Retrospective diagnosis

Retrospective diagnosis

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 classifications.cite web
date=2004-01-12
url=http://www.medterms.com/script/main/art.asp?articlekey=26040
title=MedTerms: Retrodiagnosis
publisher=MedicineNet.com
accessdate=2008-08-08] cite book
url=http://books.google.co.uk/books?id=lFi2zHG5XWMC&pg=PR15&lpg=PR15&dq=%22more+than+a+game,+with+ill-defined+rules+and+little+academic+credibility%22&source=web&ots=X8jN7rwPTe&sig=egOsSHbtuSUog7dJquxXoq1gIss&hl=en&sa=X&oi=book_result&resnum=2&ct=result
author=Elmer, Peter
title=The healing arts: health, disease and society in Europe, 1500-1800
publisher=Manchester University Press
location=Manchester
year=2004
pages=xv
isbn=0-7190-6734-0] Alternatively, it can be the more general attempt to give a modern name to an ancient and ill-defined scourge or plague.cite book
author=Burnham, John C.
title=What is medical history?
publisher=Polity
location=Cambridge, UK
year=2005
pages=76–78
isbn=0-7456-3224-6]

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",cite book
author=Kevin P. Siena
title=Sins of the flesh: responding to sexual disease in early modern Europe
publisher=Centre for Reformation and Renaissance Studies
location=Toronto
year=2005
pages=12
isbn=0-7727-2029-0] 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.Getz, Faye M. Western Medieval Medicine in cite book
author=Greene, Rebecca
title=History of medicine
publisher=Institute for Research in History
location=New York, NY
year=1988
pages=
isbn=0-86656-309-1
oclc=
doi=
accessdate=] The understanding of the history of illness can benefit from modern science. For example, knowledge of the insect vectors of malaria and yellow fever 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 parody, where characters from fiction are "diagnosed". Squirrel Nutkin may have had Tourette syndromecite journal
author=Williams TM, Kim, Williams G
title=Excessive impertinence or a missed diagnosis?
journal=BMJ
volume=311
issue=7021
pages=1700–1
year=1995
pmid=8541765
url=http://bmj.com/cgi/pmidlookup?view=long&pmid=8541765] and Tiny Tim could have suffered from distal renal tubular acidosis (type I).cite journal
author=Lewis DW
title=What was wrong with Tiny Tim?
journal=Am. J. Dis. Child.
volume=146
issue=12
pages=1403–7
year=1992
month=December
pmid=1340779]

The term "retrospective diagnosis" is also sometimes used by a clinical pathologist to describe a medical diagnosis in a person made some time after the original illness has resolved or after death. In such cases, analysis of a physical specimen may yield a confident medical diagnosis. The search for the origin of AIDS has involved posthumous diagnosis of AIDS in people who died decades before the disease was first identified.cite journal
author=Hooper, E.
title=Sailors and star-bursts, and the arrival of HIV
url=http://bmj.bmjjournals.com/cgi/content/full/315/7123/1689
journal=BMJ | year=1997 | pages=1689–1691 | volume=315 | issue=7123
pmid= 9448543] Another example is where analysis of preserved umbilical cord tissue enables the diagnosis of congenital cytomegalovirus infection in a patient who had later developed a central nervous system disorder.cite journal
author=Ikeda S, Tsuru A, Moriuchi M, Moriuchi H
title=Retrospective diagnosis of congenital cytomegalovirus infection using umbilical cord
journal=Pediatr. Neurol.
volume=34
issue=5
pages=415–6
year=2006
month=May
pmid=16648007
doi=10.1016/j.pediatrneurol.2005.10.006]

Examples

* Was the English sweat caused by hantavirus?
* Was the black death due to bubonic plague?
* Was "the great pox" syphilis or several venereal diseases?
* Could Franklin D. Roosevelt's paralytic illness have been Guillain-Barré syndrome rather than poliomyelitis?cite journal
author=Goldman AS, Schmalstieg EJ, Freeman DH, Goldman DA, Schmalstieg FC
title=What was the cause of Franklin Delano Roosevelt's paralytic illness?
journal=J Med Biogr
volume=11
issue=4
pages=232–40
year=2003
pmid=14562158
url=http://www.rsmpress.co.uk/jmb_2003_v11_p232-240.pdf
doi=
accessdate=2008-03-02]
* Did botulism cause the religious visions experienced by Julian of Norwich?
* King George III of the United Kingdom exhibited the classic symptoms of porphyria? [cite journal |author=Macalpine I, Hunter R |title=The "insanity" of King George 3d: a classic case of porphyria |journal=Br Med J |volume=1 |issue=5479 |pages=65–71 |year=1966 |month=January |pmid=5323262 |pmc=1843211]
* Did Abraham Lincoln have Marfan syndrome?cite journal |author=Young I |title=Understanding Marfan's syndrome |journal=BMJ |volume=303 |issue=6815 |pages=1414–5 |year=1991 |month=December |pmid=1773142 |pmc=1671667 |doi= |url=]
* Could Burke and Wills have died of thiaminase poisoning?cite journal |author=Earl JW, McCleary BV |title=Mystery of the poisoned expedition |journal=Nature |volume=368 |issue=6473 |pages=683–4 |year=1994 |month=April |pmid=8152477 |doi=10.1038/368683a0 |url=http://dx.doi.org/10.1038/368683a0]
* Did Tutankhamun have Klippel-Feil syndrome?cite journal |author=Boyer RS, Rodin EA, Grey TC, Connolly RC |title=The skull and cervical spine radiographs of Tutankhamen: a critical appraisal |journal=AJNR Am J Neuroradiol |volume=24 |issue=6 |pages=1142–7 |year=2003 |pmid=12812942 |doi= |url=http://www.ajnr.org/cgi/pmidlookup?view=long&pmid=12812942]

ee also

* Samuel Johnson's health
* List of people with epilepsy (includes notes on retrospective diagnosis and misdiagnosis of historical figures)

References

Further reading

*cite book
author=Mackowiak, Philip A.
title=Post-Mortem: Solving History's Great Medical Mysteries
publisher=The American College of Physicians
year=2007
isbn=1-930513-89-5


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