A
retrospective diagnosis (also
retrodiagnosis or
posthumous diagnosis) is the practice of identifying an illness in a historical figure using modern knowledge, methods and
disease classificationsNosology is a branch of medicine that deals with classification of diseases.-Types of Classification:...
. Alternatively, it can be the more general attempt to give a modern name to an ancient and ill-defined scourge or plague.
Retrospective diagnosis is practised by medical historians, general historians and the media with varying degrees of scholarship.
A
retrospective diagnosis (also
retrodiagnosis or
posthumous diagnosis) is the practice of identifying an illness in a historical figure using modern knowledge, methods and
disease classificationsNosology is a branch of medicine that deals with classification of diseases.-Types of Classification:...
. Alternatively, it can be the more general attempt to give a modern name to an ancient and ill-defined scourge or plague.
Retrospective diagnosis is practised by medical historians, general historians and the media with varying degrees of scholarship. At its worst it may become "little more than a game, with ill-defined rules and little academic credibility." The process often requires "translating between linguistic and conceptual worlds separated by several centuries", and assumes our modern disease concepts and categories are privileged. Crude attempts at retrospective diagnosis fail to be sensitive to historical context, may treat historical and religious records as scientific evidence, or ascribe pathology to behaviours that require none. The understanding of the history of illness can benefit from modern science. For example, knowledge of the insect vectors of
malariaMalaria is a vector-borne infectious disease caused by a eukaryotic protist of the genus Plasmodium. It is widespread in tropical and subtropical regions, including parts of the Americas, Asia, and Africa. Each year, there are approximately 350–500 million cases of malaria, killing between one and...
and
yellow feverYellow fever is an acute viral disease. The virus, a 40 to 50 nm enveloped RNA virus of the family of Flaviviridae is transmitted by the bite of mosquitoes...
can be used to explain the changes in extent of those diseases caused by drainage or urbanisation in historical times.
The practice of retrospective diagnosis has been mocked in
parodyA parody , in contemporary usage, is a work created to mock, comment on, or poke fun at an original work, its subject, author, style, or some other target, by means of humorous, satiric or ironic imitation...
, where characters from fiction are "diagnosed". Squirrel Nutkin may have had
Tourette syndromeTourette syndrome is an inherited neuropsychiatric disorder with onset in childhood, characterized by the presence of multiple physical tics and at least one vocal tic; these tics characteristically...
and
Tiny TimTiny Tim is a fictional character in the classic story A Christmas Carol by Charles Dickens. He is the son of Bob Cratchit...
could have suffered from distal
renal tubular acidosisRenal tubular acidosis is a medical condition that involves an accumulation of acid in the body due to a failure of the kidneys to appropriately acidify the urine. When blood is filtered by the kidney, the filtrate passes through the tubules of the nephron, allowing for exchange of salts, acid...
(type I).
The term
retrospective diagnosis is also sometimes used by a
clinical pathologistClinical pathology , Laboratory Medicine , Biopathology , or Clinical/Medical Biology , is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids, such as blood, urine, and tissues using the tools of chemistry,...
to describe a
medical diagnosisIn medicine, diagnosis is a label given for a medical condition or disease identified by its signs, symptoms, and from the results of various diagnostic procedures...
in a person made some time after the original illness has resolved or after death. In such cases, analysis of a
physical specimenMedical: A laboratory specimen is a sample of a medical patient's tissue, fluid, or other material derived from the patient used for laboratory analysis to assist differential diagnosis or staging of a disease process...
may yield a confident medical diagnosis. The search for the
origin of AIDSHIV, the virus that causes AIDS, originated in non-human primates in sub-Saharan Africa and was transferred to humans during the late 19th or early 20th century....
has involved posthumous diagnosis of
AIDSAcquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus ....
in people who died decades before the disease was first identified. Another example is where analysis of preserved
umbilical cordIn placental mammals, the umbilical cord is the connecting cord from the developing embryo or fetus to the placenta...
tissue enables the diagnosis of congenital
cytomegalovirusCytomegalovirus is a herpes viral genus of the Herpesviruses group: in humans it is commonly known as HCMV or Human Herpesvirus 5 . CMV belongs to the Betaherpesvirinae subfamily of Herpesviridae, which also includes Roseolovirus...
infection in a patient who had later developed a
central nervous systemThe central nervous system is the part of the nervous system that functions to coordinate the activity of all parts of the bodies of bilaterian animals—that is, all animals more advanced than sponges or jellyfish. In vertebrates, the central nervous system is enclosed in the meninges. It contains...
disorder.
Examples
- Was the English sweat caused by hantavirus
Hantaviruses belong to the Bunyaviridae family of viruses. The Bunyaviridae family is divided into 5 genera: Orthobunyavirus, Nairovirus, Phlebovirus, Tospovirus, and Hantavirus. Like all members of this family, hantaviruses have genomes comprised of three negative-sense, single-stranded RNA...
?
- Was the black death
The Black Death was one of the deadliest pandemics in human history, peaking in Europe between 1348 and 1350. It is widely thought to have been an outbreak of bubonic plague caused by the bacterium Yersinia pestis, but this view has recently been challenged...
due to bubonic plaguePlague is a deadly infectious disease caused by the enterobacteria Yersinia pestis . Plague is a zoonotic, primarily carried by rodents and spread to humans via fleas. Plague is notorious throughout history, due to the unrivaled scale of death and devastation it brought...
?
- Was "the great pox" syphilis
Syphilis is a sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum subspecies pallidum. The route of transmission of syphilis is almost always through sexual contact, although there are examples of congenital syphilis via transmission from mother to child in utero.The...
or several venereal diseases?
- Could Franklin D. Roosevelt's paralytic illness
Franklin D. Roosevelt's paralytic illness began at age 39, when Roosevelt got a fever after exercising heavily at a vacation in Canada. After his death the illness became a major part of his image, even though during his life it was kept from public view. He was diagnosed with poliomyelitis two...
have been Guillain-Barré syndromeGuillain–Barré syndrome is an acute inflammatory demyelinating polyneuropathy , an autoimmune disorder affecting the peripheral nervous system, usually triggered by an acute infectious process. It is included in the wider group of peripheral neuropathies...
rather than poliomyelitisPoliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route. The term derives from the Greek , meaning "grey", , referring to the "spinal cord", and the suffix -itis, which denotes inflammation...
?
- Did botulism
Botulism also known as botulinus intoxication is a rare but serious paralytic illness caused by botulinum toxin, which is produced by the bacterium Clostridium botulinum...
cause the religious visions experienced by Julian of NorwichJulian of Norwich is thought of as one of the greatest English mystics. Little is known of her life aside from her writings. Even her name is uncertain, the name "Julian" coming from the Church of St Julian in Norwich, where she was an anchoress...
?
- Did King George III of the United Kingdom
George III was King of Great Britain and King of Ireland from 25 October 1760 until the union of these two countries on 1 January 1801, after which he was King of the United Kingdom of Great Britain and Ireland until his death...
exhibit the classic symptoms of porphyriaPorphyrias are a group of inherited or acquired disorders of certain enzymes in the heme biosynthetic pathway . They are broadly classified as acute porphyrias and cutaneous porphyrias, based on the site of the overproduction and accumulation of the porphyrins...
?
- Did Abraham Lincoln
Abraham Lincoln was the 16th President of the United States, serving from March 1861 until his assassination in April 1865. He successfully led his country through its greatest internal crisis, the American Civil War, preserving the Union and ending slavery...
have Marfan syndromeMarfan syndrome is a genetic disorder of the connective tissue.It is sometimes inherited as a dominant trait. It is carried by a gene called FBN1, which encodes a connective protein called fibrillin-1. People have a pair of FBN1 genes. Because it is dominant, people who have inherited one affected...
?
- Could Burke and Wills
In 1860-61 Robert O'Hara Burke and William John Wills led an expedition of 19 men with the intention of crossing Australia from Melbourne in the south to the Gulf of Carpentaria in the north, a distance of around 3,250 kilometres...
have died of thiaminaseThiaminase is an enzyme that metabolizes or breaks down thiamine into two molecular parts.The old name was "Aneurinase". There are two types: -Sources:Source include:* Bracken , Nardoo and other plants....
poisoning?
- Did Tutankhamun
Tutankhamun , Egyptian was an Egyptian Pharaoh of the Eighteenth dynasty , during the period of Egyptian history known as the New Kingdom...
have Klippel-Feil syndromeKlippel–Feil syndrome is a rare disease, initially reported in 1912 by Maurice Klippel and André Feil from France, characterized by the congenital fusion of any 2 of the 7 cervical vertebrae....
?
See also
- Samuel Johnson's health
Samuel Johnson's health has been a focus of the biographical and critical analysis of his life. His medical history was well documented by Johnson and his friends, and those writings have allowed later critics and doctors to infer diagnoses of conditions that were unknown in Johnson's day.His...
- List of people with epilepsy (includes notes on retrospective diagnosis and misdiagnosis of historical figures)