Cyclic Vomiting Syndrome Plagued Darwin

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Charles Darwin, long associated with the phrase “survival of the fittest,” was himself plagued by an often debilitating condition, the identity of which has long puzzled historians. Now John Hayman, associate professor at Monash University in Melbourne, has suggested Darwin suffered from cyclic vomiting syndrome.

Cyclic vomiting syndrome is a rare inherited disorder characterized by recurrent, prolonged episodes of severe nausea, vomiting, and prostration with no apparent cause. Vomiting occurs at frequent intervals for hours or days, usually 1 to 4. The condition can begin at any age and last for months, years, or decades. Some people experience cyclic vomiting several times a month while others have it a few times a year.

The condition affects females slightly more often than males. People who have cyclic vomiting syndrome often have a family history of migraine, and in fact this condition is sometimes referred to as abdominal migraine. The relentless vomiting is usually accompanied by extreme thirst and abdominal pain, and less often headache, low-grade fever, and diarrhea. Episodes may be triggered by an event, such as an infection, or by stress, anxiety, eating certain foods, physical exhaustion, or hot weather, among others.

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According to the Cyclic Vomiting Syndrome Association, this syndrome is often misdiagnosed as stomach flu or food poisoning. Because there are no blood tests or procedures that can help diagnose the disorder, the diagnosis is usually reached after physicians have carefully evaluated the patient’s history, physical examination results, and lab studies to rule out other diseases. The National Institute for Diabetes and Digestive and Kidney Diseases reports that the number of people who have cyclic vomiting syndrome is not known, but it is believed the disorder is underreported and misdiagnosed.

Darwin wrote in his diary that he was “troubled with palpitations and pain about the heart,” and he experienced nausea, vomiting, headaches, stomach and skin problems for most of his adult life. His mother and other members of his family experienced many of the same symptoms, and Darwin’s mother died from severe abdominal pain when her son was only eight years old. The proponent of evolution was sometimes called a hypochondriac because of his symptoms. Some speculated that he has panic disorders, that he felt guilt over conflicts with his earlier religious beliefs, or that he had a tropical infection.

Hayman notes in the British Medical Journal that “the syndrome is related to migraine but is linked to genetic abnormalities.” He also points out that Darwin’s “personal inherited genetic variation made him substantially ‘less fit,’” but that having cyclic vomiting syndrome did not impair his fertility. Darwin fathered ten children during the years that he suffered from cyclic vomiting syndrome.

SOURCES:
Cyclic Vomiting Syndrome Association
Guardian, Dec. 14, 2009
National Institute for Diabetes and Digestive and Kidney Diseases

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