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To the Editor:
—In the April 29 issue of The Journal, Dr. Phillip E. Rothman cites an instance of the portrayal of the symptoms of a disease in a fictional character appearing before the malady was systematically studied and recorded authoritatively in medical literature, and quotes the character Joe, the fat boy, in Dickens's Pickwick Papers, who was a victim of narcolepsy. May I be permitted to point out another character by the same author that showed sharp power of observation by the writer? In 1848 Dickens, in Dombey and Son, chapter XXXVII, capably described the last illness of Mrs. Skewton. His delineation of her speechless state, her staring at the ceiling, the making of inarticulate guttural sounds in answer to questions, well depict the symptom complex of hemiplegia. The gradual recovery of some motion in the right hand, though not of speech, shows fidelity to nature in a remarkable
Hagemann JA. PORTRAYALS OF DISEASE IN FICTION. JAMA. 1933;100(21):1713. doi:10.1001/jama.1933.02740210061031
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