Hayman John, Finsterer Josef
Clinical Pathology, The University of Melbourne, Melbourne, AUS.
Neurology, Krankenanstalt Rudolfstiftung, Vienna, AUT.
Cureus. 2022 Nov 30;14(11):e32065. doi: 10.7759/cureus.32065. eCollection 2022 Nov.
Charles Darwin suffered from a relapsing, debilitating illness for much of his adult life with numerous, differing symptoms. His occasional problems as a student, his seasickness throughout the voyage of the , and his brief illnesses when ashore in South America and Australia were all early expressions of this illness. Diagnoses for Darwin's illness are as numerous as his symptoms and are equally variable. Many diagnoses reflect the medical fashion of their time; psychological and psychogenic diagnoses once flourished. These diagnoses have recently been comprehensively reviewed in an uncritical and unbiased account. Rather than a repeat review of diagnoses this paper aims to critique and make a critical appraisal of the diagnoses given. As stated, they are not all right. Some are not wrong but are simply incomplete. Pathological mitochondrial DNA (mtDNA) mutations are the cause of a variety of childhood diseases and more recently have been recognized as the cause of some adult-onset conditions with a plethora of presenting symptoms. The diagnosis favored here is that Darwin suffered from such a disorder due in his case to a maternally inherited pathological mtDNA mutation. This proposal should be seen in the context of and subject to similar critical appraisal. Diagnosing Darwin may have a unique, correct solution, a solution that would benefit those who suffer from a similar disorder today and who, like Darwin, are misdiagnosed, misunderstood, and inappropriately treated.
查尔斯·达尔文成年后的大部分时间都患有反复发作、使人衰弱的疾病,症状多种多样。他学生时代偶尔出现的问题、在整个航行过程中的晕船,以及在南美洲和澳大利亚上岸时的短暂疾病,都是这种疾病的早期表现。对达尔文疾病的诊断和他的症状一样多,而且同样各不相同。许多诊断反映了当时的医学潮流;心理和心因性诊断曾一度盛行。最近有人对这些诊断进行了全面、不加批判且公正的回顾。本文并非要重复对诊断的回顾,而是旨在对已给出的诊断进行批判和批判性评价。如前所述,它们并非全对。有些并非错误,只是不完整。病理性线粒体DNA(mtDNA)突变是多种儿童疾病的病因,最近还被认为是一些具有大量症状的成人发病疾病的病因。这里倾向的诊断是,达尔文患有这样一种疾病,在他的病例中是由于母系遗传的病理性mtDNA突变所致。这一观点应放在相应背景下看待,并接受类似的批判性评价。诊断达尔文的疾病可能有一个独特、正确的答案,这个答案将造福于如今那些患有类似疾病、像达尔文一样被误诊、误解和接受不恰当治疗的人。