The Queen of Britain Who Died Because She Wouldn't Admit She Had a Hernia

Caroline of Brandenburg-Ansbach had been queen consort of Great Britain for ten years by the time her concealed strangulated umbilical hernia killed her in November 1737. She was 54 years old. Her husband George II — who would survive her by 23 years and die in his own undignified way on a Kensington Palace privy — was 54 at the time of her death. He never remarried.

The documentary record of her dying — particularly the first-person account by Lord Hervey, the courtier who attended her almost continuously through her twelve days of decline — is one of the most thorough surviving accounts of any 18th-century royal death. The interest is not the death itself. The interest is the specific medical-personal circumstance behind it. Caroline had been carrying her hernia in secret for fourteen years.

The injury

The hernia was acquired during the birth of her youngest surviving child, Princess Louisa (later Queen of Denmark), on 18 December 1724. The childbirth was traumatic — Caroline was 41 at the time, the labour was prolonged, the surviving accounts suggest substantial postpartum hemorrhage. The tear in her abdominal wall through which her intestine progressively herniated was not noticed by the attending physicians, who were occupied with the bleeding. By the time Caroline had recovered from the immediate postpartum complications several weeks later, she had a visible swelling above her navel that had not been there before the birth.

Caroline did not tell anyone. The 18th-century English aristocratic-female reluctance to acknowledge any bodily defect — particularly one that suggested reduced reproductive function — combined with the specific royal-political pressures on her position (her husband was unfaithful, she was politically essential to him as a stabilising court figure, her appearance and reputation were political assets) produced a sustained decision to conceal the injury. She wore progressively heavier corseting through the 1730s. She maintained discomfort throughout the period.

The hernia was concealed even from her own physicians. The standard royal-medical examinations of the period were superficial; the queen was attended by physicians who were socially incapable of demanding a thorough bodily examination of her person. Her three surviving daughters — Anne, Caroline, and Mary — knew about it. George II appears not to have known.

The rupture

On the morning of 9 November 1737, after a long walk in cold rain in Kensington Gardens, Caroline returned to St James’s Palace and complained of acute abdominal pain. She attended her usual late-morning audience with Walpole and her early-afternoon court reception. By late afternoon the pain was incapacitating. By evening she was in bed.

The royal physicians arrived in the late evening and over the following two days performed the standard 18th-century medical interventions — bleeding, purging, warm compresses, various herbal medications — without diagnostic success. Caroline did not tell them about the hernia. The royal anatomists conducted long discussions about the cause of the pain without arriving at the obvious proximate explanation, because they were not allowed to examine the queen’s abdomen.

The hernia was discovered on the morning of the fifth day, 13 November, by John Ranby, the royal surgeon, after Caroline had finally admitted in confidence to her daughter Princess Caroline that she had been hiding an abdominal injury for fourteen years. Princess Caroline had told the king. The king had ordered Ranby to perform an immediate examination.

Ranby attempted surgical reduction of the strangulated hernia over the following five days. The 18th-century surgical options were limited: open the abdominal cavity (with substantial mortality risk under pre-anaesthetic, pre-antiseptic conditions), attempt manual reduction through the abdominal wall (with damage to the herniated intestine), or allow the strangulation to progress (with certain death from gangrene). He attempted the manual reduction. The intestine was already gangrenous by the time he reached it. Infection followed within hours.

Caroline died on the morning of 20 November 1737.

The Hervey memoirs

The most consequential surviving documentary source for the death is John, Lord Hervey’s Some Materials Towards Memoirs of the Reign of King George II — the private journal Hervey kept through the 1730s, intended for posthumous publication, eventually published in 1848, 105 years after Hervey’s death. Hervey was the queen’s closest courtier of the period and was present at most of the twelve-day deathbed.

He recorded the long conversations between the queen and the king. Caroline’s deathbed instruction to George II was that he should remarry. George reportedly replied: “No, I shall have mistresses.” Caroline, by Hervey’s account, smiled and said: “Ah, that needn’t prevent it.”

Hervey also records the political-personal subplot: Caroline’s refusal to admit her substantially-estranged eldest son Frederick, Prince of Wales to her deathbed. Frederick had been formally banned from St James’s two years earlier after a quarrel about the birth of his first child. He stood outside her apartments for several days during her dying, requesting admittance. He was repeatedly refused. He was not present at her death. He outlived his mother by 14 years and died in 1751, supposedly of a cricket-ball injury but actually of a pulmonary abscess.

Aftermath

Caroline was buried in Westminster Abbey on 17 December 1737. George II ordered that her tomb be designed with a removable end so that his own coffin could be placed next to hers when he died (which it eventually was, in 1760); the removable end is still visible on the Hanoverian royal tomb in the Henry VII Lady Chapel. He outlived her by 23 years and never remarried. He did continue to keep a series of mistresses, including the Countess of Yarmouth.

The political consequences of Caroline’s death for the Walpole administration were significant. She had been Walpole’s chief court ally for fifteen years; her death substantially weakened his position with George II. Walpole’s eventual fall in 1742 was partly attributable to the political vacuum Caroline’s death produced at court.

The medical taboo against examining royal bodies that had killed Caroline was substantially relaxed within a generation. Subsequent 18th-century British royal deaths — George II in 1760, Frederick in 1751, George III in 1820 — were attended by physicians with explicit institutional authority to demand physical examinations of the monarch. No subsequent British royal is known to have died from a concealable medical condition.