There is a prevalent consensus that most of Charles Darwin’s lifelong symptoms are not attributable to organic disease.1-5 It would seem unlikely that he contracted chronic Chagas disease in South America, because his symptoms began before he ever set foot on the HMS Beagle.2 His various complaints were intermittent, many improved with age, and he had a long life, dying from a heart attack at age seventy-three. Nor is it likely that he suffered for decades from brucellosis, myocarditis, narcolepsy, diabetic hypoinsulinism, “suppressed gout,” “catarrhal dyspepsia,” Ménière’s disease, or allergy to pigeons.1-5 He may have had the occasional symptom from the medications he was taking throughout his life, including arsenic that may have been the cause of his skin eruptions.
Many authors have focused on his relations with the various members of his family.3 He came from a family of doctors, grandfather Erasmus being the most illustrious. Charles’s mother died when he was eight, and his sisters never filled her place. With his father Robert Waring, a prominent no-nonsense physician, he had a complex relationship, and he went on the Beagle voyage against his wishes.2,3 At one time his father admonished him that he would never amount to anything as he cared only for shooting, dogs, and rat catching.3 It seems that his father was one of the several physicians taking care of his symptoms, and may have been more comfortable with a doctor-patient arrangement substituting for a close father-son relationship.3 Then there were also difficulties with Emma, his deeply religious wife, who could not understand how such a nice and gentle man would get involved in propounding theories so at variance with the teaching of the established Church of England and the Christian dogma.1,3
In the absence of a proven organic disease, many authors have focused on possible afflictions of the mind. Mild depression, though unlikely, was suggested by the psychiatricaly inclined gastroenterologist from the Mayo Clinic, Dr. Walter C Alvarez, author of the once widely read Nervousness, Pain, and Indigestion. More persuasive was the suggestion of Barlow and Noyes that Darwin had panic attacks and agoraphobia, a combination in itself sufficient to account for most of the reported symptoms.4 These would not necessarily explain the daily flatulence and gastrointestinal symptoms, and in 2009 Dr. John Hayman postulated that Darwin suffered from cyclical vomiting syndrome, with secondary complications such as atopic dermatitis with staphylococcal infections, inherited from a maternally pathological mitochondrial DNA mutation.6 Yet whatever the underlying cause, Darwin clearly exhibited symptoms of a long-standing neurosis, anxiety state, obsessional hypochondriasis, or perhaps a chronic personality disorder that would constitute as much of the make-up of a person as the shape of his head, nose, or feet.
There also remains the issue of the relation between such a disordered state of mind, whatever that may have been, and creativity or intellectual activity. William Bean, the prolific editor of the Archives of Internal Medicine, once stated that creativity comes from what, for a lack of a better name, might be called the unconscious, the subconscious, or an intermediate form of mentation, perhaps something like Freud’s id. Imagination, creativity, and discovery often tend to come unbidden and in some ways may be promoted by illness.1 Sir George Pickering also wrote about this in his Creative Illness, and in the case of Florence Nightingale stressed the advantages of getting one’s way in getting things done through chronic invalidism.7 Darwin seems to have been able to take advantage of his illness to get more time for his work, seclusion, and protection from visitors, friends and social obligations, committees, membership in societies, and other activities that would take him away from his work.3 Famously he delayed publishing his theories on evolution until shaken into activity by the threat of being preempted by his friend Alfred Russel Wallace.5 No doubt there will be in the future more reviews and more theories about this famous man’s illnesses. Yet no one can lift the veil over the mystery that each human being is a complex psychological construct, unique and different from others, and the author of On the Origin of Species was clearly unlike anybody else.
- Bean WB. The illness of Charles Darwin. American Journal of Medicine 1978; 65: 572 (Sept)
- Woodruff AW. Darwin’s health in relation to his voyage to South America. British Medical Journal 1965,1: 745 (March)
- Katz-Sidlow RJ. In the Darwin family tradition: another look at Charles Darwin’s ill health. Journal of the Royal Society of Medicine 1998; 91: 484 (Sept)
- Barloon TJ and Noyes R. Charles Darwin and panic disorder. JAMA 1997; 227: 138 (Jan)
- Beninder E. The descent of man and the ascent of the Darwins. Hospital Practice 1983; page 203
- Hayman J. Charles Darwin’s illness revisited. British Medical Journal 2009;339: b4968
- Pickering G. Creative malady. London, George Allen and Unwin Ltd 1974
GEORGE DUNEA, MD, Editor-in-Chief