King George III was known for his episodes of ‘madness’ which were associated with constipation, weakness of the limbs, abdominal pain, tachycardia, darkened urine, seizures and hoarseness. According to Macalpine and Hunter, these symptoms were closely linked to the diagnosis of acute intermittent porphyria. The paper published in 1966 caused a ruckus in the field, as this was the first paper suggesting that King George III suffered from a physical illness. Prior to this, the common belief was that the he suffered from the somatic manifestation of a psychiatric illness. Till date this matter has been debated and no conclusion has yet been reached to, as it is not possible to perform metabolic tests.
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Hence, the paper by Ventura et al. recommends that DNA analysis along with appropriate genetic counselling and biochemical tests for the levels of porphyrins are the most accurate methods to diagnose porphyria. It is however, interesting to note that there still exists a lot of ambiguity in the field and based on the evidence presented it is still hard to diagnose King George III’s illness. Most critics of this diagnosis argue that diagnoses cannot be made solely on symptoms, even though they coin his illness to be Bipolar disorder based on his symptoms. It is interesting how this is a case debated till date with no solid