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April 23, 1997

The Dueling Diagnoses of Darwin

Author Affiliations

St Luke's—Roosevelt Hospital Center New York, NY

JAMA. 1997;277(16):1275-1276. doi:10.1001/jama.1997.03540400025013

To the Editor.  —While I agree with Drs Barloon and Noyes1 that Charles Darwin had an illness that may be diagnosed as "panic disorder," I should like to make 3 comments about this diagnosis. First, as I have shown, Darwin had episodes of facial eczema that appear to have been psychosomatic in origin and that often were caused by controversies over his revolutionary ideas.2 As far as I can determine, skin afflictions are not among the many somatic complaints that comprise panic disorder.Second, it is possible that Darwin's many gastrointestinal symptoms were the result of Chagas disease, which he contracted by him during the Beagle voyage. This disorder was first active and then became inactive, permanently injuring the parasympathetic nerves of his stomach and making it more sensitive to sympathetic stimulation and hence more sensitive to the psychosomatic impact of his anxieties.3 An organic impairment best explains the lifelong