THE YEAR OF THE THREE KAISERS

THE YEAR OF THREE KAISERS

                                                                            by
                                                             Arthur Lyons

     The importance of political or military figures in history is often speculated on and thinking of alternate scenarios can be a fascinating exercise. What, for instance, would the world be like absent a Jesus Christ, Henry VIII, Napoleon, or George Washington?

      If the great man theory of history needs an example the events in Berlin in 1888 will serve as well as any. In 1888 Europe was relatively stable. The various powers were at peace and existed under more or less constitutional monarchies. The various large and petty states making up the German Federation had agreed to unify in 1871 under the leadership of Prussia in the exuberance following the Franco-Prussian War.

     A hero of the Franco-Prussian War was the able and relatively liberal Crown Prince of the Empire of Germany, Frederick III of

Frederick III, by Heinrich von Angeli
(Wickipedia)

Prussia, son and heir of the aging emperor Wilhelm I (1797-1888). Frederick was married to Queen Victoria’s daughter, the Princess Royal Victoria, and both were progressives. Though under effective control of Otto von Bismark, the 91 year-old Wilhelm’s talented and conservative chancellor, Germany was looking forward to a more open society under the upcoming reign of the liberal Frederick.

     In early 1887 Frederick, or “Fritz” as he was known, a non-smoker, complained of hoarseness. He was treated symptomatically for several months but when his hoarseness persisted he was examined by several prominent physicians. They concluded that the Crown Prince was suffering from a potentially lethal cancer of the larynx. Curative surgery, to open the larynx and resect the cancer or the entire larynx, was recommended. The operation was risky, and both medical and political issues were at stake.

Princess Royal Victoria by Heinrich
von Angeli (Wickepedia)

     Frederick’s wife, Victoria, insisted that another specialist be called in. The most famous laryngologist of the day was the London surgeon Morell Mackenzie (1837-1892). He had written several books including a definitive text on diseases of the throat and nose, and invented a number of surgical instruments. With the agreement of Frederick’s physicians Mackenzie was called to Berlin. After examining the Prince he recommended a biopsy using a laryngoscope, the first of the Prince’s physicians to do so. None of the attendings had used the laryngoscope for this, and Mackenzie had to find a suitable one in a local shop. He sent the biopsy specimen to Rudolf Virchow, the famous pathologist at Berlin’s Charité Hospital, but Virchow, using available techniques, could not make a diagnosis of cancer. A second and then a third biopsy were done. The second contained insufficient tissue but the third was an adequate

Sir Morell Mackenzie (Wickepedia)

specimen. None showed cancer, and Mackenzie could not recommend surgery. Syphilis was considered as a diagnosis, not unusual at the time.

     Over the next few months Frederick worsened, and two more specialists, one from Berlin (Dr. Krause) and one from Vienna (Dr. von Schrötter), were called in. The unanimous opinion now was that the Prince had cancer and would not live long. His father, Wilhelm, died in March, 1888, and the weakened Frederick assumed the throne. He reigned only 99 days before succumbing to his cancer. An autopsy was done by Virchow, assisted by Paul Langerhans (also to become famous). This time cancer was found.

     The press, partly controlled by Bismark, blazed the case across the headlines in a largely partisan manner. Articles harshly critical of Mackenzie and favorable to the German doctors abounded. A supposedly “official” German report turned out also to be a polemic. Mackenzie was stung. After initial praise and having gained a knighthood he was now humiliated, though both Frederick and Victoria affirmed that he had acted appropriately. His esteem was shattered and his practice dwindled. Trying to save his

Mackenzie's answer to attackers
(Hathi Trust)

tarnished reputation, Mackenzie published a self-serving book, The Fatal Illness of Frederick the Noble, stating his case, revealing patient details, and denigrating the skill of the German doctors. It was unprofessional and the Royal College of Surgeons censured him for it. Mackenzie only partly recovered his practice and, being an asthmatic, died four years later, in 1892, of influenza pneumonia.

     Kaiser Wilhelm II (1859-1941), after Frederick’s death, was the third German emperor that year of 1888. With his paranoia, withered left arm, and an abiding hatred for all things English he managed to rule Germany with his reactionary policies until his abdication in 1918. He fired Bismarck and started Germany on a militaristic course that led to two 20th C. World Wars, the Russian Revolution, and the other horrors of the next century. It is reasonable to assume that had the pacifistic Frederick been Kaiser for long enough the futures of Germany and Europe would have been entirely different.

      Mackenzie should not be forgotten, though. He founded the Hospital for Diseases of the Throat in London, the first of its

From text on laryngoscopy. Note candle
as light source (Hathi Trust)
(You can zoom in on this image)

kind in the world. He had learned laryngoscopy from Johann Czermak in Budapest and published the first English text on the subject, which went into three editions and was widely translated (as was his text mentioned above). He invented new instruments. He was a cofounder of the Journal of Rhinology and Laryngology and, in the year of his return from Germany, founded the British Rhinolaryngology Association (Otology added in 1895). Many of his numerous students became leaders in the field. It was the very skill he was known for that ensnared him in the tragic events around Prince Frederick.

SOURCES:

Thorwald, J. The Century of the Surgeon 1954 New York. Pantheon
McKenzie, Sir M. The Fatal illness Frederich the Noble 1888 London.    

    Low, Marston, Searle

Stevenson, R Scott. Morell Mackenzie: The Story of a Victorian 

     Tragedy. 1947 New York, Henry Schuman

Weir, Neil. Otolaryngology: An Illustrated History. 1990. Butterworths,

     London

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