Darwin's Illness

27. The Possibility of Adrenal Disease

27 The Possibility of Adrenal Disease Betsy King has suggested that Darwin was ill because of a diminished function of the cortex of his adrenal gland, caused by his 1834 Chilean fever and its treatment with calomel and manifested by symptoms of hypoadrenalism, including hypoglycemia (low blood sugar).1 There are several serious medical objections to this diagnosis. (1) The adrenal gland supports the body in situations of acute stress. Darwin experienced such a situation in his 1834 illness, which affected “every secretion” of his body.2 If his adrenal had been only partly available, his chances of surviving the illness would have been small. (2) If he survived with damaged adrenals, he would have had weakness and fatigue (major symptoms of hypoadrenalism), and he would not have been able to participate in the strenuous explorations of the Andean Mountains. (3) After his return to England he often recovered rapidly from his periods of fatigue and weakness, whereas if his adrenals had been impaired , his recovery would have been much slower. (4) Even in his most severe episodes of vomiting, he does not appear to have gone into shock—a physical state of low blood pressure, with cold extremities, disturbances of consciousness , and somnolence—whereas individuals with adrenal insufficiency, who also have vomiting, have a high risk of going into shock. (5) If his symptoms were caused by an organic deficiency of his adrenals, it does not seem likely that they would have improved in his later years.3 The role of hypoglycemia in his illness may never have been known because the occurrence of low blood sugar can be diagnosed only by chemical tests that were not available in Victorian times. ...