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HOME > PAST ISSUE > May-June 2009 > Article Detail

MARGINALIA

Darwin’s Enigmatic Health

After his world travels, Darwin became ill—but the cause remains unknown

Keith Thomson

More Theories than Conclusions

Many books and articles have been written about Darwin’s afflictions. The latest and best of these is Darwin’s Illness by the psychiatrist Ralph Colp, Jr., a revision and extension of his To Be an Invalid, published in 1977. New readers of Colp’s work will be amazed at the depth of Darwin’s physical miseries and shocked at their persistence. They will perhaps be less surprised by the ineffectiveness of contemporary doctors or the primitiveness of their remedies.

Modern attempts to explain the causes of Darwin’s ill health often concentrate on its later manifestations and the dramatic “stomach” problems. As reviewed by Colp, the suggested causes range from hiatus hernia of the diaphragm to arsenic poisoning, lupus erythematosus, adrenal disease and giardiasis (a parasitic bowel infection, also known as the “beaver fever” of travelers). Recently, Crohn’s disease has been proposed, along with systemic lactose intolerance (a late-developing, secondary type). The last two would account for the exhaustion, pain and vomiting and might be alleviated by dieting, but they are usually associated with diarrhea, one of the few symptoms of which Darwin did not complain. Allergies have been proposed, among the more ingenious being an allergy to his experimental pigeons. None of these suggestions has proved fully satisfactory or convincing.

Colp, although recognizing the psychosomatic elements of Darwin’s illnesses, in addition favors the opinion that Darwin suffered from Chagas disease (a form of trypanosomiasis). Darwin was definitely bitten by the cinch bug vector (Triatoma infestans) in South America on at least one occasion, but he did not show the typical initial local infection that is caused by rubbing the bug’s excreta into the open bite. (All accounts say that, unlike malaria, Chagas is difficult to acquire from the bite alone.) Nor did Darwin display typical late symptoms, which has led Colp to propose that he suffered first a subclinical version and then a secondary manifestation.

Among conditions that have not yet been proposed or fully explored for Darwin, as far as I can determine, are hypoglycemia, celiac disease (allergy to wheat gluten) and gastroesophageal reflux disease. All three may show adult onset. Reflux is an interesting possibility because it is helped by sitting upright and also causes nighttime waking. In extreme manifestations, the pain, gas and cramping in the upper abdomen are severe. It is very sensitive to stress and, if unaddressed, its effects increase with time.




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