Where does that come from? A regular column that examines the history and origins of a particular medical topic.

Like anyone else, the Queen and other members of the royal family have a doctor to attend their various ailments. There are various levels of grade, some with archaic names in the post - from Resident Medical Attendant and Physician Extraordinary to the top job of Physician in Ordinary. The surgeons have a similar hierarchical ladder, the top surgeon being known as the Sergeant Surgeon. It has been this way for centuries and continues to this day, and all have been privy to regal secrets which they usually carry to their grave. But Queen Victoria's last Physician in Ordinary, Sir James Reid, did not; he kept a diary. It has surfaced in recent years and extracts revealing bits of titillating scandal about the Royal Household have been published by his granddaughter-in-law, Michaela Reid, in her book As Sir James, published by Eland in 1987.

Dr Reid was a Scotsman born in Aberdeenshire in 1849. A bright lad, he graduated top of his class in medicine in Aberdeen in 1872. After working for some time in London he took a post in Vienna and, though he did not know it at the time, it turned out to be a most propitious move and one which eventually would change his life for ever: he became fluent in the German language.

In 1877 he returned to work as a country GP in north-east Scotland. Queen Victoria loved to take her holidays in Balmoral, her residence in that part of the country, as she liked the people and general ambiance of the place. So when in 1881 her then doctor retired she cast about for a successor, stipulating he must be Scottish and, as most of her relatives were from Germany, conversant with the German language. As a Scotsman fluent in that language, Reid seemed to be an ideal candidate. Victoria interviewed him and his reputed skill, honesty and good humour won the day. So at the tender age of 31 James Reid got the job of Resident Medical Attendant.

Queen Victoria, by now aged 62, suffered chronic indigestion, rheumatism, had cataracts and above all was a chronically anxious and depressed individual and had become a demanding, manipulative and creative invalid. Reid saw her three or four times a day and often during the night to hear her recount her fears and ruminate about her sins. Despite all this - and crucial to the story - apart from feeling her pulse he never physically examined the regal personage. The first time he ever saw her undressed and lying down was on 16 January 1901, six days before she died, which is when the story gets interesting.

In 1898 the old Queen handed Reid two memoranda and spoke about what she wished to be done on her death. The papers had been written 24 years before in 1875. One stated she wished her ‘devoted personal attendant and true friend John Brown' to be near at hand when she was on her deathbed. As he had died in 1883, this request was redundant. The second note gave rambling instructions regarding the family and, crucially, what the attendant physician had to do in secret.

After her majesty's death on 22 January 1901 she was undressed and for the first time ever her doctor of 20 years saw her naked. To his surprise he saw she had a large ventral hernia and uterine prolapse. The ventral hernia was a great bulge in the abdominal wall due to weakness of the muscles probably a result of her nine pregnancies. The prolapse was a falling of the uterus down the vagina. There are several degrees of this condition from an unseen slight descent, to the appearance of a lump at the vaginal orifice to the actual exterioration of the whole organ to the outside. The latter is uncommon, but again a prolapse is related to a long obstetrical history. As Reid made no record and his patient had been too embarrassed to mention it, we do not know the womb's degree of descent.

The body was washed and numerous memorabilia placed in the coffin by the staff. These included photographs, the dressing gown of her late husband, Prince Albert, plaster casts of the hands of some relatives, children's embroidery and flowers. Then came the furtive act entrusted to Sir James Reid three years before and which he recorded in his diary.

While the maids fussed about assembling the various bits of bric-a-brac, Reid approached the body from the left side. He quietly moved the flowers nestling in the dead Queen's left hand and placed a photograph of John Brown and a lock of her old retainer's hair wrapped in tissue paper in that hand. The Queen had stipulated the side, possibly as it was nearer the heart. Sir James also put a second wedding ring on one of her fingers. The first ring was given by Prince Albert on their marriage; the second had been given to her years before by John Brown (it had belonged to his mother).

John Brown had been Queen Victoria's personal servant, originally at Balmoral, next Windsor and then Osborne House on the Isle of Wight where the Queen had died. He had worked for her for 34 years. After Albert's death, Brown became a close attendant who helped her onto her horse and served at table. He was the only person able to speak gruffly to her and be rude without admonishment. The degree of closeness of their association is pure speculation and certainly nobody knows whether or not they had a sexual relationship. Nonetheless the ring was pretty significant circumstantial evidence. Reid's diary throws no light on the matter.

Be that as it may, having completed his charge, the faithful doctor rearranged the flowers and casually moved away knowing his act of homage had been unobserved. When the family viewed the body no mention was made of the pious act, presumably because nobody was aware of it.

So Queen Victoria carried her secret to the grave and presumably the photo, hair and ring are still there in her grave located in the royal mausoleum at Frogmore in Windsor Great Park. It is highly unlikely anyone will look inside her coffin to find out in our lifetime.

Extract from Not Your Ordinary Doctor by Jim Leavesley, in which he looks at about 60 doctors who have found fame in areas other than medicine. Published by Allen and Unwin, December 2010.