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J R Soc Med. 2004 August; 97(8): 412.
PMCID: PMC1079579

The sickly Stuarts

In his review of Professor Holmes' book The Sickly Stuarts— the Medical Downfall of a Dynasty (June 2004 JRSM1) Milo Keynes indicates that the name Stuart (or Stewart) originated with Lord Darnley. In fact it came from Robert II's father two centuries earlier. The dates of Henry, Duke of Gloucester were 1640–1660, not 1620–1640 as noted. Keynes suggests that hyperparathyroidism might explain the ills of James VI and I, but porphyria seems more likely. His complex of symptoms is difficult to disentangle, including gout, rickets and arthritis, but he complained of darkened urine and realized that his reasoning was impaired when this happened. His mother, Mary Queen of Scots, suffered from blistering of her hands in strong sunlight, suggesting a familial porphyria. A more detailed account of James' illness may be found in Purple Secret: Genes, 'Madness' and the Royal Houses of Europe by Röhl, Warren and Hunt.2


1. Keynes M. The Sickly Stuarts—the Medical Downfall of a Dynasty [Book Review]. J R Soc Med 2004;97: 306-7
2. Röhl J, Warren M, Hunt D. Purple Secret: Genes, 'Madness' and the Royal Houses of Europe. London: Bantam, 1998

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press