The Anglo-German physician Ida Macalpine MD, FRCP (1899-1974) was awarded an MD by the Friedrich-Alexander-Universität, Erlangen in 1927, before she emigrated to Britain with her two sons in 1933. In Britain Macalpine studied for and received a Scottish medical qualification in order to practise in the United Kingdom. Macalpine then specialised in psychiatry and was appointed psychiatrist at St Bartholomew’s Hospital, London, and her son Richard Hunter MD, FRCPsych, FRCP (1923-1981) studied at St Bartholomew’s (where he was house surgeon to Sir Geoffrey Keynes), before following his mother into psychiatry. Both Ida Macalpine and Richard Hunter were also distinguished historians of medicine, in which capacity they are best remembered for their book 300 Years of Psychiatry 1535-1860 (1963) and their publications on porphyria. The first of these was ‘The “Insanity” of King George III: A Classic Case of Porphyria’ (1966) and it was followed by ‘Porphyria in the Royal Houses of Stuart, Hanover, and Prussia: A Follow-up Study of George III’s Illness’ (1968), both of which were published in the British Medical Journal, and then collected in Porphyria – A Royal Malady with two further pieces in support of their papers.

This copy was sent by Richard Hunter to his former colleague, the noted surgeon, and historian and bibliographer of science Sir Geoffrey Keynes, and Hunter’s covering letter thanks Keynes for some offprints, continuing: ‘Mother and I have the honour to reciprocate by sending you a booklet about to be published (12 January) by the BMJ on our George III & House of Stuart & Hanover studies – we hope you will enjoy it’. The letter concludes with a postscript ‘[y]ou are mentioned in footnote 14’ (footnote 14 of ‘Porphyria in the Royal Houses of Stuart, Hanover, and Prussia’ refers to Keynes’s The Life of William Harvey).

Hunter’s second letter to Keynes, written the following day, explains that ‘our letters must have crossed’ and mentions the copy of Porphyria – A Royal Malady which had already been sent. After discussing Keynes’s work on Harvey, Hunter writes, apparently in response to a reference provided by Keynes, that ‘[w]e are not sure whether porphyria could account for the “beneficial evacuation of nature” on King James’s left arm [reported by Harvey] but it is not impossible & is certainly an interesting suggestion’. The final item in the group is a further paper on George III’s illness, inscribed to Keynes by Hunter.

Macalpine and Hunter’s hypothesis was (and remains) controversial, and much of the contemporary debate about it took place in the correspondence columns of the British Medical Journal, and Keynes evidently read and collected these pieces, which he extracted from the individual issues and kept with his copy of the book. The year after Porphyria – A Royal Malady was published, Macalpine and Hunter’s wrote George III and the Mad-Business (1969), which was a primary source for Alan Bennett’s play The Madness of George III (1991) – indeed, Macalpine is a character in the final scene of the play – and the film The Madness of King George (1994).
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