The very travels that inspired Charles Darwin's theory of evolution and shaped modern biology may have led to one of the illnesses that plagued the British naturalist for decades and ultimately led to his death, a gastroenterologist said Friday.
Darwin's ailments were the topic of an annual conference in Baltimore that offers modern medical diagnoses for the mysterious illnesses and deaths of historical figures. In past years, the conference hosted by the University of Maryland School of Medicine and Veterans Administration's Maryland Health Care System has looked at Alexander the Great, Wolfgang Amadeus Mozart and Booker T. Washington.
"It is particularly poignant that the scientists and physicians of his time could not provide Darwin, the father of modern life sciences, with relief from the ailments that affected so much of his life," said Philip A. Mackowiak, the VA Maryland medical care clinical center chief and UM medical school professor who started the conference in 1995. He had Darwin on his running list of candidates for years.
During Darwin's life and after his death, many diagnoses have been made, but gastroenterologist Dr. Sidney Cohen, Thomas Jefferson University medical college professor of medicine and research director, said many of them just don't fit. Cohen, who assessed Darwin's ailments for the conference, identified three illnesses: cyclic vomiting syndrome, Chagas disease and Helicobacter pylori.
"One illness did not explain his ailments," Cohen said. "There were symptoms all over the place. Putting it all together over his lifetime with multiple illnesses made it work."
Darwin, who lived from 1809 to 1882, traveled the world in his 20s cataloging and observing wildlife and later published "On the Origin of Species." Throughout his life, Darwin sought help for multiple health problems, which at times included vomiting stomach acids after every meal, violent cardiac palpitations and headaches. He was diagnosed with many conditions including schizophrenia, hypochondria and appendicitis.
Cohen concluded that Darwin suffered from cyclic vomiting syndrome early in his life with recurrent bouts of vomiting, alternating with periods of normal health. His weight and nutrition remained normal because he rarely vomited food, just stomach acid and other secretions.
The gastroenterologist also believes Darwin contracted Chagas disease during his five-year trip around the globe on the HMS Beagle in his 20s. The hypothesis involving the parasitic illness that can lie dormant for years has been advanced in the past.
Darwin wrote about being bitten by a triatomid, which can carry the illness, while traveling in Argentina, Cohen said. He also told of suffering a feverish illness after being bitten, as those infected with Chagas would. That illness aligns with Darwin's gastrointestinal complaints and the heart disease that beset Darwin later in life and eventually caused his death, Cohen said.
He believes Darwin also suffered from Helicobacter pylori, the bacteria that cause peptic ulcer disease and often occurs with Chagas.
In modern times, cyclic vomiting might be treated with anti-migraine drugs with some success, Cohen said. But treatment for Chagas might still be difficult after the illness damages the body, he said.
Ruth Padel, a poet and great-great-granddaughter of the patient being discussed, read to the audience at the conference from her book, "Darwin: A Life in Poems," including a poem about the insect that bit him, how he watched it fill up with blood and the process of Chagas disease within the body.
Darwin's ailments did not keep him from his work, but his work and personal experiences with illness _ both his own and his childrens' _ influenced each other. When his daughter died around the time that he was making many of his realizations about evolution, he was haunted by two ideas: that her illnesses _ now thought to be tuberculosis _ could have been inherited from him, and that inbreeding _ he had married his first cousin _ weakened the species, Padel said.
"He felt responsible," she said. "The loneliness after that, realizing that this was survival of the fittest in action. The bleakness of his own theories played out in his own family was really very painful."