Charles Darwin's illness
Encyclopedia
For much of his adult life, Charles Darwin's health was repeatedly compromised by an uncommon combination of symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...

s, leaving him severely debilitated for long periods of time. However, in some ways this may have helped his work, and Charles Darwin
Charles Darwin
Charles Robert Darwin FRS was an English naturalist. He established that all species of life have descended over time from common ancestry, and proposed the scientific theory that this branching pattern of evolution resulted from a process that he called natural selection.He published his theory...

 wrote "Even ill-health, though it has annihilated several years of my life, has saved me from the distractions of society and amusement."

He consulted with more than 20 doctors, but, with the medical science
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

 of the time, the cause remained undiagnosed
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...

. He tried all available treatments, but, at best, they had only temporary success. More recently, there has been much speculation as to the nature of his illness.

Development of illness and symptoms

As a medical student at Edinburgh University, Darwin found that he was too sensitive to the sight of blood and the brutality of surgery at the time, so he turned his attention to natural history
Natural history
Natural history is the scientific research of plants or animals, leaning more towards observational rather than experimental methods of study, and encompasses more research published in magazines than in academic journals. Grouped among the natural sciences, natural history is the systematic study...

, an extramural interest he developed further when studying at the University of Cambridge
University of Cambridge
The University of Cambridge is a public research university located in Cambridge, United Kingdom. It is the second-oldest university in both the United Kingdom and the English-speaking world , and the seventh-oldest globally...

 to qualify as a clergyman.

On 10 December 1831, as he waited in Plymouth
Plymouth
Plymouth is a city and unitary authority area on the coast of Devon, England, about south-west of London. It is built between the mouths of the rivers Plym to the east and Tamar to the west, where they join Plymouth Sound...

 for the voyage on HMS Beagle
Second voyage of HMS Beagle
The second voyage of HMS Beagle, from 27 December 1831 to 2 October 1836, was the second survey expedition of HMS Beagle, under captain Robert FitzRoy who had taken over command of the ship on its first voyage after her previous captain committed suicide...

 to begin, he suffered from chest pain and heart palpitations, but told no one at the time in case it stopped him from going on the survey expedition. During the voyage, he suffered badly from sea-sickness during the eighteen months he was at sea, but he spent much of the three years and three months he was on land in strenuous exploration. In Argentina
Argentina
Argentina , officially the Argentine Republic , is the second largest country in South America by land area, after Brazil. It is constituted as a federation of 23 provinces and an autonomous city, Buenos Aires...

 at the start of October 1833, he collapsed with a fever. He spent two days in bed, and then memories of a young shipmate who had died of the fever persuaded him to take a boat down river to Buenos Aires
Buenos Aires
Buenos Aires is the capital and largest city of Argentina, and the second-largest metropolitan area in South America, after São Paulo. It is located on the western shore of the estuary of the Río de la Plata, on the southeastern coast of the South American continent...

, lying ill in his cabin until the fever passed. On 20 September 1834, while returning from a horseback expedition in the Andes
Andes
The Andes is the world's longest continental mountain range. It is a continual range of highlands along the western coast of South America. This range is about long, about to wide , and of an average height of about .Along its length, the Andes is split into several ranges, which are separated...

 mountains, he fell ill and spent the month of October in bed in Valparaiso
Valparaíso
Valparaíso is a city and commune of Chile, center of its third largest conurbation and one of the country's most important seaports and an increasing cultural center in the Southwest Pacific hemisphere. The city is the capital of the Valparaíso Province and the Valparaíso Region...

. In his journal for 25 March 1835, while to the east of the Andes near Mendoza
Mendoza, Argentina
Mendoza is the capital city of Mendoza Province, in Argentina. It is located in the northern-central part of the province, in a region of foothills and high plains, on the eastern side of the Andes. As of the , Mendoza's population was 110,993...

, he noted "an attack (for it deserves no less a name) of the Benchuca
Triatoma infestans
Triatoma infestans, commonly called vinchuca and also known as "barber bug", is a blood-sucking bug and the most important vector of Trypanosoma cruzi which can lead to Chagas disease...

, a species of Reduvius
Reduviidae
Reduviidae is a large, cosmopolitan family of predatory insects in the suborder Heteroptera...

, the great black bug of the Pampas", a member of the Triatominae
Triatominae
The members of Triatominae , a subfamily of Reduviidae, are also known as conenose bugs, kissing bugs, assassin bugs or triatomines. Most of the 130 or more species of this subfamily are haematophagous, i.e. feed on vertebrate blood; a very few species feed on other invertebrates...

 which are associated with Chagas' disease.

After the voyage ended on 2 October 1836, he quickly established himself as an eminent geologist
Geology
Geology is the science comprising the study of solid Earth, the rocks of which it is composed, and the processes by which it evolves. Geology gives insight into the history of the Earth, as it provides the primary evidence for plate tectonics, the evolutionary history of life, and past climates...

, at the same time secretly beginning speculations on transmutation
Transmutation of species
Transmutation of species was a term used by Jean Baptiste Lamarck in 1809 for his theory that described the altering of one species into another, and the term is often used to describe 19th century evolutionary ideas that preceded Charles Darwin's theory of natural selection...

 as he conceived of his theory
Inception of Darwin's theory
The inception of Darwin's theory occurred during an intensively busy period which began when Charles Darwin returned from the survey voyage of the Beagle, with his reputation as a fossil collector and geologist already established...

. On 20 September 1837, he suffered "an uncomfortable palpitation of the heart" and as "strongly" advised by his doctors, left for a month of recuperation in the countryside. That October he wrote, "Of late anything which flurries me completely knocks me up afterwards, and brings on a violent palpitation of the heart." In the spring of 1838 he was overworked, worried and suffering stomach upsets and headaches which caused him to be unable to work for days on end. These intensified and heart troubles returned, so in June he went "geologising" in Scotland and felt fully recuperated. Later that year however, bouts of illness returned — a pattern which would continue. He married Emma Wedgwood
Emma Darwin
Emma Darwin was the wife and first cousin of Charles Darwin, the English naturalist, scientist and author of On the Origin of Species...

 on 29 January 1839, and in December of that year as Emma's first pregnancy progressed, he fell ill and accomplished little during the following year.

For over forty years Darwin suffered intermittently from various combinations of symptoms such as: malaise
Malaise
Malaise is a feeling of general discomfort or uneasiness, of being "out of sorts", often the first indication of an infection or other disease. Malaise is often defined in medicinal research as a "general feeling of being unwell"...

, vertigo
Vertigo (medical)
Vertigo is a type of dizziness, where there is a feeling of motion when one is stationary. The symptoms are due to a dysfunction of the vestibular system in the inner ear...

, dizziness
Dizziness
Dizziness refers to an impairment in spatial perception and stability. The term is somewhat imprecise. It can be used to mean vertigo, presyncope, disequilibrium, or a non-specific feeling such as giddiness or foolishness....

, muscle spasm
Spasm
In medicine a spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. It is sometimes accompanied by a sudden burst of pain, but is usually harmless and ceases after a few minutes...

s and tremor
Tremor
A tremor is an involuntary, somewhat rhythmic, muscle contraction and relaxation involving to-and-fro movements of one or more body parts. It is the most common of all involuntary movements and can affect the hands, arms, eyes, face, head, vocal folds, trunk, and legs. Most tremors occur in the...

s, vomiting, cramps and colic
Colic
Colic is a form of pain which starts and stops abruptly. Types include:*Baby colic, a condition, usually in infants, characterized by incessant crying*Renal colic, a pain in the flank, characteristic of kidney stones...

s, bloating
Bloating
Bloating is any abnormal general swelling, or increase in diameter of the abdominal area. As a symptom, the patient feels a full and tight abdomen, which may cause abdominal pain sometimes accompanied by increased borborygmus or more seriously the total lack of borborygmus.-Symptoms:The most common...

 and nocturnal intestinal gas
Flatulence
Flatulence is the expulsion through the rectum of a mixture of gases that are byproducts of the digestion process of mammals and other animals. The medical term for the mixture of gases is flatus, informally known as a fart, or simply gas...

, headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...

s, alterations of vision
Visual perception
Visual perception is the ability to interpret information and surroundings from the effects of visible light reaching the eye. The resulting perception is also known as eyesight, sight, or vision...

, severe tiredness, nervous exhaustion, dyspnea
Dyspnea
Dyspnea , shortness of breath , or air hunger, is the subjective symptom of breathlessness.It is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations...

, skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...

 problems such as blister
Blister
A blister is a small pocket of fluid within the upper layers of the skin, typically caused by forceful rubbing , burning, freezing, chemical exposure or infection. Most blisters are filled with a clear fluid called serum or plasma...

s all over the scalp
Scalp
The scalp is the anatomical area bordered by the face anteriorly and the neck to the sides and posteriorly.-Layers:It is usually described as having five layers, which can conveniently be remembered as a mnemonic:...

 and eczema
Eczema
Eczema is a form of dermatitis, or inflammation of the epidermis . In England, an estimated 5.7 million or about one in every nine people have been diagnosed with the disease by a clinician at some point in their lives.The term eczema is broadly applied to a range of persistent skin conditions...

, crying
Crying
Crying is shedding tears as a response to an emotional state in humans. The act of crying has been defined as "a complex secretomotor phenomenon characterized by the shedding of tears from the lacrimal apparatus, without any irritation of the ocular structures"...

, anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...

, sensation of impending death and loss of consciousness, fainting, tachycardia
Tachycardia
Tachycardia comes from the Greek words tachys and kardia . Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate...

, insomnia
Insomnia
Insomnia is most often defined by an individual's report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions:...

, tinnitus
Tinnitus
Tinnitus |ringing]]") is the perception of sound within the human ear in the absence of corresponding external sound.Tinnitus is not a disease, but a symptom that can result from a wide range of underlying causes: abnormally loud sounds in the ear canal for even the briefest period , ear...

, and depression
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...

.

Water treatment

Darwin had no success with conventional treatments. In 1849, after about four months of incessant vomiting he took up the recommendation of his friend Captain Sulivan
Bartholomew Sulivan
Sir Bartholomew James Sulivan was a British sailor and hydrographer, born at Tregew, Flushing, near Falmouth, Cornwall.He was a leading advocate of the value of nautical surveying in relation to naval operations...

 and cousin Fox
William Darwin Fox
The Reverend William Darwin Fox was an English clergyman, naturalist, and a 2nd cousin of Charles Robert Darwin.- Early life :...

 to try the water therapy
Hydrotherapy
Hydrotherapy, formerly called hydropathy, involves the use of water for pain-relief and treating illness. The term hydrotherapy itself is synonymous with the term water cure as it was originally marketed by practitioners and promoters in the 19th century...

 regimen at Dr James Gully
James Manby Gully
Dr James Manby Gully , was a Victorian medical doctor, well known for practising hydrotherapy, or the "water cure". Along with his partner James Wilson, he founded a very successful "hydropathy" clinic in Malvern, Worcestershire, which had many notable Victorians, including such figures as Charles...

's Water Cure Establishment at Malvern
Malvern, Worcestershire
Malvern is a town and civil parish in Worcestershire, England, governed by Malvern Town Council. As of the 2001 census it has a population of 28,749, and includes the historical settlement and commercial centre of Great Malvern on the steep eastern flank of the Malvern Hills, and the former...

. He read Gully's book, which provided case histories and had a price list at the back. Darwin rented a villa at Malvern for his family and started a two-month trial of the treatment on 10 March. Gully agreed with Darwin's self-diagnosis of nervous dyspepsia
Dyspepsia
Dyspepsia , also known as upset stomach or indigestion, refers to a condition of impaired digestion. It is a medical condition characterized by chronic or recurrent pain in the upper abdomen, upper abdominal fullness and feeling full earlier than expected when eating...

 and set him a routine including being heated by a spirit lamp until dripping with perspiration, then vigorous rubbing with cold wet towels and cold foot baths, a strict diet, and walks. Darwin enjoyed the attention and the demanding regime which left him no time to feel guilty about not working. His health improved rapidly, and he felt that the water cure was "no quackery". He had no faith in the homœopathic medicines
Homeopathy
Homeopathy is a form of alternative medicine in which practitioners claim to treat patients using highly diluted preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient...

 Gully gave him three times a day but took them obediently. They stayed on until 30 June, and back home at Down House
Down House
Down House is the former home of the English naturalist Charles Darwin and his family. It was in this house and garden that Darwin worked on his theories of evolution by natural selection which he had conceived in London before moving to Downe....

, he continued with the diet and with the water treatment aided by his butler. He followed the rules about rising early and rationing his working time and had the Sandwalk constructed in the grounds for his walking exercise, setting a routine which he continued.

In September, his sickness returned during the excitement of a British Association for the Advancement of Science
British Association for the Advancement of Science
frame|right|"The BA" logoThe British Association for the Advancement of Science or the British Science Association, formerly known as the BA, is a learned society with the object of promoting science, directing general attention to scientific matters, and facilitating interaction between...

 meeting, and Darwin made a day visit to Malvern, then recuperated at home. In June 1850, after losing time to illness (without vomiting), he spent a week at Malvern. Later that year he wrote to Fox about the credulity of his "beloved Dr Gully" who when his daughter was ill, had her treated her with a clairvoyant
Clairvoyance
The term clairvoyance is used to refer to the ability to gain information about an object, person, location or physical event through means other than the known human senses, a form of extra-sensory perception...

 girl to report on internal changes, a mesmerist to put her to sleep, John Chapman
John Chapman (publisher)
John Chapman was a publisher who had medical training and was based at 142 Strand, London.His entry in the Concise Dictionary of National Biography, reads: "Chapman, John physician, author, publisher; apprencticed at Worksop and was in business in Adelaide; studied medicine in Paris and at St...

 as homœopathist and himself as hydropathist, after which Gully's daughter recovered. Darwin explained to Fox his wrathful scepticism about clairvoyance and worse, homeopathy. Thinking the infinitesimal doses were against all common sense and should be compared against the effects of no treatment at all. Gully had pestered Darwin to subject himself to clairvoyance, and when he saw the clairvoyant, he tried to test her by asking her to read the number on a banknote he had in an envelope, but she scornfully said this was something her maidservant did and proceeded to diagnose horrors in Darwin's insides, a tale he recounted for years afterwards. When Darwin's own young daughter Annie
Anne Darwin
Anne Elizabeth "Annie" Darwin was the second child and eldest daughter of Charles and Emma Darwin. According to biographers, she was a delightful child who brought much happiness to her parents. Eminent Darwin scholar E...

 had persistent indigestion, he confidently took her to Gully on 24 March 1851 and after a week, left her there to take the cure but a fortnight later was recalled by Dr. Gully as Annie had bilious fever. Dr. Gully was attentive and repeatedly reassured them that she was recovering, but after a series of crises, Annie died on 23 April. Darwin was heartbroken at this tragic loss, but surprisingly stayed well in the aftermath, busy with organising the funeral arrangements.

Darwin kept records of the effects of the continuing water treatment at home and in 1852 stopped the regime, having found that it was of some help with relaxation but overall had no significant effect, indicating that it served only to decrease his psychosomatic symptomatology.

With the memories of Annie's death, Darwin did not want to return to Malvern. In 1856, he began writing for publication of his theory
Publication of Darwin's theory
The publication of Darwin's theory brought into the open Charles Darwin's ideas of evolution through natural selection, the culmination of more than twenty years of work....

, and he pressed on, overworking, until by March 1857 illness was cutting his working day "ridiculously short". He found a new hydrotherapist, Dr. Edward Wickstead Lane, whose Moor Park
Moor Park, Farnham
Moor Park, Farnham, Surrey, England is a Grade II listed house set in some of grounds. It was formerly known as Compton Hall. The present house dates from 1630 but has been substantially altered, particularly in 1750 and 1800...

 hydropathic establishment near Farnham
Farnham
Farnham is a town in Surrey, England, within the Borough of Waverley. The town is situated some 42 miles southwest of London in the extreme west of Surrey, adjacent to the border with Hampshire...

 in Surrey
Surrey
Surrey is a county in the South East of England and is one of the Home Counties. The county borders Greater London, Kent, East Sussex, West Sussex, Hampshire and Berkshire. The historic county town is Guildford. Surrey County Council sits at Kingston upon Thames, although this has been part of...

 was only 40 miles from Darwin's home. His condition was much as when Darwin 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." Darwin arrived on 22 April and wrote to Fox that "it is really quite astonishing & utterly unaccountable the good this one week has done me", deciding to stay on to 5 May. He enjoyed the more relaxed regime, which did not include clairvoyance, mesmerism or homeopathy, as Lane did "not believe in all the rubbish which Dr G. does." Darwin became a complete 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
Joseph Dalton Hooker
Sir Joseph Dalton Hooker OM, GCSI, CB, MD, FRS was one of the greatest British botanists and explorers of the 19th century. Hooker was a founder of geographical botany, and Charles Darwin's closest friend...

 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." He then contradicted himself by asking about alpine species.

He returned to Moor Park from 16–29 June and 5–12 November 1857 and from 20 April to 3 May 1858, but this retreat was unavailable when he was shocked by receipt of Wallace's paper on 18 June, as Dr. Lane was put on trial accused of adultery with a lady patient. Darwin was able to resume treatment at Moor Park from 25–31 October 1858, as he struggled on to write On the Origin of Species despite repeated health problems. He was able to keep writing thanks to visits to the spa on 5–18 February, 21–28 May and 19–26 July 1859.

With the proofs of the book returned to the printers, he was worn out. On 2 October, he left for Ilkley
Ilkley
Ilkley is a spa town and civil parish in West Yorkshire, in the north of England. Ilkley civil parish includes the adjacent village of Ben Rhydding and is a ward within the metropolitan borough of Bradford. Approximately north of Bradford, the town lies mainly on the south bank of the River Wharfe...

 and had treatment at Ilkley Wells hydropathic establishment operated by Dr. Edmund Smith, a surgeon and hydropathic doctor. Emma brought their children on 17 October, and the family including Darwin stayed in North House, Wells Terrace, which he rented. Reading the first adverse reviews there, his health worsened with a sprained ankle followed by a swollen leg and face, boils and a rash. He had an "odious time", and wrote of Smith that "he constantly gives me impression, as if he cared very much for the Fee & very little for the patient". By 6 November, he felt worse than when he came. Emma and the children went home on 24 November. Darwin stayed on in the establishment, and for the last ten days of the stay, he felt much better. He returned home on 7 December, and under pressure of work, his health slipped back a bit.

As arguments continued, Darwin had more stomach upsets, and on 28 June 1860, two days before the famous 1860 Oxford evolution debate
1860 Oxford evolution debate
The 1860 Oxford evolution debate took place at the Oxford University Museum on 30 June 1860, seven months after the publication of Charles Darwin's On the Origin of Species. Several prominent British scientists and philosophers participated, including Thomas Henry Huxley, Bishop Samuel...

, he fled to Lane's new hydropathic establishment at Sudbrooke Park, Petersham
Petersham
Petersham is a place in the London Borough of Richmond upon Thames on the east of the bend in the River Thames south of Richmond, which it shares with neighbouring Ham. It provides the foreground of the scenic view from Richmond Hill across Petersham Meadows, with Ham House further along the River...

, near Richmond in Surrey
Surrey
Surrey is a county in the South East of England and is one of the Home Counties. The county borders Greater London, Kent, East Sussex, West Sussex, Hampshire and Berkshire. The historic county town is Guildford. Surrey County Council sits at Kingston upon Thames, although this has been part of...

 and recuperated as well as reading reports of the debate.

Darwin avoided further hydropathy, perhaps recalling his time at Ilkley, and Lane left the business for a while after selling Sudbrooke Park. In 1863, Darwin's illness worsened seriously, and Emma Darwin persuaded her husband to return to Malvern. His cousin Fox had earlier told him that Gully had suffered a mental breakdown and was unavailable. They arrived on 2 September, but Darwin felt that he was being fobbed off with the supervising physician, Dr. Ayerst. Emma arranged for Dr. Gully to attend and endorse Ayerst's treatment, but by then Darwin's eczema was too raw to bear any water. Darwin had a complete breakdown and on 13 October, left the spa worse than when he arrived. His ill health was the worst he had ever experienced and continued until the start of 1866.

Continuing illness

Darwin desperately tried many different therapies, within the limitations of medical science of his time. He took all kinds of medicines, including bismuth
Bismuth
Bismuth is a chemical element with symbol Bi and atomic number 83. Bismuth, a trivalent poor metal, chemically resembles arsenic and antimony. Elemental bismuth may occur naturally uncombined, although its sulfide and oxide form important commercial ores. The free element is 86% as dense as lead...

 compounds and laudanum
Laudanum
Laudanum , also known as Tincture of Opium, is an alcoholic herbal preparation containing approximately 10% powdered opium by weight ....

, and even tried quack
Quackery
Quackery is a derogatory term used to describe the promotion of unproven or fraudulent medical practices. Random House Dictionary describes a "quack" as a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, or...

 therapies, such as electrical stimulation of the abdomen with a shocking belt. On 16 May 1865, he wrote to John Chapman
John Chapman (publisher)
John Chapman was a publisher who had medical training and was based at 142 Strand, London.His entry in the Concise Dictionary of National Biography, reads: "Chapman, John physician, author, publisher; apprencticed at Worksop and was in business in Adelaide; studied medicine in Paris and at St...

, who was now a qualified specialist in dyspepsia
Dyspepsia
Dyspepsia , also known as upset stomach or indigestion, refers to a condition of impaired digestion. It is a medical condition characterized by chronic or recurrent pain in the upper abdomen, upper abdominal fullness and feeling full earlier than expected when eating...

, sickness and psychological medicine. Chapman had sent Darwin a book about a therapy for seasickness of applying ice bags to the small of the back, and Darwin invited him to Down House
Down House
Down House is the former home of the English naturalist Charles Darwin and his family. It was in this house and garden that Darwin worked on his theories of evolution by natural selection which he had conceived in London before moving to Downe....

 to try out this therapy. In a manuscript dated 20 May 1865, thought to have been for Chapman, Darwin described his symptoms:
In his autobiography of 1876, Darwin wrote of his illness, emphasising that it was brought on by "excitement":

Possible causes

Medical science has tried repeatedly to pinpoint the etiology
Etiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....

, and many hypotheses were made, such as:
  • Minor, spontaneous Cerebral hemorrhage with Insomnia
    Insomnia
    Insomnia is most often defined by an individual's report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions:...

  • Crohn's Disease
    Crohn's disease
    Crohn's disease, also known as regional enteritis, is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms...

  • Psychosomatic disease
  • Panic disorder
    Panic disorder
    Panic disorder is an anxiety disorder characterized by recurring severe panic attacks. It may also include significant behavioral change lasting at least a month and of ongoing worry about the implications or concern about having other attacks. The latter are called anticipatory attacks...

  • Chagas' disease
  • Ménière's disease
    Ménière's disease
    Ménière's disease is a disorder of the inner ear that can affect hearing and balance to a varying degree. It is characterized by episodes of vertigo and tinnitus and progressive hearing loss, usually in one ear. It is named after the French physician Prosper Ménière, who, in an article published...

  • Lactose intolerance
    Lactose intolerance
    Lactose intolerance, also called lactase deficiency or hypolactasia, is the inability to digest and metabolize lactose, a sugar found in milk...

  • Lupus erythematosus
    Lupus erythematosus
    Lupus erythematosus is a category for a collection of diseases with similar underlying problems with immunity . Symptoms of these diseases can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs...

  • Arsenic poisoning
    Arsenic poisoning
    Arsenic poisoning is a medical condition caused by increased levels of the element arsenic in the body. Arsenic interferes with cellular longevity by allosteric inhibition of an essential metabolic enzyme...

  • Multiple allergies
    Allergy
    An Allergy is a hypersensitivity disorder of the immune system. Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment. A substance that causes a reaction is called an allergen. These reactions are acquired, predictable, and rapid...

  • Hypochondria
    Hypochondria
    Hypochondriasis or hypochondria refers to excessive preoccupation or worry about having a serious illness. This debilitating condition is the result of an inaccurate perception of the body’s condition despite the absence of an actual medication condition...

  • Asperger's Syndrome
  • Migraine
    Migraine
    Migraine is a chronic neurological disorder characterized by moderate to severe headaches, and nausea...

    .
  • Cyclic Vomiting Syndrome
    Cyclic vomiting syndrome
    Cyclic vomiting syndrome or cyclical vomiting syndrome is a condition whose symptoms are recurring attacks of intense nausea, vomiting and sometimes abdominal pain and/or headaches or migraines...

    .
  • Chronic Fatigue Syndrome
    Chronic fatigue syndrome
    Chronic fatigue syndrome is the most common name used to designate a significantly debilitating medical disorder or group of disorders generally defined by persistent fatigue accompanied by other specific symptoms for a minimum of six months, not due to ongoing exertion, not substantially...

    .

Psychic causation

Darwin found that his illness often followed stressful
Stress (medicine)
Stress is a term in psychology and biology, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance...

 situations, such as the excitement of attending a meeting. Having escaped "smoky dirty London" to his country retreat of the former parsonage of Down House
Down House
Down House is the former home of the English naturalist Charles Darwin and his family. It was in this house and garden that Darwin worked on his theories of evolution by natural selection which he had conceived in London before moving to Downe....

 at Downe
Downe
Downe is a village in the London Borough of Bromley in London, UK.Downe is south west of Orpington and south east of Charing Cross. Downe lies in a wooded valley, and much of the centre of the village is unchanged; the former village school now acts as the village hall.-Darwin:Charles Darwin...

, he became increasingly reclusive, actually fitting a mirror outside the house, so that he could withdraw when visitors were coming around the corner. When he left, it was mostly to visit friends or relatives, though he did endeavour to meet his obligations to attend scientific meetings.

Diagnosis of panic disorder and agoraphobia

These circumstances are today considered symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...

atic of social phobia
Social anxiety disorder
Social anxiety disorder , also known as social phobia, is an anxiety disorder characterized by intense fear in social situations causing considerable distress and impaired ability to function in at least some parts of daily life...

 (fear of social contact) and agoraphobia
Agoraphobia
Agoraphobia is an anxiety disorder defined as a morbid fear of having a panic attack or panic-like symptoms in a situation from which it is perceived to be difficult to escape. These situations can include, but are not limited to, wide-open spaces, crowds, or uncontrolled social conditions...

 (in the sense of fear of social gatherings or visitors outside a defined space they feel in control of); this supports a diagnosis of panic disorder
Panic attack
Panic attacks are periods of intense fear or apprehension that are of sudden onset and of relatively brief duration. Panic attacks usually begin abruptly, reach a peak within 10 minutes, and subside over the next several hours...

, which is also common following a spontaneous Cerebral hemorrhage.
Barloon and Noyes report that as a young man, Darwin had "episodes of abdominal distress, especially in stressful
Stress (medicine)
Stress is a term in psychology and biology, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance...

 situations". He had a "premorbid vulnerability" which in his youth was referred to as "sensitivity to stress of criticism in his youth". They contend that "variable intensity of symptoms and chronic, prolonged course without physical deterioration also indicate that his illness was psychiatric." Panic disorder usually appears in the teens or in early adulthood with an association with potentially stressful life transitions. The histories of panic disorder patients often include some type of separation from a person who is emotionally important to them, which may be significant as Darwin's mother died in 1817 when he was eight, though apparently Darwin had a happy childhood overall and was encouraged by his siblings. Bowlby suggested that separation anxiety
Separation anxiety
Separation anxiety may refer to:*Separation anxiety disorder or Separation anxiety test*Spider-Man & Venom: Separation Anxiety, a 1995 SNES video game*Separation Anxieties, a 2000 album by 12 Rods...

 may help cause the development of panic disorder in adulthood and that agoraphobic patients frequently describe parents as dominant, controlling, critical, frightening, rejecting, or overprotective, which matches (disputed) descriptions of Darwin's father as tyrannical (see below).

A study by Chambless and Mason says that regardless of gender, the less masculine in trait a person afflicted with panic disorder is, the more likely they are to use avoidance (social withdrawal) as a coping mechanism. Individuals who have more masculine traits often turn to external coping
Coping (psychology)
Coping has been defined in psychological terms by Susan Folkman and Richard Lazarus as "constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing" or "exceeding the resources of the person".Coping is thus expending...

 strategies (for example, alcohol
Alcohol
In chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....

). Dr. Bean wrote that while Darwin had great confidence, at the same time he was neurotic
Neurosis
Neurosis is a class of functional mental disorders involving distress but neither delusions nor hallucinations, whereby behavior is not outside socially acceptable norms. It is also known as psychoneurosis or neurotic disorder, and thus those suffering from it are said to be neurotic...

, became nervous when his routine was altered, and was upset by a holiday, trip, or unexpected visitor.

Colp disputes a diagnosis of agoraphobia, because Darwin dutifully attended 16 meetings of the Council of the Royal Society
Royal Society
The Royal Society of London for Improving Natural Knowledge, known simply as the Royal Society, is a learned society for science, and is possibly the oldest such society in existence. Founded in November 1660, it was granted a Royal Charter by King Charles II as the "Royal Society of London"...

 and was away from home about 2,000 days between 1842 and his death in 1882, but Barloon and Noyes state that Darwin only left home infrequently, usually accompanied by his wife. They cite Darwin declining an invitation: "I have long found it impossible to visit anywhere; the novelty and excitement would annihilate me."

Psychosomatic disease, social withdrawal, and isolation may also be a result of some debilitating organic disease. Hypochondria
Hypochondria
Hypochondriasis or hypochondria refers to excessive preoccupation or worry about having a serious illness. This debilitating condition is the result of an inaccurate perception of the body’s condition despite the absence of an actual medication condition...

 could be present and represent an exacerbation of organic disease. Darwin described in great length and in extreme clinical detail his suffering in his diaries (he went to the extreme of recording daily the volume and quality of his tinnitus
Tinnitus
Tinnitus |ringing]]") is the perception of sound within the human ear in the absence of corresponding external sound.Tinnitus is not a disease, but a symptom that can result from a wide range of underlying causes: abnormally loud sounds in the ear canal for even the briefest period , ear...

). It is hard to tell whether some of his mostly subjective observations were real or imaginary.

Relationship with father

Rempf imputes a psychic cause based on the theory of Oedipal complex, proposing that Darwin's illness was "an expression of repressed
Psychological repression
Psychological repression, also psychic repression or simply repression, is the psychological attempt by an individual to repel one's own desires and impulses towards pleasurable instincts by excluding the desire from one's consciousness and holding or subduing it in the unconscious...

 anger
Anger
Anger is an automatic response to ill treatment. It is the way a person indicates he or she will not tolerate certain types of behaviour. It is a feedback mechanism in which an unpleasant stimulus is met with an unpleasant response....

 toward his father" (the physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 Robert Darwin
Robert Darwin
Dr Robert Waring Darwin, F.R.S. was an English medical doctor, who today is best known as the father of the naturalist Charles Darwin. He was a member of the influential Darwin-Wedgwood family.-Biography:...

). Rempf believed that Darwin's "complete submission" to a tyrannical father prevented Darwin from expressing anger
Anger
Anger is an automatic response to ill treatment. It is the way a person indicates he or she will not tolerate certain types of behaviour. It is a feedback mechanism in which an unpleasant stimulus is met with an unpleasant response....

 towards his father and then subsequently toward others. In a similar diagnosis, English psychiatrist Dr. Rankine Good stated, "Thus, if Darwin did not slay his father in the flesh, then he certainly slew the Heavenly Father in the realm of natural history," suffering for his "unconscious patricide
Patricide
Patricide is the act of killing one's father, or a person who kills his or her father. The word patricide derives from the Latin word pater and the Latin suffix -cida...

" which accounted for "almost forty years of severe and crippling neurotic suffering." Sir Gavin de Beer disputed this explanation, claiming a physical causation.

Darwin's autobiography says of his father, "... [he] was a little unjust to me when I was young, but afterwards I am thankful to think that I became a prime favourite with him." Bradbury quotes J. Huxley and H.B.D. Kettlew: "The predisposing cause of any psychoneurosis which Charles Darwin displayed seems to have been the conflict
Emotional conflict
"Emotional conflicts and the intervention of the unconscious are the classical features of...medical psychology" for C. G. Jung. Equally, 'Freud's concept of emotional conflict as amplified by Anna Freud...Erikson and others is central in contemporary theories of mental disorder in children,...

 and emotion
Emotion
Emotion is a complex psychophysiological experience of an individual's state of mind as interacting with biochemical and environmental influences. In humans, emotion fundamentally involves "physiological arousal, expressive behaviors, and conscious experience." Emotion is associated with mood,...

al tension springing from his ambivalent relations with his father ... whom he both revered and subconsciously resented." Bradbury also quotes John Chancellor's analysis: "... [Darwin's] obsessive desire to work and achieve something was prompted by hatred and resentment of his father, who had called him an idler and good-for-nothing during his youth."

Such psychoanalysis
Psychoanalysis
Psychoanalysis is a psychological theory developed in the late 19th and early 20th centuries by Austrian neurologist Sigmund Freud. Psychoanalysis has expanded, been criticized and developed in different directions, mostly by some of Freud's former students, such as Alfred Adler and Carl Gustav...

 remains controversial, particularly when based only on writings.

Relationship with wife, nervousness about being left alone

Peter Brent writes in his biography of Darwin, Darwin: A Man of Enlarged Curiosity, that Charles and Emma Darwin
Emma Darwin
Emma Darwin was the wife and first cousin of Charles Darwin, the English naturalist, scientist and author of On the Origin of Species...

's "ties to each other were linked to childhood and the very beginnings of memory. They had a common history, a joint tradition. It is hard to think their relationship a passionate one, but it was happy, and the happiness had deep roots." Bradbury—himself a social psychologist—draws on this biography to argue that in Darwin's letters, Emma was "always the mother, never the child, Darwin always the child, never the father." Darwin gave his wife the nickname "mammy", writing, "My dearest old Mammy ... Without you, when sick I feel most desolate .. Oh Mammy, I do long to be with you and under your protection for then I feel safe." Brent states that it is difficult to see that that this is a thirty-nine year old man writing to his wife and not a young child writing to his mother. Barloon and Noyes quote Darwin's admission to Dr. Chapman of "nervousness when Emma leaves me", which they interpret as a fear of being alone associated with his panic disorder.

Like his mother, Darwin's wife Emma was devoutly Unitarian
Unitarianism
Unitarianism is a Christian theological movement, named for its understanding of God as one person, in direct contrast to Trinitarianism which defines God as three persons coexisting consubstantially as one in being....

. His father, speaking from experience, warned Charles before he proposed to Emma that "some women suffered miserably by doubting about the salvation of their husbands, thus making them likewise to suffer." Darwin did tell Emma of his ideas at that stage, and, while she was deeply concerned about the danger to his afterlife expressed in the Gospel
Gospel
A gospel is an account, often written, that describes the life of Jesus of Nazareth. In a more general sense the term "gospel" may refer to the good news message of the New Testament. It is primarily used in reference to the four canonical gospels of Matthew, Mark, Luke, and John...

, "If a man abide not in me...they are burned", she married him and remained fully supportive of his work throughout their marriage. She read and helped with his "Essay" setting out his theory in 1844, long before he showed his theory to anyone else. She went through the pages, making notes in the margins pointing out unclear passages and showing where she disagreed. As his illness progressed, she nursed him, restraining him from overworking and making him take holiday breaks, always helping him to continue with his work.

Religious tension

Darwin had a complex relationship to religion. The Darwin–Wedgwood family
Darwin–Wedgwood family
The Darwin–Wedgwood family is actually two interrelated English families, descended from the prominent 18th century doctor, Erasmus Darwin, and Josiah Wedgwood, founder of the pottery firm, Josiah Wedgwood and Sons, the most notable member of which was Charles Darwin...

 were of the Unitarian church, with his grandfather Erasmus Darwin
Erasmus Darwin
Erasmus Darwin was an English physician who turned down George III's invitation to be a physician to the King. One of the key thinkers of the Midlands Enlightenment, he was also a natural philosopher, physiologist, slave trade abolitionist,inventor and poet...

 and father taking this to the extent of Freethought
Freethought
Freethought is a philosophical viewpoint that holds that opinions should be formed on the basis of science, logic, and reason, and should not be influenced by authority, tradition, or other dogmas...

, but, in the repressive climate of the early 19th century, his father complied with the Anglican Church of England
Church of England
The Church of England is the officially established Christian church in England and the Mother Church of the worldwide Anglican Communion. The church considers itself within the tradition of Western Christianity and dates its formal establishment principally to the mission to England by St...

.

Charles Darwin's education
Charles Darwin's education
Charles Darwin's education gave him a foundation in the doctrine of Creation prevalent throughout the West at the time, as well as knowledge of medicine and theology. More significantly, it led to his interest in natural history, which culminated in his taking part in the second voyage of the...

 at school was Anglican, then after in Edinburgh
Edinburgh
Edinburgh is the capital city of Scotland, the second largest city in Scotland, and the eighth most populous in the United Kingdom. The City of Edinburgh Council governs one of Scotland's 32 local government council areas. The council area includes urban Edinburgh and a rural area...

, he joined student societies where his tutors espoused Lamarckian
Jean-Baptiste Lamarck
Jean-Baptiste Pierre Antoine de Monet, Chevalier de la Marck , often known simply as Lamarck, was a French naturalist...

 materialism
Materialism
In philosophy, the theory of materialism holds that the only thing that exists is matter; that all things are composed of material and all phenomena are the result of material interactions. In other words, matter is the only substance...

. He liked the thought of becoming a country clergyman, and before studying at the University of Cambridge
University of Cambridge
The University of Cambridge is a public research university located in Cambridge, United Kingdom. It is the second-oldest university in both the United Kingdom and the English-speaking world , and the seventh-oldest globally...

, "as I did not then in the least doubt the strict and literal truth of every word in the Bible, I soon persuaded myself that our Creed must be fully accepted." The clergyman naturalist professors there who became his lifelong friends fully accepted an ancient earth but opposed evolutionism
Evolutionism
Evolutionism refers to the biological concept of evolution, specifically to a widely held 19th century belief that organisms are intrinsically bound to increase in complexity. The belief was extended to include cultural evolution and social evolution...

 which they felt would undermine the social order. He did well at theology and, in his finals, came 10th out of a pass list of 178. At both universities, he saw how evolution was associated with radicals and democrats seeking to overthrow society and how publicly supporting such ideas could lead to destruction of reputation, loss of position and even imprisonment for blasphemy.

At Cambridge, he was convinced by William Paley
William Paley
William Paley was a British Christian apologist, philosopher, and utilitarian. He is best known for his exposition of the teleological argument for the existence of God in his work Natural Theology, which made use of the watchmaker analogy .-Life:Paley was Born in Peterborough, England, and was...

's writings of design by a Creator
Teleological argument
A teleological or design argument is an a posteriori argument for the existence of God based on apparent design and purpose in the universe. The argument is based on an interpretation of teleology wherein purpose and intelligent design appear to exist in nature beyond the scope of any such human...

, but, on the Beagle expedition
Second voyage of HMS Beagle
The second voyage of HMS Beagle, from 27 December 1831 to 2 October 1836, was the second survey expedition of HMS Beagle, under captain Robert FitzRoy who had taken over command of the ship on its first voyage after her previous captain committed suicide...

, his findings contradicted Paley's beneficent view. On his return, his deepening speculations led to the inception of Darwin's theory
Inception of Darwin's theory
The inception of Darwin's theory occurred during an intensively busy period which began when Charles Darwin returned from the survey voyage of the Beagle, with his reputation as a fossil collector and geologist already established...

, and he increasingly disbelieved in the Bible, gradually becoming what was later termed an agnostic
Agnosticism
Agnosticism is the view that the truth value of certain claims—especially claims about the existence or non-existence of any deity, but also other religious and metaphysical claims—is unknown or unknowable....

.

Darwin was clearly worried by the implications of his ideas and desperate to avoid distress to his naturalist friends and to his wife. When first telling his friends, he wrote "it is like confessing a murder", and his writings at the time of the publication of Darwin's theory
Publication of Darwin's theory
The publication of Darwin's theory brought into the open Charles Darwin's ideas of evolution through natural selection, the culmination of more than twenty years of work....

 suggest emotional turmoil. What is unclear is whether this was anxiety about disgrace and damage to his friends, or about his loss of faith in Christianity, or indeed a rational fear of the harsh treatment he had seen meted out to radicals and proponents of evolutionism.

The Chagas hypothesis

Advanced for the first in time in 1959 by eminent Israel
Israel
The State of Israel is a parliamentary republic located in the Middle East, along the eastern shore of the Mediterranean Sea...

i specialist in tropical medicine
Tropical medicine
Tropical medicine is the branch of medicine that deals with health problems that occur uniquely, are more widespread, or prove more difficult to control in tropical and subtropical regions....

 Dr. Saul Adler
Saul Adler
Saul Adler FRS was an Israeli expert on Parasitology.-Early life:Adler was born in 1895 in Kerelits , then in the Russian Empire, now in Belarus. In 1900, he and his family moved to England and they settled in Leeds...

 from Hebrew University, the hypothesis of Chagas disease
Chagas disease
Chagas disease is a tropical parasitic disease caused by the flagellate protozoan Trypanosoma cruzi. T. cruzi is commonly transmitted to humans and other mammals by an insect vector, the blood-sucking insects of the subfamily Triatominae most commonly species belonging to the Triatoma, Rhodnius,...

 was based partly on the fact that during the Beagle expedition
Second voyage of HMS Beagle
The second voyage of HMS Beagle, from 27 December 1831 to 2 October 1836, was the second survey expedition of HMS Beagle, under captain Robert FitzRoy who had taken over command of the ship on its first voyage after her previous captain committed suicide...

, Darwin was bitten by the insect
Insect
Insects are a class of living creatures within the arthropods that have a chitinous exoskeleton, a three-part body , three pairs of jointed legs, compound eyes, and two antennae...

 vector of this disease near Mendoza
Mendoza, Argentina
Mendoza is the capital city of Mendoza Province, in Argentina. It is located in the northern-central part of the province, in a region of foothills and high plains, on the eastern side of the Andes. As of the , Mendoza's population was 110,993...

 to the east of the Argentinian
Argentina
Argentina , officially the Argentine Republic , is the second largest country in South America by land area, after Brazil. It is constituted as a federation of 23 provinces and an autonomous city, Buenos Aires...

 Andes
Andes
The Andes is the world's longest continental mountain range. It is a continual range of highlands along the western coast of South America. This range is about long, about to wide , and of an average height of about .Along its length, the Andes is split into several ranges, which are separated...

 while on one of his land exploration trips. He noted in his journal for 26 March 1835:
"At night I experienced an attack, & it deserves no less a name, of the Benchuca, the great black bug of the Pampas. It is most disgusting to feel soft wingless insects, about an inch long, crawling over ones body; before sucking they are quite thin, but afterwards round & bloated with blood, & in this state they are easily squashed."


The great black bug of the Pampa
Pampa
The Pampas are the fertile South American lowlands, covering more than , that include the Argentine provinces of Buenos Aires, La Pampa, Santa Fe, Entre Ríos and Córdoba, most of Uruguay, and the southernmost Brazilian State, Rio Grande do Sul...

s is identified by Richard Keynes
Richard Keynes
Richard Darwin Keynes, CBE, FRS was a British physiologist. He was a great-grandson of Charles Darwin, and edited accounts and illustrations of Darwin's famous voyage aboard the HMS Beagle into The Beagle Record: Selections From the Original Pictorial Records and Written Accounts of the Voyage of...

 as Triatoma infestans
Triatoma infestans
Triatoma infestans, commonly called vinchuca and also known as "barber bug", is a blood-sucking bug and the most important vector of Trypanosoma cruzi which can lead to Chagas disease...

, commonly called "vinchuca", the vector for Trypanosoma cruzi
Trypanosoma cruzi
Trypanosoma cruzi is a species of parasitic euglenoid trypanosomes. This species causes the trypanosomiasis diseases in humans and animals in America...

 which leads to Chagas disease. It is unlikely that Darwin was infected on this occasion as he did not mention having a fever in the days following the incident, but it is possible that he could have been infected in September 1834 when he recorded being ill but made no note about being bitten by a Benchuca at that time.

Arguments for the Chagas hypothesis were mainly his gastric
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...

 symptoms and some of his nervous
Brain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...

 signs and symptoms (caused in Chagas by an imbalance of the autonomic nervous system
Autonomic nervous system
The autonomic nervous system is the part of the peripheral nervous system that acts as a control system functioning largely below the level of consciousness, and controls visceral functions. The ANS affects heart rate, digestion, respiration rate, salivation, perspiration, diameter of the pupils,...

), malaise and fatigue, as well as his ultimate cause of death, which seems to have been chronic cardiac failure (present in ca. 20% of Chagas patients, with cardiomegaly
Cardiomegaly
Cardiomegaly is a medical condition wherein the heart is enlarged. It is generally categorized in the following manner:* Cardiomegaly due to dilation* Cardiomegaly due to ventricular hypertrophy** Left ventricular hypertrophy...

 and ventricular tip aneurysm
Aneurysm
An aneurysm or aneurism is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. Aneurysms can commonly occur in arteries at the base of the brain and an aortic aneurysm occurs in the main artery carrying blood from the left ventricle of the heart...

) accompanied by lung edema.

Evidences against the Chagas hypothesis are numerous, however:
  • Darwin died at a relatively old age for his time (73 years old);
  • The symptoms abated as he aged, which is not typical for the disease, where age exacerbates the symptoms;
  • He did not seem to have several of the pathological damages present at chronic Chagas disease, such as megacolon
    Megacolon
    Megacolon is an abnormal dilation of the colon . The dilatation is often accompanied by a paralysis of the peristaltic movements of the bowel...

     and megaesophagus
    Megaesophagus
    Megaesophagus is a condition in humans, cats and dogs where peristalsis fails to occur properly and the esophagus is enlarged. Normally, when the dog's esophagus is functioning properly, it acts as a muscle and pushes the food down the esophagus into the stomach. However, when a dog has...

    ;
  • Some of the symptoms, such as tachycardia
    Tachycardia
    Tachycardia comes from the Greek words tachys and kardia . Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate...

    , fatigue and tremors, were already present before the Beagle voyage;
  • The numerous partial exacerbations and remissions are unusual in Chagas disease;
  • The incidence of trypanosome-infested benchucas in Mendoza, Argentina (which has a colder climate), where Darwin reported the bite, is very low;
  • No other members of Beagles crew who accompanied Darwin in his land trip showed signs of a similar disease;


Recently, unsuccessful requests were made to test Darwin's remains for T. cruzi DNA
DNA
Deoxyribonucleic acid is a nucleic acid that contains the genetic instructions used in the development and functioning of all known living organisms . The DNA segments that carry this genetic information are called genes, but other DNA sequences have structural purposes, or are involved in...

 at the Westminster Abbey
Westminster Abbey
The Collegiate Church of St Peter at Westminster, popularly known as Westminster Abbey, is a large, mainly Gothic church, in the City of Westminster, London, United Kingdom, located just to the west of the Palace of Westminster. It is the traditional place of coronation and burial site for English,...

 by using modern PCR techniques but were met with a refusal by the Abbey's curator
Curator
A curator is a manager or overseer. Traditionally, a curator or keeper of a cultural heritage institution is a content specialist responsible for an institution's collections and involved with the interpretation of heritage material...

. The attempt was the subject of a recent documentary of Discovery Health Channel
Discovery Health Channel
Discovery Health Channel is a website owned by Discovery Communications, created for people interested in health and wellness. Until December 31, 2010, it was a U.S. cable television specialty channel dedicated to television programming that highlights various aspects of health and wellness...

.

Ménière's disease

The hypothesis of Ménière's disease
Ménière's disease
Ménière's disease is a disorder of the inner ear that can affect hearing and balance to a varying degree. It is characterized by episodes of vertigo and tinnitus and progressive hearing loss, usually in one ear. It is named after the French physician Prosper Ménière, who, in an article published...

 has gained some popularity. A diagnosis of Ménière's disease is based on a series of symptoms, some of which were present in Darwin's case, such as tinnitus
Tinnitus
Tinnitus |ringing]]") is the perception of sound within the human ear in the absence of corresponding external sound.Tinnitus is not a disease, but a symptom that can result from a wide range of underlying causes: abnormally loud sounds in the ear canal for even the briefest period , ear...

, vertigo
Vertigo (medical)
Vertigo is a type of dizziness, where there is a feeling of motion when one is stationary. The symptoms are due to a dysfunction of the vestibular system in the inner ear...

, dizziness
Dizziness
Dizziness refers to an impairment in spatial perception and stability. The term is somewhat imprecise. It can be used to mean vertigo, presyncope, disequilibrium, or a non-specific feeling such as giddiness or foolishness....

, nausea
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...

, motion sickness
Motion sickness
Motion sickness or kinetosis, also known as travel sickness, is a condition in which a disagreement exists between visually perceived movement and the vestibular system's sense of movement...

, vomiting
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...

, continual malaise
Malaise
Malaise is a feeling of general discomfort or uneasiness, of being "out of sorts", often the first indication of an infection or other disease. Malaise is often defined in medicinal research as a "general feeling of being unwell"...

 and fatigue. The fact that Darwin did not suffer from hearing loss and that "fullness" of the ears is never mentioned practically excludes Ménière's disease. The definition of this disease is, however, not very solid, and some form of "atypical Ménière's disease" remains a remote possibility. Motion sickness was present throughout his life and became apparent very early, when he suffered horribly of seasickness during the whole Beagle voyage. Darwin himself had the opinion that most of his health problems had an origin in his four-year bout with seasickness. Later, he could not stand traveling by carriage, and only horse riding would not affect his health. Psychic alteration often accompanies Ménière's and many other chronic diseases. An argument put forward for a diagnosis of Ménière's is that Darwin hunted
Hunting
Hunting is the practice of pursuing any living thing, usually wildlife, for food, recreation, or trade. In present-day use, the term refers to lawful hunting, as distinguished from poaching, which is the killing, trapping or capture of the hunted species contrary to applicable law...

 a lot when he was young and could have damaged his inner ear
Ear
The ear is the organ that detects sound. It not only receives sound, but also aids in balance and body position. The ear is part of the auditory system....

 with the repeated noise
Noise
In common use, the word noise means any unwanted sound. In both analog and digital electronics, noise is random unwanted perturbation to a wanted signal; it is called noise as a generalisation of the acoustic noise heard when listening to a weak radio transmission with significant electrical noise...

 of shooting. While it is not unlikely that the noise damaged the inner ear and caused tinnitus, it could not have caused Ménière's disease. While Ménière's disease patients suffer during vertigo attacks from sickness and vomiting, the dyspepsia
Dyspepsia
Dyspepsia , also known as upset stomach or indigestion, refers to a condition of impaired digestion. It is a medical condition characterized by chronic or recurrent pain in the upper abdomen, upper abdominal fullness and feeling full earlier than expected when eating...

 problems of Darwin have nothing to do with it. One of the diagnoses that he received from his physicians at the time was that of "suppressed gout
Gout
Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint. The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected . However, it may also present as tophi, kidney stones, or urate...

"; the idea that this was an early name for Ménière's lacks any ground.

Cyclic Vomiting Syndrome

The pathologist John A Hayman has presented a case that Darwin's symptoms indicate that he suffered from Cyclic Vomiting Syndrome
Cyclic vomiting syndrome
Cyclic vomiting syndrome or cyclical vomiting syndrome is a condition whose symptoms are recurring attacks of intense nausea, vomiting and sometimes abdominal pain and/or headaches or migraines...

, an illness associated with mitochondrial DNA
Mitochondrial DNA
Mitochondrial DNA is the DNA located in organelles called mitochondria, structures within eukaryotic cells that convert the chemical energy from food into a form that cells can use, adenosine triphosphate...

 abnormalities. His paper on the topic was accepted by the BMJ
BMJ
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...

 and the Medical Journal of Australia, and was published in December 2009. This has been supported by a more recent analysis which explained the illness as being due to a combination of Cyclic Vomiting Syndrome, Chagas disease, and Helicobacter pylori.

Other possible causes

Evidence for familial systemic lactose intolerance
Lactose intolerance
Lactose intolerance, also called lactase deficiency or hypolactasia, is the inability to digest and metabolize lactose, a sugar found in milk...

 syndrome was that vomiting and gastrointestinal symptoms usually appeared two to three hours after meals and that, apparently, Darwin got better when he stopped taking milk
Milk
Milk is a white liquid produced by the mammary glands of mammals. It is the primary source of nutrition for young mammals before they are able to digest other types of food. Early-lactation milk contains colostrum, which carries the mother's antibodies to the baby and can reduce the risk of many...

 or cream
Cream
Cream is a dairy product that is composed of the higher-butterfat layer skimmed from the top of milk before homogenization. In un-homogenized milk, over time, the lighter fat rises to the top. In the industrial production of cream this process is accelerated by using centrifuges called "separators"...

.

Food intolerance and lactase deficiency may also be confused with food allergies
Food allergy
A food allergy is an adverse immune response to a food protein. They are distinct from other adverse responses to food, such as food intolerance, pharmacological reactions, and toxin-mediated reactions....

. Symptoms include difficulty swallowing and breathing, nausea, vomiting, diarrhea, and abdominal pain. Upon reaching several other organs in the body, allergens can cause hives, eczema
Eczema
Eczema is a form of dermatitis, or inflammation of the epidermis . In England, an estimated 5.7 million or about one in every nine people have been diagnosed with the disease by a clinician at some point in their lives.The term eczema is broadly applied to a range of persistent skin conditions...

, lightheadedness, weakness, hypotension
Hypotension
In physiology and medicine, hypotension is abnormally low blood pressure, especially in the arteries of the systemic circulation. It is best understood as a physiologic state, rather than a disease. It is often associated with shock, though not necessarily indicative of it. Hypotension is the...

, etc. This has been proposed as the source of Darwin's illness, but the hypothesis is improbable, because, as with lactose intolerance, its temporal and causal relationship with food is easily established, and this was not always the case.

Chronic arsenic poisoning (arsenicosis) has been considered too. This hypothesis has been advanced by John H. Winslow, who published a book arguing that Darwin took arsenic
Arsenic
Arsenic is a chemical element with the symbol As, atomic number 33 and relative atomic mass 74.92. Arsenic occurs in many minerals, usually in conjunction with sulfur and metals, and also as a pure elemental crystal. It was first documented by Albertus Magnus in 1250.Arsenic is a metalloid...

 at low dosages as a remedy and that there was "a very close match" between his symptoms and those of arsenicosis. However, it is highly improbable too, due to the long duration of the illness (40 years), the abruptness of symptoms, the cause of his death, and the absence of many symptoms and signs of this kind of poisoning (persistent weight loss
Weight loss
Weight loss, in the context of medicine, health or physical fitness, is a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue...

 and diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

, the appearance of dark brown callus
Callus
A callus is an especially toughened area of skin which has become relatively thick and hard in response to repeated friction, pressure, or other irritation. Rubbing that is too frequent or forceful will cause blisters rather than allow calluses to form. Since repeated contact is required, calluses...

es on the palms and the soles of the feet and of skin, known as hyperpigmentation
Hyperpigmentation
In dermatology, hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin.-Causes:Hyperpigmentation may be caused by sun damage, inflammation, or other skin injuries, including those related to acne vulgaris...

).

Barry Marshall
Barry Marshall
Barry James Marshall, AC, FRS, FAA is an Australian physician, Nobel Prize laureate in Physiology or Medicine, and Professor of Clinical Microbiology at the University of Western Australia. Marshall is well-known for proving that the bacterium Helicobacter pylori Barry James Marshall, AC, FRS, FAA...

 proposed in February 2009 that the cause of Darwin's illness was the ulcer-causing bacterium Helicobacter pylori
Helicobacter pylori
Helicobacter pylori , previously named Campylobacter pyloridis, is a Gram-negative, microaerophilic bacterium found in the stomach. It was identified in 1982 by Barry Marshall and Robin Warren, who found that it was present in patients with chronic gastritis and gastric ulcers, conditions that were...

. Marshall, who together with Robin Warren
Robin Warren
John Robin Warren AC is an Australian pathologist, Nobel Laureate and researcher who is credited with the 1979 re-discovery of the bacterium Helicobacter pylori, together with Barry Marshall.- Life and career :...

 won the Nobel Prize in 2005 for discovery of the bacterium, states that this was a very common gastric infection of the time which causes ulcers in 10% of infected persons and causes dyspepsia in another 10% or so. He had yet to have a short paper on this accepted for publication.

Combined causes

From a clinical point of view, perhaps Darwin suffered from more than one disease, and had many psychosomatic complications and phobias arising from his debilitating condition. This is known to happen with many patients today, such as in severe cases of panic disorder, usually accompanied by hypochondria and depression.

Dr. Peter Medawar
Peter Medawar
Sir Peter Brian Medawar OM CBE FRS was a British biologist, whose work on graft rejection and the discovery of acquired immune tolerance was fundamental to the practice of tissue and organ transplants...

 has supported the diagnosis that Darwin's health problems were part organic, part psychological. Colp concluded that Darwin's illness consisted most probably of panic disorder without agoraphobia, psychosomatic skin disorder, and possibly Chagas disease of the stomach, which he suggested "was first active and then became inactive, permanently injuring the parasympathetic nerves of his stomach and making it more sensitive to sympathetic stimulation and hence more sensitive to the psychosomatic impact of his anxieties. An organic impairment best explains the lifelong chronicity of many of his abdominal complaints." Thus, the psychological aspects of Darwin's illness might be both a cause and an effect of Darwin's illness. D.A.B. Young wrote in a Royal Society journal in 1997 that the psychogenic view of Darwin's sickness "holds the field". The proponent of Chagas disease, Dr. Saul Adler, stated that Darwin may have suffered both from Chagas disease and from "an innate or acquired neurosis".

At a conference hosted by the University of Maryland, Baltimore
University of Maryland, Baltimore
University of Maryland, Baltimore, was founded in 1807. It comprises some of the oldest professional schools in the nation and world. It is the original campus of the University System of Maryland. Located on 60 acres in downtown Baltimore, Maryland, it is part of the University System of Maryland...

, School of Medicine on the topic of Darwin's ailments, gastroenterologist Dr. Sidney Cohen of Thomas Jefferson University
Thomas Jefferson University
Thomas Jefferson University is a private health sciences university in Center City, Philadelphia, Pennsylvania in the United States. The university consists of six constituent colleges and schools, Jefferson Medical College, Jefferson College of Graduate Studies, Jefferson School of Health...

 concluded that in his early years Darwin had suffered Cyclic Vomiting Syndrome
Cyclic vomiting syndrome
Cyclic vomiting syndrome or cyclical vomiting syndrome is a condition whose symptoms are recurring attacks of intense nausea, vomiting and sometimes abdominal pain and/or headaches or migraines...

, but as he had brought up secretions such as stomach acid rather than food, this had not affected his weight and nutrition. He believed that Chagas disease
Chagas disease
Chagas disease is a tropical parasitic disease caused by the flagellate protozoan Trypanosoma cruzi. T. cruzi is commonly transmitted to humans and other mammals by an insect vector, the blood-sucking insects of the subfamily Triatominae most commonly species belonging to the Triatoma, Rhodnius,...

 contracted during the Beagle voyage was consistent with Darwin's account of his fever at that time and his later gastrointestinal complaints, as well as the heart disease later in life that led to Darwin's death. In addition, Helicobacter pylori
Helicobacter pylori
Helicobacter pylori , previously named Campylobacter pyloridis, is a Gram-negative, microaerophilic bacterium found in the stomach. It was identified in 1982 by Barry Marshall and Robin Warren, who found that it was present in patients with chronic gastritis and gastric ulcers, conditions that were...

 which often occurs with Chagas would have caused Darwin to have peptic ulcer disease.

Hereditary disease

Many of Darwin's children suffered from similarly vague illnesses for much of their early lives, but it has been speculated that part of this may have been simply because he encouraged a household where sickness was a form of attention and socialization. Darwin himself—concerned with heredity
Heredity
Heredity is the passing of traits to offspring . This is the process by which an offspring cell or organism acquires or becomes predisposed to the characteristics of its parent cell or organism. Through heredity, variations exhibited by individuals can accumulate and cause some species to evolve...

—wondered if he had passed on his generally infirm condition to his children and was especially interested if his marriage to Emma Wedgwood
Emma Darwin
Emma Darwin was the wife and first cousin of Charles Darwin, the English naturalist, scientist and author of On the Origin of Species...

, a cousin, was not perhaps also responsible (his concerns later in life with the effects of inbreeding
Inbreeding
Inbreeding is the reproduction from the mating of two genetically related parents. Inbreeding results in increased homozygosity, which can increase the chances of offspring being affected by recessive or deleterious traits. This generally leads to a decreased fitness of a population, which is...

 were potentially motivated by this personal aspect as well).

Contribution to Darwin's work

Interestingly enough, it seems that Darwin's maladies actually may have contributed a lot to what many believe was a long and fruitful creative process in science. George Pickering, in his book Creative Malady (1974), wrote that isolated from social life and obligations of a "normal" scientist, such as administrative and teaching work, Darwin had ample time and material comforts for researching, thinking, and writing extensively, which he did. Despite the long periods of unproductivity caused by ill health, Darwin produced much research. Darwin often complained that his malady robbed him of half a lifetime, but even so, many believe that his scientific contributions can be compared favorably to those of such figures as Isaac Newton
Isaac Newton
Sir Isaac Newton PRS was an English physicist, mathematician, astronomer, natural philosopher, alchemist, and theologian, who has been "considered by many to be the greatest and most influential scientist who ever lived."...

 and Albert Einstein
Albert Einstein
Albert Einstein was a German-born theoretical physicist who developed the theory of general relativity, effecting a revolution in physics. For this achievement, Einstein is often regarded as the father of modern physics and one of the most prolific intellects in human history...

.

Darwin himself wrote about this, in his autobiographical "Recollections of the Development of my Mind and Character" (1876):
Lastly, I have had ample leisure from not having to earn my own bread. Even ill-health, though it has annihilated several years of my life, has saved me from the distractions of society and amusement.

Conclusions

The exact nature of Darwin's illness or illnesses remain mysterious at this time. Unless sophisticated molecular probing of his biological remains is allowed, no definitive diagnosis can be reached. At the same time, historical investigations are probabilistic. There appears to be increasing support for the diagnosis that both organic and psychological ailments combined to cause his illness.

The issue has become embroiled in the creation-evolution controversy
Creation-evolution controversy
The creation–evolution controversy is a recurring cultural, political, and theological dispute about the origins of the Earth, humanity, life, and the universe....

, with allegations that creationists are drawing attention to interpretations of the illness to damage Darwin's reputation and counter-allegations that admirers of Darwin refuse to accept faults in the man.

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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