Retrospective diagnosis

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A retrospective diagnosis (also retrodiagnosis or posthumous diagnosis) is the practice of identifying an illness after the death of the patient (sometimes a historical figure) using modern knowledge, methods and disease classifications. [1] [2] Alternatively, it can be the more general attempt to give a modern name to an ancient and ill-defined scourge or plague. [3]

Contents

Historical research

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". [2] The process often requires "translating between linguistic and conceptual worlds separated by several centuries", [4] and assumes our modern disease concepts and categories are privileged. [4] 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. [5] Darin Hayton, a historian of science at Haverford College, claims that retrodiagnosing famous individuals with autism in the media is pointless, as historical accounts often contain incomplete information. [6]

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. [3]

The practice of retrospective diagnosis has been applied in parody, where characters from fiction are "diagnosed"; e.g., authors have speculated that Squirrel Nutkin may have had Tourette syndrome [7] and that Tiny Tim could have had distal renal tubular acidosis (type I). [8]

Postmortem diagnosis

Post-mortem diagnosis is considered a research tool, and also a quality control practice [9] and it allows to evaluate the performance of the clinical case definitions. [10] 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. [11] 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. [12]

Examples

Retrospective diagnoses of autism

There have been many published speculative retrospective diagnoses of autism of historical figures. English scientist Henry Cavendish is believed by some to have been autistic. George Wilson, a notable chemist and physician, wrote a book about Cavendish entitled The Life of the Honourable Henry Cavendish (1851), which provides a detailed description that indicates Cavendish may have exhibited many classic signs of autism. [23] [24] [25] [26] The practice of retrospectively diagnosing autism is controversial. Professor Fred Volkmar of Yale University is not convinced; he claims that "There is unfortunately a sort of cottage industry of finding that everyone has Asperger's." [25]

See also

Related Research Articles

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References

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  4. 1 2 Kevin P. Siena (2005). Sins of the flesh: responding to sexual disease in early modern Europe. Toronto: Centre for Reformation and Renaissance Studies. p. 12. ISBN   978-0-7727-2029-0.
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  6. ↑ Hayton, Darin. "Isaac Newton was Autistic, or Not". Darin Hayton, Historian of Science. Retrieved 7 May 2019.
  7. ↑ Williams TM, Kim, Williams G (1995). "Excessive impertinence or a missed diagnosis?". BMJ. 311 (7021): 1700–1. doi:10.1136/bmj.311.7021.1700. PMC   2539093 . PMID   8541765.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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  10. ↑ Saracci R (1991). "Is necropsy a valid monitor of clinical diagnosis performance?". BMJ. 303 (6807): 898–900. doi:10.1136/bmj.303.6807.898. PMC   1671185 . PMID   1933005.
  11. ↑ Hooper, E. (1997). "Sailors and star-bursts, and the arrival of HIV". BMJ. 315 (7123): 1689–1691. doi:10.1136/bmj.315.7123.1689. PMC   2128008 . PMID   9448543.
  12. ↑ Ikeda S, Tsuru A, Moriuchi M, Moriuchi H (May 2006). "Retrospective diagnosis of congenital cytomegalovirus infection using umbilical cord". Pediatr. Neurol. 34 (5): 415–6. doi:10.1016/j.pediatrneurol.2005.10.006. PMID   16648007.
  13. ↑ Murray ED.; Cunningham MG; Price BH. (2012). "The role of psychotic disorders in religious history considered". The Journal of Neuropsychiatry and Clinical Neurosciences. 24 (4): 410–26. doi:10.1176/appi.neuropsych.11090214. PMID   23224447. S2CID   207654711.
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  15. 1 2 Edge, Joanne. "Diagnosing the past". Wellcome Collection. Retrieved 18 February 2019.
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  17. ↑ Hindmarch, J. Thomas; Savory, John (2008). "The Death of Napoleon, Cancer or Arsenic?" (PDF). Clinical Chemistry. 54 (12): 2092–3. doi:10.1373/clinchem.2008.117358.
  18. ↑ Goldman AS, Schmalstieg EJ, Freeman DH, Goldman DA, Schmalstieg FC (2003). "What was the cause of Franklin Delano Roosevelt's paralytic illness?" (PDF). J Med Biogr. 11 (4): 232–40. CiteSeerX   10.1.1.691.2120 . doi:10.1177/096777200301100412. PMID   14562158. S2CID   39957366. Archived from the original (PDF) on 2008-03-07. Retrieved 2008-03-02.
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  20. ↑ Shuster, Sam (2008). "The nature and consequence of Karl Marx's skin disease". British Journal of Dermatology. Blackwell Publishing Ltd. 158 (1).
  21. ↑ Earl JW, McCleary BV (April 1994). "Mystery of the poisoned expedition". Nature. 368 (6473): 683–4. Bibcode:1994Natur.368..683E. doi:10.1038/368683a0. PMID   8152477. S2CID   6835422.
  22. ↑ Otaiku AI (April 2018). "Did René Descartes Have Exploding Head Syndrome?". Journal of Clinical Sleep Medicine. 14 (4): 675–8. doi:10.5664/jcsm.7068. PMC   5886445 . PMID   29609724.
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  25. 1 2 Goode, Erica (9 October 2001). "CASES; A Disorder Far Beyond Eccentricity". The New York Times. Retrieved 26 November 2007.
  26. ↑ James I (2003). "Singular scientists". J R Soc Med. 96 (1): 36–9. doi:10.1177/014107680309600112. PMC   539373 . PMID   12519805.

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