Darwin’s Disease

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“Every generation thinks they have the answers to life’s great questions . . . .”

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The University of Maryland School of Medicine annually invites specialists to apply modern medical insight to history’s enigmatic sufferers. They recently considered the baffling maladies afflicting Charles Darwin. He suffered intermittent chronic vomiting most of his life, but additional problems struck him after his historic voyage. Gathering clues from photographs and written descriptions, the group believes he had long suffered a non-debilitating chronic ailment but then contracted Chagas’ disease during the voyage of the Beagle. He was bitten by a South American bug now known to carry the parasitic disease. The disease may lie dormant for decades and emerge to cause digestive and cardiac problems. Chagas’ disease was probably the cause of his cardiac disease and death 47 years later.

Of course, given that it is impossible to go back and test these conclusions scientifically, Dr. Philip Mackowiak, director of the conference and author of the book Post Mortem: Solving History's Great Medical Mysteries, acknowledges their limitations. But he hopes “that these historical reassessments hold a lesson for today’s physicians. Every generation thinks they have the answers to life’s great questions, and subsequent generations say, ‘Aren’t they quaint? What were they thinking of?’ In trying to do the best we can, we have to be humble and realize that in the final analysis, it [our best answers] may not be all that good.”

Thank you, Dr. Mackowiak, we couldn’t have said it better ourselves. Even with patients in front of us, we as physicians sometimes find that with the best that science has to offer, answers can elude us. How much more is that true of our efforts when we try to draw scientific conclusions about the past. We can evaluate scientific evidence left from the past, but we can never go back to test our interpretations to see if we were right. Modern science needs to borrow a page from Dr. Mackowiak’s book of humility.

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