Peters T J
Iron Lock Cottage, Beeston Brook, Tiverton, Tarporley, Cheshire CW6 9NH, UK.
J R Coll Physicians Edinb. 2013;43(2):161-8. doi: 10.4997/JRCPE.2013.215.
Retrospective diagnosis of illness in historical figures is a popular but somewhat unreliable pastime due to the lack of detailed information and reliable reports about clinical features and disease progression. Modern computer-based diagnostic programmes have been used to supplement historical documents and accounts, offering new and more objective approaches to the retrospective investigations of the medical conditions of historical persons. In the case of King George III, modern technology has been used to strengthen the findings of previous reports rejecting the popular diagnosis of variegate porphyria in the King, his grandson Augustus d'Esté and his antecedent King James VI and I. Alternative diagnoses based on these programmes are indicated. The Operational Criteria in Studies of Psychotic Illness (OPCRIT) programme and the Young mania scale have been applied to the features described for George III and suggest a diagnosis of bipolar disorder. The neuro-diagnostic programme SimulConsult was applied to Augustus d'Esté and suggests a diagnosis of neuromyelitis optica rather than acute porphyria with secondarily multiple sclerosis, as proposed by others. James VI and I's complex medical history and the clinical features of his behavioural traits were also subjected to SimulConsult analysis; acute porphyria was rejected and the unexpected diagnosis of attenuated (mild) Lesch-Nyhan disease offered. A brief review of these approaches along with full reference listings to the methodology including validation are provided. Textual analysis of the written and verbal outputs of historical figures indicate possible future developments in the diagnosis of medical disorders in historical figures.
由于缺乏关于临床特征和疾病进展的详细信息及可靠报告，对历史人物的疾病进行回顾性诊断是一种流行但不太可靠的消遣方式。现代基于计算机的诊断程序已被用于补充历史文献和记录，为回顾性研究历史人物的健康状况提供了新的、更客观的方法。以乔治三世国王为例，现代技术已被用于强化先前报告的结果，这些报告否定了对国王本人、其孙子奥古斯塔斯·德·埃斯特以及其先辈詹姆斯六世和一世普遍诊断的混合型卟啉病。文中指出了基于这些程序的其他诊断结果。用于精神病性疾病研究的操作标准（OPCRIT）程序和青年躁狂量表已应用于乔治三世所描述的特征，并提示诊断为双相情感障碍。神经诊断程序SimulConsult已应用于奥古斯塔斯·德·埃斯特，结果提示诊断为视神经脊髓炎，而非其他人所提出的急性卟啉病继发多发性硬化。詹姆斯六世和一世复杂的病史及其行为特征的临床特点也接受了SimulConsult分析；急性卟啉病被排除，并给出了出人意料的诊断结果，即症状减轻（轻度）的莱施-奈恩病。本文简要回顾了这些方法，并提供了包括验证在内的方法学的完整参考文献列表。对历史人物书面和口头记录的文本分析表明了对历史人物疾病诊断未来可能的发展方向。
