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. Alternatively, it can be the more general attempt to give a modern name to an ancient and ill-defined scourge or plague.

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". 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.Getz, Faye M. Western Medieval Medicine in Darin Hayton, a historian of science at

Haverford College Haverford College ( ) is a private university, private Liberal arts colleges in the United States, liberal arts college in Haverford, Pennsylvania, United States. It was founded as a men's college in 1833 by members of the Religious Society of Fr ...

, claims that retrodiagnosing famous individuals with autism in the media is pointless, as historical accounts often contain incomplete information. The understanding of the history of illness can benefit from modern science. For example, knowledge of the insect vectors of

malaria Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...

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 applied in

parody A parody is a creative work designed to imitate, comment on, and/or mock its subject by means of satire, satirical or irony, ironic imitation. Often its subject is an Originality, original work or some aspect of it (theme/content, author, style, e ...

, where characters from fiction are "diagnosed"; e.g., authors have speculated that Squirrel Nutkin may have had

Tourette syndrome Tourette syndrome (TS), or simply Tourette's, is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) tic. Common tics are blinkin ...

and that Tiny Tim could have had distal renal tubular acidosis (type I).

Postmortem diagnosis

Post-mortem diagnosis is considered a research tool, and also a quality control practice and it allows to evaluate the performance of the clinical case definitions. The term ''retrospective diagnosis'' is also sometimes used by a clinical pathologist to describe a

medical diagnosis Medical diagnosis (abbreviated Dx, Dx, or Ds) is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as a diagnosis with the medical context being implicit. The information ...

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 The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...

in people who died decades before the disease was first identified. Another example is where analysis of preserved

umbilical cord In Placentalia, placental mammals, the umbilical cord (also called the navel string, birth cord or ''funiculus umbilicalis'') is a conduit between the developing embryo or fetus and the placenta. During prenatal development, the umbilical cord i ...

tissue enables the diagnosis of

congenital A birth defect is an abnormal condition that is present at childbirth, birth, regardless of its cause. Birth defects may result in disability, disabilities that may be physical disability, physical, intellectual disability, intellectual, or dev ...

cytomegalovirus ''Cytomegalovirus'' (CMV) (from ''cyto-'' 'cell' via Greek - 'container' + 'big, megalo-' + -''virus'' via Latin 'poison') is a genus of viruses in the order '' Herpesvirales'', in the family '' Herpesviridae'', in the subfamily '' Betaherp ...

infection in a patient who had later developed a

central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain, spinal cord and retina. The CNS is so named because the brain integrates the received information and coordinates and influences the activity o ...

disorder.

Examples

* Did

Abraham Abraham (originally Abram) is the common Hebrews, Hebrew Patriarchs (Bible), patriarch of the Abrahamic religions, including Judaism, Christianity, and Islam. In Judaism, he is the founding father who began the Covenant (biblical), covenanta ...

Moses In Abrahamic religions, Moses was the Hebrews, Hebrew prophet who led the Israelites out of slavery in the The Exodus, Exodus from ancient Egypt, Egypt. He is considered the most important Prophets in Judaism, prophet in Judaism and Samaritani ...

Jesus Jesus (AD 30 or 33), also referred to as Jesus Christ, Jesus of Nazareth, and many Names and titles of Jesus in the New Testament, other names and titles, was a 1st-century Jewish preacher and religious leader. He is the Jesus in Chris ...

, Saint Paul or

Muhammad Muhammad (8 June 632 CE) was an Arab religious and political leader and the founder of Islam. Muhammad in Islam, According to Islam, he was a prophet who was divinely inspired to preach and confirm the tawhid, monotheistic teachings of A ...

have psychotic spectrum psychological symptoms? * Did

Tutankhamun Tutankhamun or Tutankhamen, (; ), was an Egyptian pharaoh who ruled during the late Eighteenth Dynasty of Egypt, Eighteenth Dynasty of ancient Egypt. Born Tutankhaten, he instituted the restoration of the traditional polytheistic form of an ...

have Klippel–Feil syndrome? * Did

Alfred the Great Alfred the Great ( ; – 26 October 899) was King of the West Saxons from 871 to 886, and King of the Anglo-Saxons from 886 until his death in 899. He was the youngest son of King Æthelwulf and his first wife Osburh, who both died when Alfr ...

have

Crohn's disease Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract. Symptoms often include abdominal pain, diarrhea, fever, abdominal distension, and weight loss. Complications outside of the ...

? * Did

botulism Botulism is a rare and potentially fatal illness caused by botulinum toxin, which is produced by the bacterium ''Clostridium botulinum''. The disease begins with weakness, blurred vision, Fatigue (medical), feeling tired, and trouble speaking. ...

cause the religious visions experienced by Julian of Norwich? * Was the English sweat caused by

hantavirus ''Orthohantavirus'' is a genus of viruses that includes all hantaviruses (family ''Hantaviridae'') that cause disease in humans. Orthohantaviruses, hereafter referred to as hantaviruses, are naturally found primarily in rodents. In general, each ...

? * Was the

Black Death The Black Death was a bubonic plague pandemic that occurred in Europe from 1346 to 1353. It was one of the list of epidemics, most fatal pandemics in human history; as many as people perished, perhaps 50% of Europe's 14th century population. ...

due to

bubonic plague Bubonic plague is one of three types of Plague (disease), plague caused by the Bacteria, bacterium ''Yersinia pestis''. One to seven days after exposure to the bacteria, flu-like symptoms develop. These symptoms include fever, headaches, and ...

? * Was "the great pox"

syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms depend on the stage it presents: primary, secondary, latent syphilis, latent or tertiary. The prim ...

or several venereal diseases? * Did King

George III of the United Kingdom George III (George William Frederick; 4 June 173829 January 1820) was King of Great Britain and Ireland from 25 October 1760 until his death in 1820. The Acts of Union 1800 unified Great Britain and Ireland into the United Kingdom of Great ...

exhibit the classic symptoms of

porphyria Porphyria ( or ) is a group of disorders in which substances called porphyrins build up in the body, adversely affecting the skin or nervous system. The types that affect the nervous system are also known as Porphyria#Acute porphyrias, acute p ...

? * Were the conditions blamed on witches at the

Salem witch trials The Salem witch trials were a series of hearings and prosecutions of people accused of witchcraft in Province of Massachusetts Bay, colonial Massachusetts between February 1692 and May 1693. More than 200 people were accused. Not everyone wh ...

caused by ergotism? * Did

Napoleon Napoleon Bonaparte (born Napoleone di Buonaparte; 15 August 1769 – 5 May 1821), later known by his regnal name Napoleon I, was a French general and statesman who rose to prominence during the French Revolution and led Military career ...

die from

stomach cancer Stomach cancer, also known as gastric cancer, is a malignant tumor of the stomach. It is a cancer that develops in the Gastric mucosa, lining of the stomach. Most cases of stomach cancers are gastric carcinomas, which can be divided into a numb ...

, or was he poisoned with

arsenic Arsenic is a chemical element; it has Symbol (chemistry), symbol As and atomic number 33. It is a metalloid and one of the pnictogens, and therefore shares many properties with its group 15 neighbors phosphorus and antimony. Arsenic is not ...

? * Could Franklin D. Roosevelt's paralytic illness have been

Guillain–Barré syndrome Guillain–Barré syndrome (GBS) is a rapid-onset Paralysis, muscle weakness caused by the immune system damaging the peripheral nervous system. Typically, both sides of the body are involved, and the initial symptoms are changes in sensation ...

rather than

poliomyelitis Poliomyelitis ( ), commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 75% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe ...

? * Did

Abraham Lincoln Abraham Lincoln (February 12, 1809 – April 15, 1865) was the 16th president of the United States, serving from 1861 until Assassination of Abraham Lincoln, his assassination in 1865. He led the United States through the American Civil War ...

have

Marfan syndrome Marfan syndrome (MFS) is a multi-systemic genetic disorder that affects the connective tissue. Those with the condition tend to be tall and thin, with dolichostenomelia, long arms, legs, Arachnodactyly, fingers, and toes. They also typically ha ...

? * Did

Karl Marx Karl Marx (; 5 May 1818 – 14 March 1883) was a German philosopher, political theorist, economist, journalist, and revolutionary socialist. He is best-known for the 1848 pamphlet '' The Communist Manifesto'' (written with Friedrich Engels) ...

have

hidradenitis suppurativa Hidradenitis suppurativa (HS), sometimes known as acne inversa or Verneuil's disease, is a long-term dermatological condition characterized by the occurrence of inflamed and swollen lesions, lumps. These are typically painful and break open, r ...

? * Could Burke and Wills have died of thiaminase poisoning? * Did

René Descartes René Descartes ( , ; ; 31 March 1596 – 11 February 1650) was a French philosopher, scientist, and mathematician, widely considered a seminal figure in the emergence of modern philosophy and Modern science, science. Mathematics was paramou ...

have Exploding head syndrome?

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. Sacks, Oliver
Henry Cavendish: An early case of Asperger's syndrome?
Neurological Foundation of New Zealand (Reprinted with permission from the American Neurological Association). Retrieved on 28 June 2007. The practice of retrospectively diagnosing autism is controversial. Professor Fred Volkmar of

Yale University Yale University is a Private university, private Ivy League research university in New Haven, Connecticut, United States. Founded in 1701, Yale is the List of Colonial Colleges, third-oldest institution of higher education in the United Stat ...

is not convinced; he claims that "There is unfortunately a sort of

cottage industry The putting-out system is a means of subcontracting work, like a tailor. Historically, it was also known as the workshop system and the domestic system. In putting-out, work is contracted by a central agent to subcontractors who complete the p ...

of finding that everyone has Asperger's."

Historical research

Postmortem diagnosis

Examples

Retrospective diagnoses of autism

See also

References

Further reading