The 99 day Emperor: Friedrich III’s fight with cancer

On 9th March 1888, Crown Prince Friedrich of Prussia succeeded his father, Wilhelm I, as German Emperor and King of Prussia. However, Friedrich’s reign was overshadowed by his terminal battle with throat cancer, which tragically took his life just 99 days after he inherited his new role. Please be aware that some of the topics in this blog may be distressing to some readers.

Before we begin, let’s talk about Friedrich’s relation to Queen Victoria. In May 1851 Friedrich travelled to England to meet Queen Victorias eldest daughter, Princess Victoria at the opening of the Great Exhibition. The two became engaged four years later and married in January 1858. Together the couple had a total of eight children. Despite getting engaged while the princess was aged just 13, their relationship was a true love match due to their shared liberal views.

Following social norms of the time, Friedrich was a lifelong smoker, which is believed to have caused tumours in his throat. By the 1880s, the Crown Prince had began suffering from symptoms such as, breathlessness, coughing and difficulty talking. In January 1887 he attended a ball and many guests found themselves shocked at the state of his condition; with one person describing how he was “so hoarse that he could hardly say a word”.

The following month, Friedrich underwent medical examinations and was diagnosed with a thickening of the mucus membrane over his vocal cords, caused by chronic laryngeal catarrh. His personal doctors tried to scrape the membrane away but, after several attempts, the method proved to be unsuccessful.

After further examinations, doctors diagnosed the problem as being caused by a nodule on the left vocal cord. Unfortunately for Friedrich it was decided that the best way to remove it would be to insert an electric wire, which would then be used to burn the nodule away. However, just like the first method, this, too, failed and the Crown Prince was forced to undergo even more examinations.

Five months later, on 17th May, Friedrich was formally diagnosed with a laryngeal tumour and a British specialist named Morell Mackenzie travelled to Berlin to help determine the next steps. After further inspection it was decided that Friedrich would need to undergo a thyrotomy to see whether or not the tumour was malignant.

The biopsy was taken just a few days later and, to everyone’s surprise, no cancer was found. From there, the Crown Prince was told that he would be fully recovered within a matter of months. While Mackenzie was positive in his prognosis, others weren’t convinced and a second biopsy was taken on 9th June. Once again, no cancer was detected and, although his symptoms persisted, Friedrich found himself well enough to travel to Britain for Queen Victoria’s Golden Jubilee celebrations.

While he was in London, Friedrich visited Mackenzie at his Harley Street clinic. The specialist claimed that in this appointment he removed “nearly the entire growth” but by his next appointment on the 2nd August, it appeared to have regrown. Once again Mackenzie attempted to cauterise the growth, with a second attempt taking place just six days later.

According to Mackenzie’s examination on 20th August, the procedure had been successful and there were no signs of regrowth. Despite this, Friedrich continued to complain that something didn’t feel right. As was common in the Victorian era, Mackenzie suggested that his patient should spend the winter months recovering in the Italian Riviera. As you can probably imagine, this remedy had little impact on Friedrich’s health and he returned to Germany a few months later feeling no better than when he had left.

After all this back and forth, it’s no surprise that Victoria and Friedrich wanted a second opinion from respiratory specialist, Max Joseph Oertel, who had invented the laryngeal stroboscope, a device which allowed him to view and study the movement of the vocal cords in slow motion.

Upon examination, Oertel was quick to suggest surgery as the only hope for the Crown Prince’s recovery. Despite his concerns, and the Friedrich’s sudden influx of cold symptoms, his personal doctors remained unconcerned and – rather than following the specialist’s advice – prescribed a trip to Venice. In the October, Princess Victoria wrote that Friedrich’s “throat is giving no cause for fresh anxiety”, adding that he was given a 3-4 month recovery time. However, by 5th November Friedrich had completely lost the ability to speak and the pain in his throat had become excruciating. As a result, he was given regular injections of cocaine as his condition continued to decline.

Just four days later he was finally given the correct diagnosis of laryngeal cancer, with a prognosis of no more than a year left to live. It was later revealed that the growths that had been removed in May had, in fact, been cancerous. From there it was decided that a complete laryngectomy was the best option.

After months of uncertainty over his illness, Friedrich couldn’t help but shed a tear when Mackenzie told him the news. He later wrote that “to think I should have such a horrid disgusting illness… I had so hoped to have been of use to my country. Why is Heaven so cruel to me? What have I done to be thus stricken and condemned?”

After discussion with his wife, Friedrich decided against the surgery due to its high risk of complications. He then wrote to his doctors about his intentions of remaining in Italy, adding that he would only give permission to a tracheostomy if he was at risk of suffocating from the tumours.

With his final diagnosis Friedrich seemed to find peace and his health began showing signs of temporary improvement. In a letter dated 26th December he wrote that the “chronic catarrh” had taken a “turn for the better”. Tragically just a few days later his health would take another turn for the worse. Friedrich began suffering with headaches, fevers and extreme fatigue. On top of this, the right side of his throat was so swollen that he coughed violently, making it difficult for him to grasp breath.

Having suffered “embarrassing bouts of suffocation”, Friedrich underwent surgery to insert a tracheostomy; during which the cannula was accidentally forced into the wrong pipe, almost killing the patient. While the surgery was successful, the Crown Prince’s symptoms continued to deteriorate and he soon began coughing up blood.

In the morning of 9th March 1888, Friedrich succeeded his father as German Emperor and King of Prussia, a role which he had spent his life preparing for. Unfortunately this meant that the terminally ill Emperor had no choice but to leave Italy and return to his native Germany on 11th April. By this time, Friedrich had become so weak that he was unable stand. Confined to his bed, in early June the cancer perforated his oesophagus, causing him to lose the ability eat and suffer from extreme vomiting.

Heartbreakingly, on 11th June the Emperor wrote: “what’s happening to me? I must get well again; I have so much to do!” Just three days later, Queen Victoria received a telegram with the news that “The Emperor is sinking”. Friedrich passed away at 11:30 the following morning, aged just 56. He was later buried at the Kaiser Friedrich Mausoleum in Friedenskirche, Potsdam on 18th June.

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