it as impersonal as possible. One doctor insisted on the patient kneeling on a stool, facing away from him, while he fumbled under her skirts.
The arrival of new technologies in the 1830s and 40s should in theory have made the whole business of intimate physical examination less ‘blushing’. But in fact they served only to introduce a further note of obscenity. The speculum had come over from France in the 1830s, but its primary association with the examination of syphilitic prostitutes by police surgeons meant that it was hardly welcome in the genteel consulting rooms and well-heeled sickrooms of Great Britain. For, as the Lancet put it, while examination by speculum might be appropriate to ‘unsexed women’ already ‘dead to shame’, it constituted a shocking ‘immorality’ when imposed on virtuous women. Victoria herself was no friend either to physical examinations or to the technologies designed to depersonalise them. She thought the new-fangled stethoscope quite disgusting, and after her final confinement in 1857, refused any access to her doctors below the waist. It was not until attending her corpse more than forty years later that her last physician, Sir James Reid, discovered that she had for decades been suffering from a ventral hernia and a prolapsed womb.
As a specialist in women’s diseases, though, Sir Charles Clarke was impatient with such coyness. We know this because, by a stroke of archival luck, his lecture notes have survived. In these, delivered to an audience of junior doctors, Clarke gives a detailed account of the procedure formally called ‘examination per vaginam’, but which, he explains, is more earthily known as ‘the touch’. Briskly, he sets out the scenario to his young men: ‘You are called to a woman, that woman has got a vagina: you are called, having got a finger in your profession & that finger is to be introduced into the vagina.’ Then, in case the slower members of the audience have still not worked out what is to happen, Clarke helpfully summarises: ‘The whole operation consists in the introduction of the finger of the practitioner into the vagina of the woman.’
Despite his man-of-the-world tone, Sir Charles insists on certain delicacies being observed. He is adamant that ‘In making such an examination, the person of the woman should on no account be exposed.’ Instead, the patient is to lie down on the bed and be covered with a counterpane: ‘that is decency – want of it, indecency’. These niceties taken care of, Clarke then gets down to arranging the woman exactly as he wants her: ‘Let her lay on the bed covered by the bedclothes, the Pelvis close to the side of the bed on her left side, the knees drawn towards the belly & the legs bent backward on the thighs.’ The next step, says Clarke, is to ‘Cover the two fore fingers of the right hand with pomatum or cold cream, then place your hand between the woman’s thighs … Run the hand quickly up till you get it to the external parts.’ At that point, Clarke warns, all but the most experienced may fumble. Unable to see what he is doing, the junior doctor is quite likely to jab blindly at the anus. With practice, though, and feeling along the perineum as a guide, Clarke assures the young men that their fingers will eventually find their berth.
What exactly was Clarke feeling for when he fingered Lady Flora? In his lecture notes he is clear that when a woman is in her first trimester it is impossible to know by touch whether she is pregnant. By the fourth month, though – and according to the eager calendar-watchers in the palace it was now twenty-two weeks since Flora and Sir John had briefly shared a post-chaise – he would be able to tell whether the uterus was enlarged. He would also, presumably, be able to feel whether the hymen was intact, although as one doctor pointed out during the noisy months that followed, the very act of penetrating Lady Flora with his fingers may well have meant that Sir Charles Clarke was actually responsible for rupturing the very maidenhead on which he had been called to adjudicate.
For the paradox at the heart of Lady Flora’s examination was this: it turned her into the very thing that she was accused of being – a whore. It wasn’t just that internal examinations, whether made with fingers or a speculum, were strongly associated with the detection of venereal disease amongst prostitutes. It was also the belief that the act of penetrating a woman in this way was apt to ignite her sexual feelings. This didn’t matter in the case of commercial sex workers, who were already ‘spoiled’ or ‘poisoned’ or ‘hardened’ by their pre-existing sexual knowledge. But in the case where an ‘innocent’ woman was initiated into sex by these artificial means, it was quite likely to change her character. Or, as the Lancet put it, ‘The female who has been subjected to such treatment is not the same person in delicacy and purity that she was before.’ Other medical authorities pushed the point further, excitedly reporting cases of women who became addicted to the practice of internal examinations with a speculum, turning up at their doctors’ consulting rooms with a host of bogus reasons as to why the procedure should be repeated.
Sir Charles Clarke, the kind and considerate royal physician
These were not, needless to say, Lady Flora’s feelings on the subject. According to the account given by her maid Caroline Reichenbach, she experienced the internal exploration of her body with male fingers as something akin to sexual torture. ‘The examination was not over but under the chemise & dressing gown,’ reported a horrified Caroline. ‘They uncovered Lady Flora’s bosom whose head then fell back & she nearly fainted & when the examination was over she was exhausted she could not sit upright.’ Sir Charles took the first turn in examining Lady Flora’s genitalia, during which time she whimpered a little. When it came to Sir James’s turn, though, she moaned ‘very much’, due to the fact that he was ‘rough & coarse & indecent in the way he moved her clothes’. Lady Portman wasn’t much better. During the examination, which lasted three quarters of an hour, the noblewoman pushed herself up to the bed, ‘quite unmoved by Lady Flora’s sufferings mental & physical’. Clark’s later response to all this was that since the maid was foreign, she probably didn’t understand what was going on.
Sir James Clark, the royal physician who turned misdiagnosis into an art
Whatever Drs Clarke and Clark found seemed to satisfy them. Lady Flora was immediately issued with a certificate that declared, ‘although there is an enlargement of the stomach, there are no grounds for believing pregnancy does exist, or ever has existed’. There was no mention of whether or not the thirty-three-year-old was a virgin, presumably because that information was too explicit to be included in a document intended for perusal by the maiden Queen. However, Sir Charles Clarke wrote a separate note confirming that the examination showed that Lady Flora ‘was inviolate, thus putting out of the question every possible suspicion’.
Before Victoria had time to curse the way that Lady Flora had once again managed to dodge her fate, events rearranged themselves again. The very next morning, Monday the 18th, the two doctors made a private visit to Lord Melbourne to report that, on reflection, they were not at all sure about their findings. The highly experienced Sir Charles, in particular, felt that it was just possible that Lady Flora could technically be a virgin and yet also be pregnant. By this he presumably meant that semen might have found its way into her vagina on Sir John’s fingers. All that was required in this situation, as far as current medical thinking went, was for her to have been sufficiently aroused for an ovum to be released. Virgin or not, Lady Flora had clearly been a willing, even enthusiastic, participant in whatever had taken place. Or, as Victoria put it in a garbled, Germanically-inflected note to her mother several months later, ‘Sir C Clarke had said that though she is a virgin still that it might be possible and one could not tell if such things could not happen. That there was an enlargement in the womb like a child.’
This changed everything. From now on an inner court consisting of the Queen and her Prime Minister, together with Lehzen and Lady Portman, proceeded on the assumption that Lady Flora was indeed pregnant, and that it would only be a matter of time before she was obliged to bolt. (Lady Portman, who was herself expecting her fifth child, was particularly confident that there was something about Lady Flora’s waddling gait that could only be explained by pregnancy.) Until then they would have to watch with gritted teeth while the lady-in-waiting flopped around the palace looking thin and fat at the same