Sir Augustus Frederick D’Esté (1794–1848) was an illegitimate royal child, a bachelor, an active member of the Aborigines Protection Society, and the earliest known person diagnosed with multiple sclerosis.
For 24 years D’Esté kept a diary, currently held in the Royal College of Physicians’ archives, which documents what he called ‘my case’. In it, he noted down any and all symptoms, episodes, and occurrences; no gory detail was spared. It is from this account that his diagnosis could be made more than a hundred years after his death – multiple sclerosis wouldn’t even be recognised as a disease until 20 years after his final entry.
D’Esté was not a typical Englishman. He wasn’t even ‘D’Esté’ by birth – his grandfather was none other than the ruling king George III. The king declared his parents’ marriage illegitimate (it’s a long story), and eventually the name D’Esté was given to the young boy by his father. Much of his life was spent attempting to reclaim these lost titles, but he was ultimately unsuccessful.
Despite this time-consuming endeavour, D’Esté was able to pursue other interests, and his diary allows us glimpses into his personal life. What follows are a few highlights from this page-turning collection.
In 1830, at the age of 36, D’Esté describes an unfortunate setback to a relationship: ‘Whist at Ramsgate I formed a liaison with a Young woman – I find in my acts of Connection a deficiency of a wholsom vigor’.
Not a pleasant situation, but after a brief physical examination (the details of which might be best left imagined) a solution is found: ‘he gave me some Medicine and Pills and certainly some increase of vigor was brought about’.
Never one to wash over embarrassing moments, he similarly records the following:
On the 16th of January, whilst in the act of getting out of bed a considerable portion of stool flowed from me, without my having been made aware of wanting to go to the Closed stool. – This was the only solitary instance of such a disagreeable occurrence.
His faith in the advice of his doctors and medical friends at the time had D’Esté undertake all manner of treatments. Some were effective; almost all were unpleasant. His wealth and status did, however, afford D’Esté certain luxuries: ‘I am to go in a Carriage direct to the Royal Private Hot-Bath – in which I am to be by 9 o’clock, or somewhat earlier’.
Not everyone in the 19th century had access to the ‘Royal Private Hot-Bath’, nor indeed a personal carriage, however these could only have done so much to combat the less desirable aspects of the visit:
Dr Granville desires me to pay particular attention to keep my Bowels open during the whole time of my using the Water, - to effect which he recommends The Compound Rhubarb Pill
A quick search for ‘Compound Rhubarb Pill’ confirms that it is, as suspected, a laxative. The herb behind it is held in the RCP’s medicinal garden under the name Rheum officinale Baill, and can be found lurking in the flower beds in St Andrews Place – one to avoid.
Thankfully not all treatments were so messy. One of D’Esté’s clear favourites was the recommendation given by a Dr Kent: ‘Dr Kent made me eat beef-steaks twice a day, drink London Porter, and Sherry, and Madeira wines … This new system succeeded completely’. D’Esté even goes so far as to title this entry into his diary as: ‘Dr Kent arrives and saves my life’.
In other highlights, D’Esté finds time to comment on the good weather in March: ‘the loveliest days!! Direct out of Heaven!!’. He finds himself repeatedly bored by the sermons at his sister’s church, of which he knows ‘nothing about’. And he marks the purchase of a new Phaeton, a horse-drawn carriage and D’Esté’s preferred method of transportation, with a slightly anti-climactic entry: ‘I think it will turn out to my satisfaction’.
Undoubtedly D’Esté’s unique status and wealth played a large role in his life. If his diary is unable to teach us how the average person might have faced multiple sclerosis at the time, then it can at least tell us the adventures of a man who ended up travelling widely across Europe in search of the latest and greatest in contemporary medicine.
James Kenny, museum volunteer