Darwin’s illness explained
© 2013 Roy Benaroch, MD
What Charles Darwin did was really quite extraordinary. Evolution, per se, had been thought about for centuries—his own grandfather, Erasmus, had the idea of species sharing a common ancestor pretty well worked out. What Darwin did was introduce a mechanism, natural selection, that fit and explained his precise observations of the variability of species across different environments. If you’ve got some time (and maybe a few cups of coffee), read through his On the Origin of Species. It painstakingly, slowly, and very thoroughly walks though the mechanism of evolution, stopping at every step to ensure that observations from the natural world support his idea.
Darwin spent most of his life ill, starting with his voyage on The Beagle. In a Christmas, 2009 article from the British Medical Journal, professor John Hayman commemorated Darwin’s 200th birthday by trying to figure out just what malady caused his suffering. The article is behind a paywall, which is too bad. It’s pretty cool. Luckily, you’ve got me to summarize it for you:
Darwin suffered from what had been assumed to be severe sea-sickness during his journey, with episodes of nausea, vomiting, abdominal pain, weakness, and lethargy. He also complained of disabling visual disturbances, palpitations, dizziness, and “inordinate flatulence.” These symptoms occurred in spells or attacks throughout the rest of his life, though it appears that in between spells he felt fairly well—well enough to father 10 children. He also lived to the age of 73. Whatever caused these symptoms, it probably wasn’t something progressive that killed him.
A number of historians have suggested psychological diagnoses, including hypochondria and panic attacks; others have speculated that his symptoms stemmed from guilt related to issues in his relationships with his father and wife, or misgivings about how his theories fit in with his theological beliefs. Others have proposed a number of different medical diagnoses, including Meniere’s Disease, arsenic poisoning, and Chagas Disease.
In this review, the author makes a compelling case for a different diagnosis: migraine. Though most migraines in adults are dominated by headaches, in children (and some adults) the primary symptoms can be in the gut: abdominal pain, nausea, and vomiting. Terms such as “cyclic vomiting syndrome” and “abdominal migraine” are now being used to describe these atypical migraines. They’re not terribly uncommon, and they can truly be disabling. As with other migraine conditions, there are no symptoms between attacks. We don’t know for sure, but it seems likely that migraine was the cause of Darwin’s illness.
Darwin had no knowledge of genes or mutations or chromosomes—these concepts and discoveries developed later, and have provided molecular confirmation of Darwin’s theory. Archeology has also progressed exponentially since Darwin’s time, and the accumulated evidence from bench science, anthropology, archeology, and molecular genetics has reinforced the usefulness and basic truth of Darwin’s theory. I wonder how much further he could have gone with a few basic tools to treat his migraines.