George's love for his children and his grief for their loss.

It's easy to forget that he wasn't just a king, he was also a human being.

♪♪ Because the children were so young, their deaths weren't marked in the formal way a royal death normally would be, so, George doesn't have these rituals to help him deal with his loss.

I think he must have repressed his grief and it burst out during episodes of mania.

♪♪ [ Suspenseful music plays ] It's clear to me there's concrete evidence of personal trauma which could've triggered a bipolar episode... ♪♪ ...but I also want to look at the political pressures on George, too.

I know it was a tricky time to be the British king.

George was facing problems at home and abroad.

♪♪ "An account of the rise and progress of the late tumults."

♪♪ Dead bodies in the streets of London.

This is serious stuff.

♪♪ Newspaper headlines from the 1780s reveal a time of huge turmoil.

♪♪ George decided to grant some new rights to Catholics.

It seemed like a generous and liberal thing to do, but it went horribly wrong.

There were anti-Catholic riots and sectarian violence on the street.

This newspaper article here describes a Roman Catholic chapel being set fire to.

What they call the mob are out on the streets.

They're waving revolutionary flags, actually.

Things are on the brink of enormous trouble.

This era was marked by revolution, and it wasn't just Britain on the brink.

The French king faced an assassination attempt and the bloody American War of Independence was about to end almost two centuries of British rule.

Here's Cornwallis, defeated at Yorktown, doing the walk of shame.

They're taking down the British flag and they're putting up the American flag in its place.

So, George would've hoped to have added to his empire, but, instead, he must've felt that he had, effectively, lost America.

♪♪ These crises coincided with the start of the mass news era.

George had nowhere to hide.

He was exposed.

♪♪ And I've found an extraordinary letter which suggests George was afraid he was failing as a king.

Now, this is just the most fascinating document from the Royal Archives of 1782.

It's a letter that George III has drafted, saying that he's going to hand in his resignation.

"I am therefore resolved to resign My Crown."

Extraordinary.

No king had abdicated for a thousand years.

And just think of the huge stink that there was when Edward VIII abdicated in the 20th century, at a point when the monarchy was much less politically significant than it was here in the 18th century.

George has clearly agonized over his decision.

There's all sorts of crossings out and underlinings in his letter.

And there's a real sense of alienation here, and disillusionment.

Now, he never actually sent his letter of resignation to parliament, but it shows the mind of a king in turmoil.

♪♪ George is under extreme pressure to make monarchy work in this new era.

He must evolve or perish.

♪♪ George styled himself as a new, slightly more accessible, kind of a king.

His line was that he was going to listen to people's grievances and respond to them.

Now, ordinary working people didn't have the vote, but they could make political points through giving the king petitions.

They were able to take their problems straight to the top.

♪♪ Crowds gathered at the gates of the royal palace of St James, waving their petitions, begging the king for help.

And, in August 1786, something happened that I think must've increased the pressure on his already vulnerable mind.

As it says in the newspaper, "His Majesty was stepping out of his post-chariot at the garden entrance to St James's,' just over there, "when the attack was made upon his life.

The woman by whom the desperate attempt was made, had been observed waiting the King's arrival for some time."

♪♪ -The woman advanced from the crowd and presented a paper folded in the form of a petition.

The woman aimed a blow with a knife... -...at his majesty's breast with a knife concealed in a piece of paper.

The knife cut the king's waistcoat.

Accounts -- The knife was instantly wrested from the woman.

-And he hastened into the palace.

-The woman was immediately taken into custody and, on examination, appears to be insane.

♪♪ I'm fascinated by this assassination attempt, when a mentally ill woman and a soon-to-be mentally ill king came face-to-face.

Who was she, and how did George react?

♪♪ -This is a woman called Margaret Nicholson.

She's a 36-year-old spinster and needlewoman and she felt that something needed to be done to improve her life.

So, she petitions the king, so -- -So, she's writing him letters, saying, "Dear King, I want you to do this for me."

-Well, yeah, well, you know, if only it was that clear.

She wrote a -- [ Laughs ] -What sort of things?

-So, here's one of Margaret's petitions.

She thought she was due a property settlement of some sort.

She thought she was due a decent marriage, possibly to the king himself, if only he'd rid himself of his ghastly foreign wife.

-Do you think that she was suffering from some sort of mental health issue?

-Well, that's an interesting question.

She petitions the king something like twenty times, just between April and August of 1786, by her own testimony.

On the 2nd of August 1786, she's clearly had enough, so she turns up one more time.

The king gets down out of his carriage.

She's ushered towards the king.

I expect they've all seen her before, they know who she is, and she's got her little piece of paper again, but the piece of paper, this time, conceals a dagger.

-Yeah.

-And then, immediately -- this is the interesting thing, I think -- he immediately says, "The poor woman is mad.

Do not hurt her."

And we know he said that straightaway because, just about two hours later, one of the young pages who'd been attending the king testifies these were the words the king used.

-Do you think that, when he gave this compassionate reaction towards Margaret Nicholson, "Don't hurt her," do you think that he saw a fellow sufferer?

-He immediately identifies what's wrong with her, so, whether or not, yeah, it's a little bit close to home for him or he recognizes a fellow sufferer, the incident provoked a huge public conversation, in the newspaper press and elsewhere, about whether or not Margaret Nicholson was mad.

Because, if she's going to be put before a law court, it's going to have to be on a charge of high treason.

♪♪ -George's words, "Do not hurt her," became iconic.

They were in newspapers, in prints.

It was wonderful PR for the king.

His compassion towards Margaret brought mental illness into the open.

But what happened to her?

Was she treated kindly, as he'd asked?

♪♪ There's no evidence of a public trial, but there is a folder in The National Archives with her name on it.

Margaret's case went right to the top.

It was the Privy Council, the king's advisors, who decided her fate.

♪♪ Oh, yes!

♪♪ Look at all of this!

So, it's clear that they've done a pretty thorough job.

They've examined Margaret herself.

She has -- Oh!

She said here that she never meant to kill the king, but just wanted to get his attention.

And they've also talked to her brother.

He says that she came to London twenty years ago and that she'd worked as a housemaid, but she'd been sacked from that job and she had been ill.

He says that she's been "breaking out into fits of laughter in the night."

And the brother also says this.

It's extraordinary.

He says that, "reading Milton's Paradise Lost and such high style Books... had contributed to turn her Brain."

That's such an 18th-century thing, isn't it, to imagine that reading fancy books can make a woman mad?

So, what are the Privy Council going to do?

What she'd done, an assassination attempt, was treason.

She could've faced the death penalty.

But they didn't go down that route.

So, instead, they turned to the Vagrancy Act and they used that to have her shut up in Bethlem, better known as Bedlam.

This is Georgian England's most notorious madhouse.

They get her assessed by one of the doctors from Bedlam.

This is Dr. John Monro and he says that never in his life had he seen a person more disordered.

But that's really quite a strong statement, isn't it, from the man who runs England's most notorious madhouse, that he'd never seen a madder person than Margaret?

Makes you wonder if he's overstating the case, so that they can all, with good conscience, lock her up.

♪♪ [ Clang, keys jingling ] And she's not the only one.

♪♪ In November 1788, George succumbs to all the political and personal pressure and becomes seriously ill. ♪♪ After weeks of failed treatment, his doctors take an unprecedented step and secure him.

Not in Bedlam, of course, but in Kew Palace, just outside London.

♪♪ The king's eldest son senses an opportunity.

He tells everyone his father is unfit to rule and positions himself to seize power.

♪♪ Daily bulletins are tied to the gates of Kew Palace, but they are heavily censored and don't explicitly mention madness.

Speculation runs rife.

♪♪ So, here we have two infamous so-called mad people, a seamstress and a king, tied together by this assassination attempt.

I'm so intrigued!

And it was the same with the public back then -- they couldn't get enough of the story.

♪♪ -These are just a small snapshot of the many, many different images that were being produced.

A lot of the facts were few and far between and a lot of embellishment was going on.

So, here we have Margaret in Bethlem.

-Oh, my goodness!

Is that her there?

-That's supposed to be her -Oh wow.

-and this image is kind of extraordinary.

It shows this violent, strange, terrifying figure.

She's clutching straw.

Straw was used as bedding in asylums.

-Ah!

-She's kind of involved with these two figures, two of the leading revolutionaries of the day.

-So, here we've got rational masculinity -Mm!

-and here she is looking -- well, this is the archetype of the madwoman, having crazy hair.

-Exactly, kind of Medusa-style.

-Yeah.

Clearly, people are making money out of Margaret Nicholson.

Was there a real market for this?

-Absolutely.

Waxworks were being made.

People would pay to see waxworks and her lodgings were described as being besieged.

-When the king himself became ill, how was he treated by this sort of media of the 18th century?

-I think one of the really striking and surprising things is that there was very little cultural treatment of the king.

So, one of the very few images we have of the king when he went mad is this one, Filial Piety, and it shows the king looking, perhaps, ill, but none of the kind of typical iconography about madness is being applied to him.

On the left-hand side, we have the Prince of Wales, who's sort of obviously drunk.

We've got the kind of political backdrop of the regency crisis in 1788.

-I suppose here, what's really going on is that they're using the situation to make the Prince of Wales look bad.

-Exactly.

The madness of the king is being downplayed.

I think it's a bit of a no-go area.

♪♪ -The press show some respect when reporting the king's illness.

But for Margaret, not only poor, but also a woman, they show no such restraint.

[ Creaking ] She even became a spectacle.

The upper classes could go and ogle her in her cell at Bethlem.

It all smacks of double standards.

I think, if I really want to get a full picture of mental illness at this time, I need to investigate Margaret's experience, too.

♪♪ ♪♪ These two statues are the very last surviving bits of the Bethlem Hospital, where Margaret was incarcerated.

It was demolished in 1815.

They represent the different types of madness that people believed existed in the 18th century.

This one is melancholy madness.

He's calm and still.

And this one is a raving madness.

He's trying to burst out of his chains.

♪♪ These two were over the entrance when Margaret arrived.

Not exactly a warm welcome.

♪♪ In the 1780s, doctors still thought they could treat people with mental illness by purging it from the body.

I'm hoping that Bethlem's archivist can help me uncover the details of Margaret's treatment.

[ Rattling ] -We actually have her admission record here, which would've been created when she first came in to the hospital.

We can see Margaret's name.

-Margaret Nicholson, there she is.

Do you know how they would've diagnosed her, what sort of an illness they thought she had?

-The hospital would've been split into male and female wings and it would've been split into melancholics and ravers.

-And where do you think she fitted into that?

-I mean, I think, generally, she's described as quite a quiet... -She's quiet.

-...withdrawn patient, I think, a lot of the time, so I'd be surprised if she was moved apart from the melancholy patients.

-These categories are not super subtle, are they?

[ Laughs ] -No, they really aren't.

-What were the conditions like in the hospital?

-They were probably not very good.

So, people were bled, people were given medication that would make them vomit or purge themselves in other ways.

-Mm.

-It was known -- round about this sort of time there's a new strain of thought that's saying this isn't working, but Bethlem is still persisting in this.

-So, is there some information about what happened next to Margaret?

Does she appear again?

-Yes, so we will see her again in the incurable admission register.

So, the incurable ward would've been the long-stay section of Bethlem.

-You say that, but the name, it's a very depressing thought, isn't it?

-It is, yes.

You know, these are people who were -A long stay.

-probably lifers... -Mm.

-...by this point.

Note says a motion was made "that Margaret Nicholson be no longer confined in her cell by a chain."

-Oh!

So, what year is this?

-This is 1791, so this is four years.

-So, she's been in chains for four years?

-She is regularly clapped in irons, yes.

-Goodness me.

I'm thinking what this means.

Does this mean that the hospital committee have decided that she's so peaceful and not hurting herself that they don't need to bother doing that?

-Yes, yes, but what is also interesting in this is the implication that she is well enough to be unchained, but she's still in the incurable wing.

-And that might be because she's this special patient.

What she did received national attention, therefore, the bar for her recovery is higher than it is for anybody else.

-It also, perhaps, implies that the hospital has been told not to release her -Not to release her.

-in any circumstance.

-Oof.

-Mm.

She has been, if you like, disposed of by the state.

♪♪ ♪♪ -It's pretty clear that, at Bethlem, they were still committed to doing things the old way -- patients in cells, chains.

And it's rather devastating to think of Margaret being written off, almost, with that word -- incurable.

♪♪ In 18th century Britain, madhouses, or asylums, were a law unto themselves.

Bethlem hadn't updated its treatment plan in 100 years.

But there was a new school of thought that mental illness was an illness of the brain, that needed to be treated in its own way.

♪♪ Some of these new ideas were to be found in this book.

It's the first proper book about madness as a mental illness.

It's called "A Treatise on Madness," by Dr. William Battie.

This was really radical stuff and he suggested that it was wrong to chain up mentally ill people.

Nor was he in favor of shock treatments, things like making people vomit.

Instead, he proposed quiet, and fresh air and exercise, which sounds extraordinarily modern, doesn't it?

That's what people are still recommended to do to this day.

Battie's book was published in 1758, so that's 30 years before the king got ill, but it was George's illness, and Margaret's, too, that raised the profile of his work.

It went mainstream and people started to implement it.

♪♪ So, while Margaret was written off as incurable, did these new ideas reach George?

♪♪ In winter 1788, George is delusional, aggressive, sleepless, and time is running out.

♪♪ A regency bill has been prepared.

If the king is not better in three months, his son will take over.

♪♪ In December 1788, the royal family make a bold decision.

They summon a man called Francis Willis, who runs a madhouse in rural Lincolnshire, to come here to Kew.

♪♪ Private madhouses begin to spring up from the 1750s onwards, as new treatments are pioneered.

Willis is one of a band of so-called mad doctors, or, to you and me, early psychiatrists.

Let me introduce you to Dr. Francis Willis.

I'm calling him Dr. Willis, but, I do know that his contemporaries might not have agreed with me in doing that because they didn't yet have the idea of a doctor of the mind.

Members of the Royal College of Physicians, for example, would've said, "No, he's just the keeper of a madhouse.

We don't count him as one of us."

So, I think it's quite an exciting decision that the royal family have called him in.

It's...a sign of how desperate they were, I think.

He's a maverick.

♪♪ This is a make-or-break moment, for him and for his nascent profession.

There's no higher-profile patient than this.

What on Earth is he going to do?

♪♪ George was treated by Willis here at Kew.

The king's tin bath still survives.

♪♪ This source is key to what happened to him.

It's a diary by Francis Willis and his son and they start off explaining what the previous doctors had given the king.

The answer is really powerful sedatives.

Here, he's been prescribed 30 drops of laudanum.

Now, that is opium dissolved in alcohol.

It's not a sustainable strategy.

It's not going to make him better.

It might even get him addicted.

It's kind of like prescribing the king heroin.

♪♪ Willis decides to put a stop to this and he radically reduces the dosage.

♪♪ He also makes a bold decision -- to treat George just as he would any other patient in his asylum and bend the king to his will.

♪♪ Oh, wow!

-I've got a straitjacket for you.

-My goodness!

What?!

[ Laughs ] -It keeps on giving.

-What is with these arms?

They're so long.

How does it work?

-Here's the back.

-It buttons up the back, so you put your arms in like that and it's done up.

Why are the sleeves so immensely long?

-So, you put your arms in there and then you hug yourself and then you get tied round the back.

-Oh.

So, it forces you to go like this, to give yourself a hug?

-Yes.

Once you've no longer got the use of your hands, your flight-and-fight mode is turned off, so that it could then support you to calm yourself down.

-I was expecting something barbaric, something that was to do with restraint.

-Compared to the manacles, which was what people were using before, this was really soft -Oh!

-and kind.

-This is a big step forward.

-Certainly, when I first looked at this, I had the same feelings as yourself.

It's like really scary, the idea of being, you know, tied up, really, but this is a treatment and most illnesses, you know, most treatments are scary.

-Let me show you some of the ways in which Dr. Willis used the straitjacket.

Well, he doesn't actually call it a straitjacket.

"The strait waistcoat was taken off from his majesty at morning yesterday, but was put on again soon after two o'clock & was not taken off till nine this morning."

Goodness me, so he was kept in his strait waistcoat for the whole of this particular night.

-Nowadays, we use drugs, and that's a chemical restraint.

-Yeah.

-Sometimes that's not appropriate, either, because it's just treating the symptom.

It's not allowing your brain to rebalance and sort itself out.

-That's really interesting, that you're using the word rebalance the brain.

That's the language that Francis Willis used in the 18th century.

Now, even if Francis Willis had the best intentions in the world, I do feel sorry for the poor king because it says here, "They beat me like a madman."

♪♪ -The king doesn't escape the brutal remedies of purges and ice-cold baths, but there were also new ideas at play.

Willis is clearly picking up on the progressive approach of William Battie.

While Margaret, in Bethlem, is chained and left to rot, Willis is encouraging George, at Kew, to take the air.

[ Birds chirping ] And even though George does try to scale the giant pagoda, a 50-meter structure, Willis is confident his strategy is having some success.

♪♪ If you leave it untreated, an episode of mania can last between days or months and, to this day, doctors don't really know why they come to an end.

But, on the 26th of February 1789, a bulletin appeared on the gate of Kew Palace.

Three months after he'd arrived, Dr. Willis has able to announce the entire cessation of his majesty's illness.

♪♪ Assuming he had bipolar disorder, it could simply be that this episode had run its course.

But it appears that Dr. Willis has cured the king.

And not a moment too soon.

The government bill that would hand power to his son is only days away.

After months of political uncertainty, George is, once again, ready to be king.

♪♪ [ Chorale plays ] ♪♪ On St George's Day, there was a huge celebration of the king's recovery, here at St Paul's Cathedral in Central London.

Now, the Archbishop of Canterbury recommended that George himself shouldn't attend.

He thought the excitement might bring on a relapse.

But George had other ideas.

He said, "No, I'm going."

"My Lord," he said to the Archbishop of Canterbury, "I have twice read over the evidence of the physicians on my case and, if I can stand that, I can stand anything."

[ Suspenseful music plays ] Thousands lined the route to St Paul's and medals were struck to commemorate the occasion.

And here is one of them.

They're not actually that hard to find because so many of them were made.

This one came off eBay.

And on one side we've got George's little face.

There he is, looking alive and well.

And, on the back, the exciting story of what's happened.

It says, "Lost to Britannia's hope but to her prayers restor'd."

♪♪ George's illness appears not to have destabilized the nation, after all.

If anything, it humanized him in the eyes of his people.

The irony is that King George III was virtually the only monarch left standing in Europe by the end of the 18th century.

♪♪ But the story doesn't end there.

There's another medal.

♪♪ Dr. Willis had his own medals struck.

He paid for these himself.

They're a different grade.

This is the cheaper, copper, version and this is the deluxe, shiny, tin model.

You've got a picture of Dr. Willis on the front and, on the back, it says, "Britons rejoice your king's restored."

The message is, "I'm Dr Willis.

I restored him."

It's the most fantastic bit of self-promotion, a bit like an advert, really, for this man you might almost call a psychiatrist.

And I think the significance is that this profession of psychiatry is coming out of the shadows.

It's getting respectable.

This is its moment of triumph, if you like, captured in tin.

♪♪ George may be restored to health, but Margaret gets no medal and no redemption.

♪♪ It would be 25 years before the British government began to tackle the horrific conditions inside public asylums.

♪♪ During that time, the king had further episodes of illness, both in 1801 and 1804.

♪♪ He convalesced for a time in the home of a friend, an MP, called George Rose.

♪♪ Witnessing the king's illness gave Rose real insight and, in 1815, he led a government investigation at the Bethlem asylum.

♪♪ These are the minutes of this parliamentary committee that's looking into "the Better Regulation of Madhouses in England."

They're calling all sorts of witnesses to give evidence and a very dark picture's being painted of existing conditions.

This part's really distressing.

We've got a witness who's seen unfortunate women locked up in their cells, naked and chained on straw, with just one blanket for a covering.

Now, George Rose clearly suspects that there have been male keepers looking after female patients, which is inappropriate.

Power could've been abused here.

And he's really going after Dr. Monro, who's in charge of the Bethlem Hospital.

Dr. Monro says, "In Bethlem, the restraint is by chains.

There is no such thing as chains in my private mental hospital."

And he's asked about this.

"Why?

Why the difference in standard?"

And Dr. Monro says, "Well, it's because chains are fit only for pauper lunatics."

Isn't that shocking?

He says, "If a gentleman was put in irons, he would not like it."

Too right!

I don't think Dr. Monro realized how much he was going to damn himself by this statement.

It caused a scandal!

People were offended by this idea of a double standard for rich and for poor.

The fallout of this was so bad that Dr. Monro had to resign.

♪♪ This committee exposed the sexual abuse and excessive restraint that had been rife for decades.

It was a watershed moment.

A process of reform had begun.

♪♪ Fearing further censure, Bethlem started keeping individual patient notes.

♪♪ Now, these books are from after 1815, when they had to keep fuller records, so I'm really hoping these might shed some more light on Margaret.

♪♪ Because of the king's illness and the reform that followed, I can now, at least, find her in the records.

♪♪ Oh, look at this!

It's progress reports in 1816, 1817, 1819.

By this time, she's been in the hospital for nearly 30 years.

It says here, "She is now in an advanced stage of her life and is perfectly deaf... She's decent in her appearance and quiet and civil in her demeanor."

It sounds to me like she's better.

And then the records stop.

It's really fantastic to get a glimpse of a real person here.

And she doesn't seem like either a criminal or a patient anymore.

She's just a quiet old lady.

Do you know what?

I've got a little tear in my eye.

♪♪ Reform really came too late for Margaret Nicholson.

She was incarcerated in Bethlem for 42 years and died on the 14th of May 1828.

♪♪ George III was suffering from chronic mania and dementia when he died, on the 29th of January 1820.

♪♪ This encounter between George and Margaret happened at -- in fact, it fed into -- this key moment of change for the science of psychiatry and for the reform of psychiatric asylums.

There's still so much more to learn about the complexities of mental illness, but this was the starting point.

-"Lucy Worsley Investigates" is available on Amazon Prime Video.

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