Darwin's lifelong illness gets a diagnosis
■ A chronic condition more frequently seen in children plagued the "father of evolution" during much of his life, according to a new study.
That Charles Darwin was incapacitated by seasickness for much of his historic voyage on the HMS Beagle may not be surprising. But the author of The Origin of Species experienced disabling nausea and vomiting for most of his life, and a researcher has now put a name to that illness -- cyclical vomiting syndrome.
Symptoms of the syndrome are an "extraordinary" match with Darwin's description of the illness that often incapacitated him into adulthood, said Dr. John Hayman, associate professor of anatomy and developmental biology at Monash University in Melbourne, Australia. He offered his diagnosis in a report posted online in December.
"My original thought was that he may have had abdominal migraine, but his symptoms did not match exactly," Dr. Hayman wrote in an e-mail. "Abdominal migraine led me to CVS, and here the symptoms seem to match."
Darwin's illness has been attributed over time to hypochondria, panic disorder, middle ear damage, arsenic poisoning from prescribed drugs and Chagas' disease from an insect bite. Dr. Hayman points out that those theories have been disallowed.
But a diagnosis of CVS fits, due to its episodic nature and association with motion sickness and atopic dermatitis, which is also among Darwin's symptoms. And the syndrome is brought on by stress -- even pleasurable stress, Dr. Hayman said.
Although CVS is primarily a disease of children, it may persist into adulthood or appear for the first time in adulthood. "This disease is neither well-known nor well-recognized, particularly in adults, although it was first described in the English literature in 1882," Dr. Hayman said.
The chronic, intermittent condition also has been linked to genetic abnormalities, and Darwin's mother and uncle had symptoms of the illness, Dr. Hayman wrote.
Darwin experienced the disorder before he boarded the Beagle and was aware he could feel worse at sea. While aboard on Dec. 30, 1831, he wrote in his diary: "Wretchedly out of spirits and very sick. I often said before starting that I had no doubt I should frequently repent of the whole undertaking, little did I think with what fervour I should do so."
Darwin also seemed to recognize that the syndrome could be triggered by pleasurable events. After his voyage, he told a former shipmate that he could not bear a visit from him. "Twice lately I could not resist seeing old friends ... and the excitement made me so ill afterwards that I have been advised not to do so again," Darwin wrote.
He underwent many medical treatments without lasting improvement, Dr. Hayman said. The most famous was cold water therapy at a British clinic.
Dr. Hayman was surprised that Darwin accomplished so much in his life, considering his struggles with CVS. "He was fortunate in having a very supportive wife, devoted servants and loyal colleagues. And, of course, he was wealthy -- he did not have to work for a living. But above all, it was his great intellect and powers of observation and deduction that drove him even when sick."
Darwin likely was affected by CVS for at least 50 years, although the syndrome became less severe in his later life, Dr. Hayman said. Darwin died in 1882 at 73 with symptoms of heart failure and cardiac ischemia.
The report wasd posted online Dec. 13, 2009, by the BMJ (link).