Enough Already

Here at the You&Me America’s Medical Magazine blog we love the history of medicine, and frequently post musings, factoids and other interesting tidbits from the past. But the editorial we is getting quite tired of people retroactively re-diagnosing historical figures. You know, “maybe so and so didn’t have x, they had y!”

In baseball the tie goes to the runner, in foil the point goes to the fencer with right of way and in diagnoses, the diagnosis, in the absence of being able to exam the patient and often the lack of any x-rays, vital signs, lab test, MRIs. CTs and so on, has to go to the medical personnel who were actually there.

This is of course a further problem when we go back more than 150 years or so, since before then expert opinion attributed illness to such things as witchcraft and humoral imbalances. At that point everything is just pure speculation, which is fun, but unfortunately accepted all too readily as fact. A case in point: King George the III of England. You may have heard he had disease called porphyria. It’s one of those Internet truths, no citation needed: the sky is blue, fat is bad for you, King George had porphyria. Knowing the Internet, would it shock you to learn that the evidence that K.G. actually had any kind of porphyria ranges between slim and none?

The way quasi-official bodies and the public have fastened on this amusing speculation and taken as fact is a disturbing reminder of the status of “mental illness” in our culture.

And poor Abraham Lincoln! Over the past 100 years he’s been identified as illegitimate, Jewish, African-American, a racist and a homosexual. Not to mention bipolar, having Marfan’s syndrome and all kinds of genetic and/or endocrine disorders. One physician writer, as we recall, was convinced he had some form of multiple endocrine neoplasia. One of the symptoms of this disorder, apparently, is muscle wasting. So why did the doctors actually doing Lincoln’s autopsy describe him as being astoundingly muscular? No problem-they were just buying into the Lincoln as superman mythand did not, in the opinion of someone 100 years or later, actually see that.

Such are the problems with trying to make retroactive diagnoses.