Charles Darwin's illness

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In 1837, soon after returning from the flve-year expedition of H.M.S. Beagle, Charles Darwin developed a mysterious illness, which continued almost to his death, 45 years later. Over the next few years he became progressively weaker until in 1842, he and his wife Emma retired to their country house in Kent.

Darwin's medical complaints included intestinal, circulatory and nervous symptoms. His complaints of indigestion suggest upper intestinal tract disease, but are not characteristic of any disease in particular. Darwin often referred his "palpitations", which might have been an arrhythmia; but precordial pain is not often mentioned and no shortness of breath or fluid retention was ever noted. His nervous symptoms are mentioned repeatedly in letters but never in much detail. He seems to have had good days and bad days, and the main feature of the bad days was exhaustion.

Darwin's own doctors seem to have been helpless; some thought him a hypochondriac, and the suspicion that they did so caused Darwin real distress. He was examined by a succession of famous physicians, including his father, Francis Darwin, but little is known about their diagnoses or recommended treatments.

"You are very kind in your inquiries about my health; I have nothing to say about it, being always the same, some days better and some days worse. I believe I have not had one whole day, or rather night, without my stomach having been greatly disordered, during the last three years, and most days great prostration of strength: thank you for your kindness; many of my friends, I believe, think me a hypochondriac." Darwin's letter to his friend Sir Joseph Dalton Hooker, an English botanist and traveller, written in 1845:

By March 28, 1849, Darwin felt that he was dying:

"I was not able to do anything one day out of three, & was altogether too dispirited to write to you or to do anything but what I was compelled. I thought I was rapidly going the way of all flesh."

"Some modern medical historians with a psychoanalytic bent have found "a wealth of evidence that unmistakably points" to the idea that Darwin's illness was "a distorted expression of the aggression, hate, and resentment felt, at an unconscious level, by Darwin towards his tyrannical father". One suggests that his turning to science was mainly the consequence of "reaction to sadomasochistic fantasies concerning his own birth and his mother's death". Another explains how in dethroning his Heavenly Father Darwin found solace for being unable to slay his earthly one. Attention has further been drawn to a continuous preoccupation on the part of Darwin with matters to do with sex. Revealing himself as a master ironist,Peter Medawar remarks on this last point:"We need look no further than the titles of his books: The Origin itself, of course; Selection in Relation to Sex; The Effects of Cross- and Self-Fertilization in the Vegetable Kingdom; and On the Various Contrivanoes by which Orchids are Fertilized by Insects. With so great a load of guilt, need we wonder that at the age of 33 Darwin should have retired from public life to live in quiet seclusion in the country? It was a sacrificial gesture, even a crucifixion: and Kempf calls attention to the inner significance of the fact that it was at the age of 33 that Christ himself was crucified." Editorial (1964) Darwin's Illness Canad Med Ass J 51:1371-2

Darwin and Dr Gully

Darwin diagnosed his own condition as "nervous dyspepsia" and on the advice of a cousin, he traveled with his family over 100 miles to the clinic and “water-cure” spa of Dr James Manby Gully at Malvern in Kent on March 10, 1849. Dr Gully had written a popular book called The Water Cure in Chronic Disease and identified himself as a homeopathic physician. Darwin was skeptical of homeopathy, and on March 19 he wrote:

“I grieve to say that Dr Gully gives me homeopathic medicines three times a day, which I take obediently without an atom of faith.”

Just eight days after arriving at Malvern, Darwin experienced a skin eruption all over his legs.

"I was at the time so unwell that I was unable to travel which added to my misery. Indeed all this winter I have been bad enough, with dreadful vomiting every week, & my nervous system began to be affected, so that my hands trembled & head was often swimming. I was not able to do anything one day out of three, & was altogether too dispirited to write to you or to do anything but what I was compelled.— I thought I was rapidly going the way of all flesh. Having heard, accidentally, of two persons who had received much benefit from the Water Cure, I got Dr Gully's bookf1 & made further enquiries, & at last started here, with wife, children & all our servants. We have taken a house for two month & have been here a fortnight. I am already a little stronger & now have had no vomiting for 10 days. Dr G. feels pretty sure he can do me good, which most certainly the regular Doctors could not. At present, I am heated by Spirit lamp till I stream with perspiration,f2 & am then suddenly rubbed violently with towels dripping with cold water: have two cold feet-baths, & wear a wet compress all day on my stomach. I eat simply, dine at 1 oclock & take several short walks daily. Even in first 8 days the treatment brought out an eruption all over my legs. I mention all this to you, as being a medical man, you might possibly like to hear about it.— I feel certain that the Water Cure is no quackery.— How I shall enjoy getting back to Down with renovated health, if such is to be my good fortune, & resuming the beloved Barnacles."

After two weeks of treatment, Darwin wrote "I much like and think highly of Dr Gully." On March 28, he had not have any vomiting for 10 days (a rare experience for him). On April 19 Darwin wrote:

“I now increase in weight, have escaped sickness for 30 days, which is thrice as long an interval, as I have had for last year; & yesterday in 4 walks I managed seven miles! I am turning into a mere walking and eating machine.”

Darwin stayed at Gully's clinic for four months. Shortly after returning home, he re-experienced his nausea, and he continued to experience digestive problems throughout his life, though he no longer experienced many of his other symptoms (fainting spells, spots before his eyes, and extensive boils) and was able to resume working.

Despite the benefits that Darwin seemed to experience, he remained skeptical about homeopathy. Three months after leaving Gully’s clinic, he wrote:

"You speak about Homœopathy; which is a subject which makes me more wrath, even than does Clairvoyance: clairvoyance so transcends belief, that one's ordinary faculties are put out of question, but in Homœopathy common sense & common observation come into play, & both these must go to the Dogs, if the infinitesimal doses have any effect whatever. How true is a remark I saw the other day by Quetelet, in respect to evidence of curative processes, viz that no one knows in disease what is the simple result of nothing being done, as a standard with which to compare Homœopathy & all other such things. It is a sad flaw, I cannot but think in my beloved Dr Gully, that he believes in everything when his daughter was very ill, he had a clairvoyant girl to report on internal changes, a mesmerist to put her to sleep, an homœopathist, viz Dr. Chapman; & himself as Hydropathist! & the girl recovered.”

According to Darwin's son, Francis, Gully's cures had only a transient effect

"He was urged to try to water cure by Fox (or Sulivan) and at last agreed to try Dr. Gully's establishment.1 — His letters to Fox show how much good the treatment did him: I fancy he thought that he found a cure for his troubles, which but like all other remedies it had only a transient effect on him. However he found it at first so good for him that he built himself a douche when he came home, & Parslow learned to be his bathman. He thought Dr. Gully a clever Dr but I do not think he liked him. He was repelled by all the homeopathy & spiritualism that Dr Gully favoured. — He so far humoured Dr G. as to allow himself to be examined by a medical clairvoyante who localized the mischief in the stomach, in doing so he followed as my father believed some unconscious hints from Gully or his assistant."

However, when, 1n 1851, Darwin's daughter Annie had persistent indigestion he took her to Gully's clinic on 24 March. Gully repeatedly reassured them that she was recovering, but Annie died on 23 April.

Hydrotherapy: Darwin and Dr Lane

Darwin never returned to Malvern, but found another hydrotherapist, Dr Edward Wickstead Lane. Darwin's condition then was much as when he had first seen Gully, and Dr Lane later wrote

"I cannot recall any [case] where the pain was as poignant as his. When the worst attacks were on, he seemed crushed with agony."

Lane's regime did not include clairvoyance, mesmerism or homeopathy; as Darwin wrote, Lane did "not believe in all the rubbish which Dr G. does," and Darwin became a convert, "well convinced that the only thing for Chronic cases is the water-cure", and wrote "I really think I shall make a point of coming here for a fortnight occasionally, as the country is very pleasant for walking." He told Hooker he had

"already received an amount of good, which is quite incredible to myself & quite unaccountable.—I can walk & eat like a hearty Christian; & even my nights are good.— I cannot in the least understand how hydropathy can act as it certainly does on me. It dulls one's brain splendidly, I have not thought about a single species of any kind, since leaving home."

Hydrotherapy, as practised by Lane, Gully and many others, was a treatment for chronic illness, and was conceived as working by promoting the "Power of Nature" to effect a cure. Treatment involved withdrawal from all drugs; according to Gully, quoting John Forbes, "in a large proportion of the cases treated by allopathic physicians, the disease is cured by Nature and not by them"; that "in a lesser, but still not a small proportion, the cured by Nature in spite of them"; and that consequently, in most cases it would be better "if all remedies, especially drugs, were abandoned." Hydrotherapy involved removing all stimulants including alcohol from the diet, and required quiet rest and a degree of seclusion - the cure would not work, according to Gully, if attempted amidst the gaiety and distractions of city life. Gully asserted nothing miraculous or supernatural about the healing properties of water; for him hydrotherapy involved a clean and simple diet in restful surroundings , with frequent mineral water baths, foot baths, douches etc. - and drinking mainly water.

Unending speculation

Many books and papers have tried to explain Darwin’s illness as organic or psychosomatic, including arsenic poisoning, typhoid, Chagas’ disease(Darwin had described being bitten by Reduviid bugs while crossing the Andes) , multiple allergy, hypochondria, panic disorder with agorophobia repressed anger towards his father Cron's disease .or bereavement syndrome. His medical history shows he had an organic problem, exacerbated by depression. According to Campbell and Mathews (2005), all Darwin’s symptoms match systemic lactose intolerance; in particular, vomiting and gut problems showed up two to three hours after a meal, the time it takes for lactose to reach the large intestine, and his family history shows a major inherited component, as with genetically predisposed hypolactasia. Darwin only got better when, by chance, he stopped taking milk and cream.