Friday, April 6, 2018

Un-Debunking the Queen Vic Myth?

Queen Victoria with five of her nine children
Several authors of late (e.g. James H. Mills in Cannabis Britannicahave sought to debunk the persistent reports than Queen Victoria used cannabis to treat menstrual cramps.

The rumor started when it was discovered that John Russell Reynolds, M.D. wrote an article published in The Lancet in 1890 extolling the virtues of cannabis for cramps and other ailments, while credited as "Physician in Ordinary to Her Majesty's Household."

Cannabis researcher Ethan Russo, M.D., co-editor of Women and Cannabis, wrote in that book that Reynolds was Victoria's "personal physician" and that "it has been widely acknowledged" that she received monthly doses of cannabis for menstrual discomfort throughout her adult life. However, Russo now concurs with Mills's assertion that we have no proof of this.

Reynolds was appointed as physician to the Queen's household in 1878, when she was 59 years old, likely past the age when she would have experienced menstrual cramps. Further, his appointment did not make him Queen Vic's personal physician, but rather one of at least 200 physicians, apothecaries and other attendants in her "medical household," to treat her staff of over 800 persons at her 12 residences. However, she often consulted with various members of her medical staff, and also physicians who were not part of the household. (A. M. Cooke, Queen Victoria's Medical HouseholdMed Hist. 1982 Jul; 26(3): 307–320.)

Famous for her prudishness, Victoria never hired a female physician and was appalled that female medical students performed dissection alongside their male counterparts. Yet, she was surprisingly experimental when it came to her own medical care. She was an early adopter of chloroform for childbirth, using it in 1853 while giving birth to her eighth child, and again in 1857 for her final childbirth, "despite opposition from members of the clergy, who considered it against biblical teaching, and members of the medical profession, who thought it dangerous." (Wikipedia)

The physician who gave the Queen chloroform for each of these births was John Snow, an eminent epidemiologist and pioneer in anesthesia, who "does not appear to have had any appointment to the Medical Household" (Cooke). So Victoria consulted with an outside specialist for a relatively unknown treatment.

It's possible, then, that Reynolds also treated the Queen while not yet one of her official physicians, possibly when she was a younger woman. He was certainly prominent enough to have caught her attention:

John Russell Reynolds (Yale University Library) 
Sir John Russell Reynolds was an eminent and highly influential physician in the Victorian era who held the Presidencies of the Royal College of Physicians of London, and of the British Medical Association. He was the protégée of the great experimental physiologist, Marshall Hall, who discovered the reflex arc, and succeeded to Hall’s clinical practice in London. Reynolds’ thought and clinical activities linked the emerging British neurology of the first half of the 19th century with its blossoming, particularly in London, from 1860 onwards. In his writings Reynolds was the first English author to apply the approach to classification of neurological disorders that is still often used, though now in modified form. 

(M. J. Eadie, The neurological legacy of John Russell Reynolds, Journal of Clinical Neuroscience, April 2007)

In his now-famous Lancet article, Reynolds writes that in 1848, a lecturer at medical school spoke of the potential of Indian hemp in medicine, but found it too variable in dosage to avoid toxic effects. Seven years later, Reynolds recounts, he made a connection with Peter Squire, the pharmacist who also supplied W. B. O'Shaughnessy, the physician who brought cannabis to the West. Squire was able to provide Reynolds with a reliable tincture of Indian hemp, with which he began experimenting in 1855 when Victoria, born in 1819, was only 36.

Reynolds recounts his experiments of over 30 years, describing carefully where he found cannabis useful and where he did not. He writes, "In senile insomnia, with wandering; where an elderly person, probably with brain-softening, in the 'delirium form' (Durand-Fardel) is fidgety at night, goes to bed, gets up again, and fusses over his clothes and hid drawers; thinks that he has some appointment to keep, and must dress himself and go out to keep it; but may be quite rational during the day, with its stimuli and real occupations. In this class of case I have found nothing comparable in utility to a moderate dose of Indian hemp—viz., one quarter to one-third of a grain of the extract, given at bedtime. It has been absolutely successful for months, and indeed years, without any increase of the dose."

By contrast, "In alcoholic delirium it is very uncertain; but has very occasionally been useful. In melancholia it is sometimes of service in converting the depression into exaltation; but I have long since discontinued its use, except when the case has merged into that of senile degeneration. In mania I have found it worse than useless, whether that malady has been chronic or acute...."

Reynolds continues, "In almost all painful maladies I have found Indian hemp by far the most useful of drugs....it is a most valuable medicine in the nocturnal cramps of old and gouty people; it in some cases relieves spasmodic asthma, and is of great service in cases of simple spasmodic dysmenorrhoea [menstrual cramps]."

Even in her youth Victoria barely had time to menstruate: she bore 9 children in 18 years. The Queen reportedly hated being pregnant and suffered from postpartum depression and "hysteria." I think it's likely, if Reynolds did use cannabis to treat Victoria, he may have done so for nervous disorders later in her life.

Reynolds "devoted himself from an early period to the study of nervous diseases" and began publishing on the topic in 1855, with Diagnosis of Diseases of the Brain, Spinal Cord, and Nerves. He "was often consulted in difficult cases of nervous disease." (Wikipedia)

Twelve years after he joined the Queen's household medical staff, he wrote, "Indian hemp, when pure and administered carefully, is one of the most valuable medicines we possess."

If Victoria used Indian hemp late in her life, it might help explain her attachment to an Indian servant in her last years, as depicted in the movie Victoria and Abdul. Maybe he brought more than curry with him to England.

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