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The King’s great illness

The great disorder or illness that struck down King Henry in August 1453 and kept him in what appears to have been a catatonic stupor for over a year. The causes are still not known to modern medicine. Most modern diagnoses of the King's illness tentatively identify it as catatonic schizophrenia. Henry's maternal grandfather King Charles VI of France suffered from recurring, severe bouts of “madness”, during which he became dangerously violent, did not recognise his wife or the fact that he was king. These bouts could last months at a time. He may have suffered from a form of schizophrenia, or bipolar disorder, or encephalitis (inflammation of the brain). The onset had been a fever and seizures in 1392. It may well be that Henry inherited a disposition to schizophrenia from his grandfather, but that is pure supposition. His symptoms were totally different to those of Charles VI. Interestingly, neither Charles's son the Dauphin nor his French grandson inherited his “madness”. Henry's half-brothers by Queen Catherine of Valois (the Tudors) seem to have avoided it too.

Nonetheless our history books abound with references to King Henry's “madness”, to his “recurring bouts of insanity” (for which there is no evidence whatever!), to his “feeble mindedness”, describing him as a “simpleton” and a “natural fool”. Popular writers like Phillippa Gregory in her novels depict even his Lancastrian supporters as saying that King Henry “has lost his wits again” or that he “hardly knows his name”!

There follow exerts from my (unpublished) biography of the King:

“The malady struck Henry at Clarendon near Salisbury without warning on or about 10th August 1453. It did not appear to be a physical disease that his attendants could recognise, but rather a mental breakdown that robbed him of the awareness of his surroundings and of the power over his limbs. The King fell into an inertia; a torpor from which he could not be roused. At first his household tried to keep the matter as quiet as possible in the hope that the fit or whatever it was would soon pass and Henry would return to his normal self. But it quickly became evident that it would not pass so easily and so could not be kept a secret for any length of time. For the time being he remained at the hunting lodge of Clarendon, since he was clearly in no condition to travel. At Westminster the Council carried on government in the King's name as if nothing had happened, but they were not going to be able so to continue if the King's state did not soon improve.

“The King's collapse must have been a great shock for Queen Margaret, but fortunately she was a strong and healthy woman, so that her pregnancy was not endangered. On 10th September the mayor and aldermen of London in their scarlet gowns and hoods came to escort the Queen up river to her lying-in at Westminster. At the beginning of October Henry was brought back to Windsor by easy stages. On Saturday, 13th October, Queen Margaret gave birth at the palace of Westminster to a healthy baby boy; a prince and heir...............The news was carried to Windsor, but it did not register with poor Henry. Soon all England was rejoicing at the birth of an heir to the throne. Two people closely affected by this happy event did not join in the general merriment. Richard, Duke of York, had lost all hope of being officially recognised as the heir-presumptive now that a prince had been born, and the child's father, King Henry, in his comatose state comprehended nothing of the news.

“In the New Year Queen Margaret brought the baby prince to be presented to the King at Windsor. Prince Edward was borne into Henry's presence, where he sat with two attendants whose task it was to keep watch over the King night and day. The Duke of Buckingham knelt before the King and presenting the child to his royal father, begged him to bless the prince, thereby giving official recognition to his son. But Henry displayed no reaction at all. He sat as if totally unconscious of the duke's presence. Buckingham remain there with the young prince in his arms still hoping for some sign from the King. After a while Margaret herself came into the chamber and taking her baby, presented it to the King as Buckingham had done, beseeching him to bless the child. She was equally unsuccessful, save that once Henry looked upon the prince and then cast his eyes down again without any further sign.

“Abbot Whethamstede, who may have seen Henry at Windsor or at least had report from someone who had, described the King in his illness for us: “....he was so lacking in understanding and memory and so incapable that he was neither able to walk upon his feet nor lift up his head, nor well to move himself from the place where he was seated.”10 This neatly sums up Henry's prostration, although as we have just seen, he does appear to have been able to move his head to some degree. These lines describe a man who has completely withdrawn within himself and is no longer aware of the world around him. Henry could still eat and drink, although undoubtedly his attendants fed him. He could move his limbs, but had no will to that end. His attendants had to raise him to his feet, supporting and guiding him as he was moved from one room to another.

“It was decided on 23rd March to send a delegation to Windsor to inform King Henry of the cardinal's death [John Kemp] and in the forlorn hope of getting some indication of whom he wanted to be appointed chancellor. The delegation was well balanced and was to consist of the bishops of Winchester, of Ely and of Chester, the earls of Warwick, Oxford and Shrewsbury, the viscounts Beaumont and Bourchier, the prior of St. John's and the lords Fauconberg, Dudley and Strourton. On 25th March they reported back to York in parliament. They had been admitted to the King's presence while he dined. After his dinner the bishop of Chester presented the lords' good wishes for the King's recovery and reported to him their diligence in the present parliament. Henry gave no answer or any sign of recognition. The other lords then advised Chester to declare the other important matters to the King , but neither he nor they could elicit any response no matter how they tried. Finally the bishop of Winchester said to the King that as they had not yet had their dinner, they would retire and then wait upon him anew after their meal. When they had finished eating, they returned to Henry in the same room and again pleaded with him for some sort of response. They then had him led between two attendants into another chamber where he lay down on his bed “and there the Lords moved and stirred the King's Highness the third time, by all the means and ways that they could think, to have answer of the said matters, and also desired to have knowledge of him, if it should like his Highness that they should wait upon him any longer, but they could have no answer, word nor sign; and therefore with sorrowful hearts came their way.” (Rot.Parl. V, p.241)

“On 15th March the Council had appointed a commission of three doctors and two surgeons to attend the King and treat his mysterious illness. The physicians were John Arundell, John Faceby and William Hatcliff, who was a fellow of King's College in Cambridge and had taken a medical doctorate in Padua. The two surgeons were Robert Warren and John Marshall. They were to employ remedies such as they could find in ancient authorities and their commission listed a wide variety of possibilities such as electuaries (a paste of powders and medicines sweeten with sugar and water or honey), potions, waters, syrups, confections, unguents, wax ointments, laxatives, clysters (enemas), suppositories, head-shaving, head-purges (application of heat to the scalp), gargles, baths, poultices, fomentations, plasters, embrocations and, of course, blood-letting.19 Dietary control would also have been practised. It is a fairly wide range of treatments opened to the doctors, although considering the high station of the patient and the degree of ignorance as to what afflicted him, we may be sure that the doctors were very cautious and would not have employed all of the above. Nevertheless, we may consider the King fortunate under the circumstances not to have been able to register everything that went on around him!

The onset of Henry's illness had been sudden, said to have been caused by a great and unexpected fright or shock. The Chronicon Angliae records: “But after he had reached Clarendon about the feast-day of St. Thomas the martyr, he fell, through a sudden and unexpected fright, into such an illness that for a full year and a half he was without natural sense or intelligence adequate to administer the government. No doctor or medicine had power to cure that illness.”20 A possible cause was the news of the defeat at Castillon and the deaths of John Talbot, Earl of Shrewsbury and his son, which we know reached him at the royal lodge at Clarendon. The shock of this news after things had appeared to be turning for the better in France, must have been severe. Not only had Henry lost another loyal servant and friend in Talbot, one of his most gifted commanders into the bargain, he was finally confronted with the hopelessness of regaining his French dominions, of the irretrievable loss of all his father had achieved and left to him. This came on top of the strain, humiliations and fears, to which he had been subjected over the past few years. He had suffered the loss of Suffolk, Moleyns, Aiscough, without being able to protect the one or avenge the others. His government had been rocked by dangerous uprisings, first of Cade and then of York. They had attempted in Somerset to wrench yet another of his trusted counsellors from him. There had even been rumours that his cousin of York might have designs upon his crown, even upon his very life. And now the collapse of the last remnants of English held France. Taken together, these would have been quite sufficient to account for a nervous breakdown in the most robust of characters, let alone in one of Henry's temperament and tender conscience. But we are not confronted here with a nervous breakdown. The matter is far more complex.

It is probably impossible from this distance in time to adduce from the scanty records the precise nature of the King's illness, but those contemporary descriptions that we do have of his sudden collapse and prostration, have permitted modern doctors and psychiatrists to make some tentative suggestions as to its diagnosis. Henry's symptoms have led some to see his illness as a form of schizophrenia. Against this diagnosis must be placed the fact that schizophrenic attacks do tend to recur and indeed to increase, and they are accompanied by a marked deterioration in the patient's personality, leading to complete mental degeneracy. This may fit the course of his French grandfather's illness, but it does not correspond to what we know of Henry. It is equally unlikely for an schizophrenic attack to have persisted for the length of Henry's prostration; indeed, if it had, Henry would have been unlikely to survive it. The symptoms better fit a diagnosis of a form of catatonic schizophrenia, which would not necessarily recur and could leave the patient without any noticeable effects on his character. Against catatonic schizophrenia is the length of the attack, although it is thought that there might have been two or more attacks following closely on each other. Improvement might have been slight and of too short a duration to be noticed or recorded. Hysteria can be largely discounted, as this relies on an audience for its effect, making the patient the centre of attention and concern. This ill accords with Henry's long and passive stupor, especially since it removed him from the centre of attention and events rather than otherwise. Also hysteria would not make the patient oblivious to what took place during the attack. Inherited insanity from his maternal grandfather, Charles VI of France, is discounted by all serious historians. The violent symptoms of the French king's illness and its course bear no resemblance at all to Henry's affliction. One might add that neither his son, Charles VII, nor the Tudor offspring of Henry's mother, Queen Catherine of Valois, exhibited any signs of madness or mental instability.

There is a third possibility: the somewhat imprecise diagnosis of a depressive or melancholic illness. This would well accord with the King's sensitive nature as well as with the background of crises and failures over the past few years. Once again, the length of the attack and the completeness of the stupor present here too difficulties. It would appear that either a catatonic schizophrenia or an illness of an acutely depressive nature were indeed what ailed Henry. One thing, however, emerges clearly. King Henry must have received the most exemplary of care. He was protected from contracting any infections or other illness, or from sustaining physical hurt, all of which could have proven fatal in his prostate condition. Dietary control was certainly part of his treatment, but he must have also been well fed, for in his state the body would need an increase in calories to sustain it. That Henry recovered without damage to his health is a tribute to the intensive care that his household devoted to him.

We have seen that Henry's collapse at Clarendon was sudden and unexpected, apparently caused by a sudden shock or fright. We have assumed the most likely cause to have been the shocking news of the defeat at Castillon with the death of Talbot and the irretrievable loss of France, coming on top of built up strain and frustration from the dangers and crises of the past few years. There is, however, another theory which appeared later in hostile Yorkist propaganda and whose ramifications attract a number of modern commentators. It is the fact of the Queen's pregnancy.

Some have envisaged Henry's stupor as the result of shock on learning that his wife was pregnant. Now a shock in the sense of surprise is out of the question. The King fell ill in August 1453, or at the earliest in July. Margaret fell pregnant early in 1453, in February at the latest. One lived very publicly in the Middle Ages and it would have been impossible for Margaret to keep her condition hidden from the ladies of her chamber, even had she wished to do so. She might conceal it from the King for some months, as they kept separate chambers and establishments, but by August when Henry collapsed at Clarendon, she was seven months gone with child! Even the most unworldly of husbands could not fail to recognize the Queen's condition. However, this is beside the point, since we know that Richard Tunstall, the King's chamberlain and reader, formally announced the good tidings to Henry early in the year, for which service he later received an annuity of £40 from the Duchy of Lancaster. Henry had known of Margaret's pregnancy from the beginning. There remains the question of shock induced by some scandalous realisation as the Queen's hour approached. Here there are two main lines of conjecture: one holding Henry to be the father and facing an intense spiritual crisis as it is borne in on him that he has fallen from his high ideals of chastity. The second hold Prince Edward to be illegitimate and Henry realising (or being informed) the child could not be his. It should be noted that there is no evidence of such a rumour existing at the time of birth or shortly thereafter.

“The virtue of chastity has always been held especially dear in the Judaic-Christian religions. The Church presented its faithful with the example of a celibate priesthood devoted to service of God, with orders of monks and nuns vowed to chastity, with virgin martyrs, and above them all the Blessed Virgin Mary herself and her chaste spouse St. Joseph. No matter how often its members (both clerical and lay) might fail, it remained the high ideal held up by the Church as the perfection for which to strive. One of Henry's favourite saints (indeed one of the most popular in all England down to the Reformation) was St. Edward the Confessor, who was reputed to remained chaste despite his marriage.22 The idea of maintaining chastity within marriage was no novelty, even if it was scarcely practised or promoted (for obvious reasons). Henry's temperament may have been more suited to the cloister than the royal court, although he had displayed an active interest in the search for a suitable bride. Spiritual writers had sometimes extolled the excellence of being able to combine both the active and the contemplative lives. Richard Rolle, a saintly fourteenth century hermit, wrote in his “Incendium Amoris” (The Fire of Love): “he who looks at a woman with natural affection yet not with lustful desire, finds he is unable to keep free from illicit urges or unclean thoughts. Often enough he feels in himself the stain of filth and even may take pleasure in the thought of developing it.” Later he writes: “If any man could achieve both lives at once, the contemplative and the active, and sustain and fulfil them , he would be great indeed.....I do not know if anybody has ever done this: it seems to me impossible to do both at once.” Rolle was one of the best known writers of the age and his works would certainly have been studied by Henry. It remains a matter of speculation as to whether such writings were responsible for the Queen's not conceiving during their first eight years of marriage. On the other hand, if Henry was persistently avoiding the Queen's bed, one would expect some complaint from Margaret or at least rumours leaking from the household. The begetting of an heir to the throne was the primary duty of a queen and thus of primary interest to the court at large. Had Henry neglected his duties as king and husband until York's attempts to have himself declared heir presumptive forced him to it? The timing would fit this conjecture, but can one imagine that his chaplains and attendant lords would have failed to leave Henry in any doubt that Margaret too had marital rights and the country had a right to expect an heir? Henry himself had displayed an ardent desire to marry and had shown great pleasure and excitement in his reception of Margaret of Anjou. Again, there are no rumours from the royal household that the Queen's failure to conceive was the result of neglect on the part of the King.

“We do not know precisely when Henry recovered his senses and willpower once more, but it seem to have been at Christmas. He seems to have recovered as suddenly as he had fallen ill, although it appears that Henry's condition had been slowly improving a little. In September Thomas Bourchier had attended the King in Windsor to do homage as the new archbishop of Canterbury and to receive from the King's hands the cross of his office. This apparently Henry could hand him, although later he confessed to being unaware of Cardinal Kemp's passing. William Paston wrote to his brother John on 6th September 1454: “My lord of Canterbury hath received his cross, and I was with him in the King's chamber when he made his homage. I told Harry Wilton [of] the demeanour betwixt the King and him; it were too long to write.”

On 9th January 1455 Edmund Clere wrote to his cousin John Paston: “Blessed be God, the King is well amended, and hath been since Christmas Day; and on Saint John's Day [27th December] commanded his almoner to ride to Canterbury with his offering, and commanded the secretary to offer to Saint Edward. And on the Monday afternoon [30th December] the Queen came to him and brought my lord Prince with her; and then he asked what the prince's name was, and the Queen told him Edward; and then he held up his hands and thanked God thereof. And he said he never knew him till that time, nor knew what was said to him, nor knew where he had been while he hath been sick till now. And he asked who were the godfathers, and the Queen told him; and he was well pleased.

And she told him that the Cardinal was dead, and he said he knew never thereof till that time;and he said one of the wisest lords in this land was dead. And my lord of Winchester and my lord of Saint John's were with him on the morrow after Twelfth Day, and he spoke to them as well as ever he did; and when they came out, they wept for joy.

And he saith he is in charity with all the world, and so he would all the lords were. And now he saith Matins of Our Lady and Evensong, and heareth his Mass devoutly; and Richard shall tell you more tidings by mouth.” (Paston Letters)

The tears of Bishop Waynflete of Winchester and of Prior Robert Botyll of the Hospitallers of St. John as they emerged from the King's chamber on 7th January are a touching testimony to the personal affection in which Henry was held. Typical too was the joyful declaration of the King that he was in charity with the whole world and wished the lords to be so too. Clere wrote his letter from Greenwich where the King had moved either immediately upon recovery or more probably in the New Year. After almost a year and a half of continuous residence, Windsor would have required a thorough cleansing and replenishing. It is likely that the Queen took Henry back to Greenwich with her. Certainly Clere's letter bears all the marks of one whose information comes from first hand witnesses, perhaps from Queen Margaret's household itself. Henry probably required a little time to fully recuperate and to digest all that had happened during his illness-induced absence from government.”

Basil Clarke in his 1975 work “Mental Disorder in Earlier Britain” thinks the sudden complete recovery unlikely, despite contemporary testimony. He writes on p. 185: “ would be surprising if a psychotic illness of one and a half years, including long periods of catatonic stupor, was followed by complete recovery without setbacks for a long time afterwards.” It was indeed remarked by contemporaries that from this time onward the King appeared to sleep more than usual, and he did seem somewhat more detached from the political turmoil around his throne. However, his actions, comments, movements in the North, in Scotland, in his long wanderings as a hidden fugitive, would argue for a reasonable strong constitution both physically and mentally. There are no further records of relapses.

During his illness Richard Duke of York had been appointed Protector. York was an ambitious, albeit a frustrated Prince of the Blood. He had been causing unrest for years and had made so many enemies and committed so many acts that could be judged treasonable, that he had an accute need for protection. He must control the King and government to be safe. He must destroy his chief opponents among the nobility, first and foremost the Beauforts, the dukes of Somerset. This led to the second battle of St. Albans, in which King Henry had been wounded in the neck by an arrow. A triumphant York now assumed the Protectorship for a second time.

This is the period which most writers describe as Henry's relapse into “madness”. As we have seen, there is no real evidence for this assumption other than York's becoming Protector once more. Faulty backward reasoning: if Henry was ill when York became Protector in 1453, then when York again became Protector in 1455 he must have been ill again! The assertion is usually backed up by Henry's request for Kemer's attendance in June (which does not in fact seem to have taken place), and the mutilated end of a Paston letter “so much rumour is here.... and some men are afeared that he is sick again.” Neither in parliament nor any of the contemporary chronicles is it asserted that Henry had relapsed into his former illness and was incapacitated. There were no delegations to report on his condition, no descriptions like that of Whethamstede's, no medical appointments, no accounts for doctors and attendants; indeed none of the contemporary evidence we have for the first illness. Even the deputation from the commons demanding York as Protector only insinuated that the King might not be able or willing to devote himself to the restoration of order and that a Protector would shield him from the stress and strain of daily business. On the positive side, there is the fact that Henry continued to contract business, to see people and to sign writs even after York had been officially appointed Protector. The terms of the appointment made provision for the King to be informed of all matters concerning his person; a difficult condition if the King were “mad” or in a stupor! Added to this is the fact that Henry allowed the protectorship to continue for only three months before he reasserted himself. His supposed “illness” would therefore be remarkably short compared with his long prostration in 1453-54. It would seem clear that there is no evidence for any relapse, nor indeed for Henry to be suffering from any disabling illness at all. York's second protectorate was just what it seems: the seizure of power (as far as his peers would permit) by the victor of the field of St. Albans.”