Feature Christmas 2009: Diagnosis

Darwin’s illness revisited

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4968 (Published 14 December 2009) Cite this as: BMJ 2009;339:b4968

Avicenna's diagnosis of Darwin's disease

Avicenna is one of the most famous ancient scholars, who lived about
1000 years ago. He wrote almost 450 treatises on a wide range of subjects,
of which around 240 have survived. In particular, 40 of his surviving
treatises concentrate on medicine.(1) His most famous works is "The Canon
of Medicine". He discusses a disease in "The Canon of Medicine", named
"Tasaode abkhare", which means "rising gas". His description on this
disease, interestingly, matches the symptoms of Darwin's disease: nausea,
vomiting, flatulence, headache, dizziness, visual disturbance and
eczema.(2)

About the pathophysiology of this disease Avicenna believed that problems
in digestive system function can lead to overproduction of
Gastrointestinal tract gases, which can transfer to different organs and
cause various symptoms synchronously. It can cause headache, dizziness and
vertigo on affecting brain, tinnitus if affecting ears and visual
hallucination if affecting eyes. He says:
"Headache which caused by Gas rise accompanied with tinnitus, vertigo,
dizziness and visual disturbance."(3)

Eczema can be another presentation of this disease, when body wants to
expel these pathogenic gases through skin. Avicenna believed that it shows
transfer of disease to skin, so other symptoms disappear when skin lesions
come out, as was present in Darwin's disease.
Temporary response to "cold water" therapy, as found in Darwin's course of
disease, appears in "Gas rising" due to liquefaction of wandering gases.

But Avicenna believes that this therapeutic approach causes chronicity of
disease. According to "The Canon of Medicine" if Avicenna wants to treat
Darwin's disease he may use three step therapeutic approach:

1- Decrease gas production by treating gastrointestinal tract digestive
problem with life style modification and compound herbal drugs which
build up digestive power.

2- Transfer inhibition of GI tract produced gases by herbs such as
Coriander

3- Lysis of transferred gases to other organs by topical use of something like chamomile oil.

Competing interests: No competing interests

18 August 2011
Heydari
student;
Mohammad H. Hashempur, Seyyed H. Mosavat
Shiraz University of Medical Sciences, Shiraz, Iran