Twelve Diseases that Changed Our World. Irwin W. Sherman

internal bleeding. He became a chronic invalid with an abnormal posture. Victoria considered him unattractive, saying, “He is tall, but holds himself worse than ever, and is a very common looking child, very pale in face, clever but an oddity—and not engaging though amusing.” The Queen was so ashamed of Leopold that he was frequently left behind while the rest of the family went on holiday. Leopold used these times to read widely, and he was one of the most intelligent of Queen Victoria's children. The Queen recognized his intellectual capacities, and when he was 24 she made him one of her private secretaries with access to state papers, a privilege denied to his brother Edward Prince of Wales. In 1881, Queen Victoria made Leopold the Duke of Albany, and the following year he married Princess Helena of Waldeck, sister of the Dutch queen. The Duke and Duchess of Albany had a daughter, Princess Alice (a carrier of hemophilia), and a son, Charles Edward Leopold, who was born shortly after his father's death at the age of 31 from a cerebral hemorrhage after falling down a flight of stairs. Charles Edward Leopold could not inherit hemophilia from his father (see p. 9–10), but at the age of 16 he did inherit the dukedom of Saxe-Coburg and Gotha from his uncle Alfred, Duke of Edinburgh, and he rose to the rank of general in the German Imperial Army. With the collapse of Germany after World War I, he had to abdicate his dukedom; however, he was a prominent member of the Deutsches Nazionalist Volks Partie (DNVP) and helped forge an alliance between it and the Nazional Sozialist (Nazi) Partie. In 1933, when Adolf Hitler was elected chancellor, the DNVP disbanded and many of its members joined the Nazis. Charles Edward Leopold became a group leader in the Nazi Brownshirts. In 1936 Hitler sent him to Britain in his capacity as President of the Anglo-German Fellowship; his real mission was to assess the possibility of an alliance between the two countries. During his stay he met with his cousin Edward VIII and several high-level politicians. After his first meeting with Edward VIII in early 1936, Charles Edward Leopold reported to Hitler that the new King would be amenable to such an alliance and would exercise his influence to make this a “guiding principle of British foreign policy.” The Duke went so far as to report that Edward dismissed the need to discuss this with the Prime Minister, Stanley Baldwin. However, the Duke was not a reliable reporter, and his assertion was never confirmed by Leopold von Hoesch, the German ambassador to Britain.

      In December 1936, Edward VIII abdicated (becoming thereafter the Duke of Windsor) to marry Wallis Simpson, an American divorcée. The following year, the Duke and Duchess of Windsor visited Germany, where the Duke met with Hitler, Goering, and Goebbels and greeted Hitler with a Nazi salute; his cousin Charles Edward Leopold celebrated the visit with a gala dinner in his honor. The cordial relationship between Hitler and the Duke of Windsor caused great consternation to the new King, George VI, and his government in the years before the outbreak of World War II. Early in the war, Germany unleashed a destructive air offensive against Great Britain. This was perceived by the Prime Minister, Winston Churchill, as a prelude to an invasion of Britain. The Duke of Windsor was reported to have recommended ending the war “before thousands more were killed or maimed to save a few politicians.” It was even rumored that Hitler was so intent on maintaining the Duke within reach of Germany that he contemplated either kidnapping or bribing him. In order to remove Edward from any German influence and to avoid having him in Britain, Churchill arranged for him to be appointed Governor of the Bahamas. In late July 1940, Hitler, through intermediaries, audaciously suggested that the Duke might return to the British throne if Germany was victorious; there is no evidence that the Duke responded to this proposal. The Duke hesitated before accepting the Governorship of the Bahamas, partly because of German-inspired rumors that the British Secret Service was planning to assassinate him once he arrived there. He eventually accepted the post and sailed for Nassau in August 1940.

      Meanwhile, Charles Edward Leopold provided encouraging, if greatly exaggerated, reports to Hitler on the pro-German party's strength in Britain, reinforcing Hitler's hope that Britain might still be persuaded to form an alliance with Germany. It has been suggested that Hitler delayed his attack on Britain in 1940 as a result. For his pro-Hitler role, Charles Edward Leopold paid a heavy price: two of his sons died in the war, and he lost most of his estates, which were in the Russian zone of Germany. After the war, the Duke and Duchess of Windsor lived in exile in France for the rest of their lives.

      Consequences

      Victoria and Albert were prolific parents, and their offspring married into almost all the royal families of Europe, which were notorious for marrying among themselves. Queen Victoria sowed the seeds that ultimately led to the demise of several European dynasties. Since the hemophilia gene is passed as a recessive rather than a dominant gene, and since affected individuals have tended to die young until fairly recently, this gene has been eliminated from most of Queen Victoria's descendants. The growth of constitutional monarchies and republics means that the gene no longer plays a role in world affairs. The gene may still exist in some descendants of Prince Leopold, Duke of Albany, and of Queen Victoria Eugenie of Spain, but these descendants are all commoners and will not contract dynastic marriages with other descendants of Queen Victoria. Porphyria, on the other hand, as a disease transmitted via a dominant gene, is still being passed from one royal generation to the next, although in none of these persons has it had the profound effects that it had on the Houses of Stuart and Hanover. Unless the present House of Windsor harbors an as yet undetected carrier, the royal curse of porphyria may have finally reached the end of the line.

      Porphyria and hemophilia illustrate how closely intertwined are disease and culture. Appreciation of this nexus can enable a better understanding of and responses to other illnesses such as the potato blight (chapter 2), the emergence of drug-resistant tuberculosis (chapter 7), and the pandemics of influenza (chapter 10) and AIDS (chapter 11). When we consider the world of the past, a time when there were no possible interventions for the “inborn errors” of porphyria and hemophilia, we can see how a disease can dramatically affect the lives of millions of people for decades. And illness, contagious or not, when present at a critical time, can affect the conduct of wars, the nature of immigration policies, the manner in which the sick are regarded by the remainder of society, and the political fortunes of nations; it can also serve to promote new strategies to protect the public health while at the same time ensuring that individual liberty is not compromised. The stories of porphyria, hemophilia, and President Kennedy's Addison's disease are tantalizing: they tempt speculation on how events in the world during the past 150 years might have turned out differently if political leaders and prominent members of royal families had not been plagued with defective genes.

      2 The Irish Potato Blight

      Grosse-Ile, lying in the middle of the St. Lawrence River, is a picturesque island with a background of majestic peaks. Grosse-Ile is also a place where thousands upon thousands of men, women, and children were detained and died. The Grosse-Ile station came into being when reports to the colonial government in Canada told of sick people from the Old World, especially the Irish, who were about to arrive via the St. Lawrence River. In response, the Assembly of Lower Canada (as Quebec was then called) passed a resolution on 23 February 1832 that made Grosse-Ile a detention station for sicknesses commonly believed to originate “in the homes of the human riff-raff.”

      The writer Susannah Moodie, who emigrated to Canada from England in 1832, described her own impression:

      “I looked up and down the glorious river; never had I beheld so many striking objects blended into one mighty whole! Nature had lavished all her noblest features in producing that enchanted scene. The rocky isle in front, with its farmhouses at the eastern point, and its high bluff at the western extremity, crowned with the telegraph . . . the middle space occupied by tents and sheds for cholera patients and its wooded shores dotted over with motley groups added to the picturesque scene . . . Never shall I forget the extraordinary spectacle that met my sight the moment we passed the low range bushes which formed a screen in front of the river. A crowd of many hundred Irish emigrants had been landed during the present and former day and all . . . men, women and children, who were not