Retrospective diagnosis: the borderline of science and the humanities

In the present day, diagnoses for aches, pains, conditions and illnesses are part of our individual medical history. Symptoms are understood, in the majority of cases, as signs that lead to answers. However, can we apply our understandings of medicine today on the perceived symptoms experienced by those in the past?

Retrospective diagnosis is a highly debatable topic which questions ethics, religion, scientific methodology and the responsibilities of historians. This post will focus on arguments surrounding the validity of a diagnosis for historical figures and consider whether a diagnosis matters in the pursuit of history. This is important to the project as King George III has retrospectively diagnosed based on evidence from his household such as doctor’s notes, diary entries, letters and even newspaper articles where suggestions for improving the King’s diet were made.

Problems with retrospective diagnosis

One of the issues identified with retrospective diagnosis is the absence of a practitioner-patient relationship which allows for the first-hand observation and interpretation of symptoms. Reports of a patient come from sources such as letters, diaries or records whose authors may fail to recognise symptoms that would aid in contemporary diagnosis. Symptoms that are recognised may also be described using different terminology that could vary in meaning. Diseases, viruses in particular, change over time so their symptoms may not remain consistent.

‘Historians have no qualms about revealing any reality, good or bad or ugly, of a historical figure’

Osamu Muramoto

Verifying a diagnosis of a historical figure is problematic as most diseases do not affect the bones. In cases where tissue is available, as with Chopin whose heart was preserved, there are other obstructions to scientific method, with arguments surrounding the preservation of peace for the deceased and respect for the people affected by the historical figure in question. Muramoto highlights that some diagnoses may be damaging or redeeming to a historical figure’s reputation. This may have a negative effect on their followers or attempt to excuse or explain away their actions.

However…

In the present day, the degree of certainty of a medical diagnosis where practitioner-patient relationship is established is not 100%. Research on the retrospective diagnosis of a historical figures is made public allowing for peer review to aid in the verification and validity of the findings.

A diagnosis can highlight the influence and impact that the disease may have had on their work or behaviours and offer new explanations. As well as adding to the historiography of an individual historical figure, it can provide a history of the disease or condition itself and can be used to create an idea of what the disease was like to live with in their period.

‘The Madness of King George’

The treatment of King George III’s illness will be discussed in a following blog of this project. Retrospective diagnosis for King George III has been based off records that were produced by his physicians. While the physicians of King George III had a practitioner-patient relationship, Joanna Edge has argued that symptoms have been chosen selectively by contemporary practitioners to suit a diagnosis.

King George III and others act as ‘windows of opportunity’ to learn more about social perceptions and medical practices of the past, so are contemporary diagnoses damaging to the interpretation of sources?

Or, by using retrospective diagnosis as a competitive theory, is it possible to use sources in innovative ways that create a broader historiography which can be verified through peer review?

Where do you stand on retrospective diagnosis? Is it a help or a hindrance? Please share your thoughts below!


Further reading:

Edge, Joanne, ‘Diagnosing the past’, Wellcome Collection (2018), https://wellcomecollection.org/articles/W5D4eR4AACIArLL8, Wellcome Collection, https://wellcomecollection.org.

Karenberg, A., ‘Retrospective Diagnosis: Use and Abuse in Medical Historiography’, Prague Medical Report, 110:2 (2009), pp. 140-145.

Muramoto, Osamu, ‘Retrospective diagnosis of a famous historical figure’, Philosophy, Ethics and Humanities in Medicine, 9:10 (2014).

Pruszewicz, Marek, ‘The mystery of Chopin’s death’, BBC News (22 December 2014), https://www.bbc.co.uk/news/magazine-29915863, BBC, https://www.bbc.co.uk.


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