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J R Soc Med. 2004 October; 97(10): 505.
PMCID: PMC1079634

The sickly Stuarts

Milo Keynes, in his diligent review of Professor Holmes’ book (June 20004 JRSM1), implies that the contents as described by him contradict rather than confirm the premise of the title. History certainly suggests that the royal Stewarts were a tough lot, prolific and often long-lived despite the dangerous, disease-ridden, wartorn times in which they lived, not to mention the unsavoury lifestyle of many of them.

King Robert II of Scotland, grandson of the Bruce, was the first monarch to hold the hereditary title of Steward. The bloodline ran unbroken from him through his son and then five descendants, all called James Stewart, and all fathering many children, in or out of royal wedlock. However the last of these, James V of Scotland died very shortly after the birth of his daughter Mary. So Mary Queen of Scots had no need in later life to marry her cousin Darnley in order to become a Stewart monarch—she was born one. She also died one, in her mid-forties, having endured imprisonment in a succession of damp and unhygienic castles over two decades until her execution. Sickly? Surely not.

‘The six Stuart monarchs’ described in Professor Holmes’ book succeeded the first eight Stewart monarchs of Scotland as described above. As Milo Keynes reports, they were in turn outlived by the Old and Young Pretenders and the latter’s brother the Cardinal; all three Jacobite Stewarts lived to a ripe old age (for the times) in exile abroad. And Sophia, Electress of Hanover, grand-daughter of James Stewart, VI and I, had initiated the Hanoverian succession which then followed and indeed occupies the British throne to this day.

A bloodline running from 1370 until the present time hardly makes the case for a strain of sickliness. Nor is a consistent pattern of hereditary disease apparent.

Therefore I agree with Milo Keynes’ closing paragraph and was interested to read Graham Brack’s thoughtful letter in the August JRSM.2 As he indicates, Holmes’ spelling of the surname is incorrect; Mary Queen of Scots was brought up in France from babyhood and married the Dauphin as Marie Stuart. The spelling in this country was always Stewart—from King Robert II, the Steward.


1. Keynes M. The Sickly Stuarts [Book review]. J R Soc Med 2004;97: 306–7
2. Brack G. The Sickly Stewarts [Letter]. J R Soc Med 2004;97: 412

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