The Appendicitis of King EdwardVII

edwardvii

King Edward VII of Great Britain (1841-1910)

King Edward VII was born on November 9, 1841 as the second child, and first son to Queen Victoria and her husband, the consort, Prince Albert.  When Queen Victoria died on January 22, 1901, after nearly 64 years as Queen, her son, Albert Edward assumed the throne as Edward VII at age 59.  Edward’s was the longest service as Prince of Wales in history.  On April 22, 2011, HRH Prince Charles surpassed Edward as the longest serving heir apparent in English History.("History of the Monarchy") 

Victoria and Edward had a difficult relationship as sovereign and heir.  They had radically different approaches to both duty and to life; Victoria was stoic and dowdy, and Edward was full of life-passionate and charming.(Aronson)  Edward was also educated, and was the first royal heir to attend college, studying what is now known as Chemical Engineering at Cambridge.(Jackman)  After the death of her husband, Prince Albert, Victoria had retreated into a quiet protective shell, rarely appearing in public, leaving Edward to fulfill the ceremonial roles of Sovereign.  Prince Albert had, however, died of acute typhoid disease while trying to handle one of Edward’s first scandals, and Victoria was said to have blamed Edward for his death.  At one point Queen Victoria wrote about Edward to his sister Maud:

I never can or shall look at him without a shudder.” (Victoria)

There was such a distinct lack of trust between mother and son that Edward was forbidden from seeing State Papers, or from any role but ceremonial duties until 1898, when Victoria’s health began to fail.("History of the Monarchy")

Edward had grown to love and understand the ceremonial duties of a sovereign, the pomp and pageantry surrounding a King, and he had an acute understanding of the role that ceremony played in the Sovereign’s ability to rule.  Victoria’s long reign presented Edward with an acute problem at the beginnings of his reign; there was no one around with personal memory of how to conduct a coronation.(Jackman)

To allow for adequate time to prepare for a truly grand event, the coronation was scheduled for the following year, on June 26, 1902.  The preparations were undertaken at enormous expense, and with the “King’s typical eye for detail.”  As the coronation ceremony for Westminster was recreated from old records, the social, external preparations according to the style of the times.  Hotels and florists invested heavily.  2500 quails, and hundreds of chickens, partridges, and sturgeons as well, were ordered for the Coronation banquet alone.(Stevenson)  Along the route that Edward was to pass to or from  the ceremony, businesses had erected viewing stands and had purchased refreshments to sell to the crowd- St. George’s hospital had spent £2000 on building stands (about £200,000 in 2011 currency), and another £500 on refreshments.(Stevenson)  By mid June, London’s hotels were full as the King’s extended, and very large, family, the crowned heads of Europe arrived.

The King had a very busy day on Friday, June 13.  After preparations for the coronation,   the King made several ceremonial visits, and closed the day with a Royal Court, or State dinner, with over 200 guests.("Court Circular ")  After a late night, the King awoke on Saturday morning with lower abdominal pain.    The King’s physician, Sir Francis Laking, was summoned, and by noon the King was feeling better and set out on a planned weekend excursion with the Queen to the Royal Pavilion at Aldershot, about sixty miles southwest of London. (Stevenson) That evening the King and Queen attended a military tattoo.("Court Circular")  By that evening the King had a recurrence of his abdominal pain, and developed a fever. (Stevenson)

Sir Francis Laking was again sent for, and arrived at Aldershot at five o’clock in the morning.  The King developed rigors and increasing pain.  Doctor Laking requested consultation with Thomas Barlow, another physician of Royal acquaintance.(Stevenson) 

Mr. Alfred Fripp, a surgeon at Guy’s Hospital in London, and the King’s personal surgeon since 1897, was also summoned.  He was greeted that Sunday morning by Lord Victor Crichton, an equerry to the King.  Mr. Fripp was given a note from Sir Francis Laking which read, “come to the Royal Pavilion, there is a patient about whom I want your opinion.”  Lord Crichton and Mr. Fripp went to Waterloo station to board a private train to Aldershot, but were intercepted by a telegram recalling the summons.(Stevenson)

The King was, in fact feeling better by Sunday afternoon, and expressed anger at Sir Francis for having called a surgeon, concerned about the rumors attendant on the arrival of a surgeon at the Royal Pavilion so close to the coronation date. (Stevenson)

On Monday, June 16, the King, in consultation with Drs. Laking and Barlow decided to travel to the Royal Palace at Windsor.  He travelled by carriage, heavily medicated, leaving the Queen to review the troops in his stead.  The King rallied at Windsor, but continued to have intermittent fevers.(Ellis)  On Tuesday, June 17, Sir Francis Laking again advised consulting with a surgeon, and was again rebuffed.  Sir Francis then elected to sit at the King’s bedside staring silently at the King, refusing to move, until the King agreed to evaluation by a surgeon.  After a half an hour, the King “confessed that the company of his physician had its limits,” and agreed to see a surgeon.  Mr. Frederick Treves, Surgeon-Sergeant to the King, and a surgeon at London Hospital, was sent for.(Stevenson)

Mr. Treves examined the King for the first time on Wednesday, June 18.  The King still had intermittent fevers and pain in the right lower quadrant of his abdomen.  He had also now developed a mass in that area of his abdomen.  Mr. Treves advised rest, and the King improved over the next several days.  By Saturday, June 21, the King had been afebrile for 2 ½ days, and the swelling in his abdomen was nearly resolved. 

Since the King had been off his busy schedule for nearly a week, rumors of the King’s illness began to circulate.  The Press Council sent a letter of inquiry to the King’s private secretary, Sir Francis Knollys, “Persistent and alarming reports are reaching us today regarding the King’s health.  Can you let us state that the reports are baseless?”  Knollys returned, “Windsor Castle, - Not a word of truth in reports. – Knollys.”(Stevenson)

The King had improved enough to resume a limited schedule by Monday, June 23.  He returned to Buckingham Palace,  and another grand pre-coronation State dinner was held that evening. ("The Court Circular - the Coronation") The menu from the evening has survived.  The eight course meal included quails, saddle of lamb, ortolans, consume, gateau, ices, and anchovy canapés.  Each course had a separate wine service.(Stevenson)

 By the early morning on Tuesday, June 24th, the King had significantly relapsed.  He had a full return of his fever, pain, and abdominal mass.  He was badly enough off that Sir Henry Knollys, brother of the King’s secretary telegraphed his wife that the King was ill, closing with the Biblical phrase,

“mene mene tekel…not yet upharsin”(Knollys)

Urgent consultations were obtained with Drs. Laking and Barlow, and Mr. Treves, but also with the two most eminent surgeons in the realm, Lord Lister and Sir Thomas Smith.  This consultation took place at ten a.m., and all present, physicians and surgeons, were in agreement that the King required emergent surgery for appendicitis.(Stevenson) 

The King refused surgery, stating that he had a duty to his Kingdom to fulfill the coronation.  The argument between doctors and patient went back and forth until Mr. Treves replied to the King saying, "I shall go to the Abbey,” by hotly stating, “then you shall go as a corpse.”(Ellis)  The King agreed to surgery and Frederick Hewitt was summoned to Buckingham Palace to administer anesthesia.(Stevenson)

The coronation was postponed with notification by the Earl Marshall to the Press Union("Illness of the King - Coronation Postponed") and the Gazette: 

Earl Marshal’s Office,

Norfolk House

St. James’s Square

I have to announce that the Solemnity of the Coronation of Their Majesties King Edward VII and Queen Alexandra is postponed from the 26th instant to a date hereafter to be determined.

NORFOLK, Earl Marshal.

June 24th, 1902” (Norfolk)

An operating theater was created in Buckingham Palace and at 12:30 p.m. the King walked into the operating room.  Ether anesthesia was administered by Sir Frederick Hewitt, the King having knighted his doctors before his surgery.  The King, being large, had obstructive apnea with the anesthetic and turned purple with hypoxia until Sir Frederick took hold of the King’s beard and pulled the mandible forward, opening the airway:

Fortunately he had a beard and this was grasped by Dr. Hewitt, the royal head was pulled forwards, and the King began to breathe again (as I was told many years afterwards by Sir Frederick Hewitt himself.”(Stevenson)

Sir Frederick Treves then applied antiseptic to the King’s abdomen and made a transverse incision into a large appendiceal abscess.  The abscess was evacuated and the abdomen was irrigated and large, stiff rubber drains were secured in place and the wound was packed with gauze.  The King emerged from the operating room at 2:00.(Stevenson; The King's Illness - Official Announcements")

Right around then, the forgotten Mr. Fripp had ventured to Westminster Abbey to check on the preparations for the coronation when he overheard a policeman say to another visitor, “Bless your soul, there won’t be any Coronation.  The King’s being operated upon at this very moment.”(Stevenson)

king surgery 1

The King recovered rapidly from his surgery.  Regular bulletins were published in the press over the next few days, and the Coronation was rescheduled for August 9th.  By a day after the surgery it was reported that the King was “sitting up in bed smoking a cigar.”("The King's Illness - Official Announcements")  The King’s medical team published several articles detailing the King’s illness in both the Lancet, and in the British Medical Journal.("The Illness of His Majesty the King")  The crowds that had descended upon London for the Coronation dispersed, and the crowned heads of Europe returned home.  The enormous amount of food obtained for the Coronation Banquet was quietly packed off to the Little Sisters of the Poor, and the charities in London’s East End all reported enormous largesse to distribute amongst the poor, who “had never eaten so well.”(Ellis)

The King’s coronation on August 9th was less grand, his extended family for the most part did not return to London.  The King was well enough to physically support the aged, ailing Archbishop of Canterbury, even assisting the frail cleric to his feet at one point.  After the ceremony, the King was asked whether he was tired, and he replied, “Wonderfully, I am not.”(Stevenson)


jsedlack@appendicitis.pro   © Jeffrey Sedlack 2012