When the bells ushered in the New Year in 1901, Queen Victoria’s reign began to diminish...
It had been suggested in Dr Reid’s final report on Queen Victoria’s death that Victoria’s decline had been caused by the indirect consequence of major depression. The Queen's Journal suggests that a severe late-life depressive episode occurring approximately in her last 5 months contributed meaningfully to her death. The antecedents of Queen Victoria's late-life depression, including multiple losses, disabilities, and chronic pain, taken together with the presentation of vegetative, affective, and late cognitive symptoms, suggested the presence of a distinctively geriatric major depressive disorder.
Shortly after Victoria and her entourage arrived at Balmoral in October 1900 The Queen was plunged into profound grief upon learning about the death of her grandson Prince Christian Victor of Schleswig Holstein, who had succumbed to malaria and enteric fever in South Africa. Then the very next day, even as the monarch was striving to rally from the impact of the tragedy, she suffered another ghastly blow. A letter was delivered for her attention and she immediately recognised the handwriting. After it had been opened, she read the correspondence from none other than Prince Christian, who had sent off the missive before falling gravely ill.
On November 6, the Court left Balmoral, never had her departure from her beloved Scottish home taken place in such sad circumstances. She was unable to make her customary visits to her old servants and retainers and, even as she left, she was distressed and in tears.” Her courtiers could discern the pain and weariness in her eyes. Many of them privately accepted they were unlikely to see her in Scotland again. And they were right. Although those working at Balmoral – knew nothing about her deteriorating health and morale.
As of November she had become frankly melancholic. Her appetite waned drastically, by the time of her death she had lost nearly half of her body weight. Malnourished and weak, in pain from osteoarthritis, she was further exhausted by insomnia; fatigue in turn compounded the inanition she had begun to develop years earlier after a leg injury. Cataracts clouded her vision, and she probably developed what would now be categorised as mild cognitive impairment. Dr Reid had attempted throughout the Queen’s last year to control her weight loss by augmenting her meager nutritional intake with Benger’s Food, a floury paste given as a dietary supplement to elderly or edentulous patients.
By December of 1900, Dr Reid wrote, there were also “… occasional slight and transitory attacks of aphasia, the latter indicating that the cerebral circulation had become damaged … .” These aphasic episodes were described as “always of an ephemeral kind and unattended by any motor paralysis”
The Queen performed her last official duty on January 14. It was an audience with the commanding general of British armies in the Boer war. She conducted her last official duty in her wheelchair at Osborne House. Two days after receiving Lord Roberts, she was unable to get out of her bed. Her doctors notified her son The Prince Of Wales about her declining health and that she could die at any moment.
On Tuesday, Jan. 15 The Queen, with assistance went for a ride in the palace grounds. However, it became incredibly clear that something was seriously wrong; she was visibly affected by some malady. On Wednesday, Jan. 16, she suffered a paralytic stroke and experienced an intense physical weakness that caused the left side of her face to sag. The only documented medical intervention given to the semi-conscious Queen throughout her final days was the administration of oxygen. In contrast, during the last year of Her Majesty’s life, Reid had been called upon to prescribe analgesic and supportive measures typically used for elderly patients in the late-Victorian era. On January 15, Sir James Reid arranged for Queen Victoria’s eyes to be examined by the German ophthalmologist Hermann Pegenstecher, who had treated her failing vision in the past by pupillary dilation around bilateral cataract. However, Dr Pegenstecher was not primarily interested in the Queen’s cataracts. He was instead concerned with fundoscopic evidence of microvascular pathology, consistent with Her Majesty’s “altered” disposition, which Reid had described several days earlier as “apathetic and childish.” According to Sir James, Dr Pegenstecher confirmed his own assessment of “cerebral degeneration”
The first public announcement of her condition appeared on January 19th coincidently the same day she became the oldest reigning monarch in British history. The New York Times lead story the next day was titled ‘QUEEN VICTORIA AT DEATH’S DOOR’ on the twenty-first another headline headed the front page ‘ QUEEN VICTORIA SINKING FAST’
But with death closing in, as many physicians have done before and since, Sir James chose to give the Queen the reassurance for which she seemed to be pleading. Having thus committed himself, he did so abundantly, promising again and again, in his baritone brogue, that she would recover.
At 6:30pm on The 22nd January 1901, Queen Victoria breathed her last surrounded by her family.
Medical documentation sourced via -‘Reid M . ( 1987 ). Ask Sir James: The life of Sir James Reid, personal physician to Queen Victoria . London : Eland .’