Practice of identifying an illness after the death of the patient
A retrospective diagnosis (also retrodiagnosis or posthumous diagnosis) is the practice of identifying an illness after the death of the patient (sometimes a historical figure) using modern knowledge, methods and disease classifications.[1][2] Alternatively, it can be the more general attempt to give a modern name to an ancient and ill-defined scourge or plague.[3]
Historical research
Retrospective diagnosis is practised by medical historians, general historians and the media with varying degrees of scholarship. At its worst it may become "little more than a game, with ill-defined rules and little academic credibility".[2] The process often requires "translating between linguistic and conceptual worlds separated by several centuries",[4] and assumes our modern disease concepts and categories are privileged.[4] Crude attempts at retrospective diagnosis fail to be sensitive to historical context, may treat historical and religious records as scientific evidence, or ascribe pathology to behaviours that require none.[5] Darin Hayton, a historian of science at Haverford College, claims that retrodiagnosing famous individuals with autism in the media is pointless, as historical accounts often contain incomplete information.[6]
The understanding of the history of illness can benefit from modern science. For example, knowledge of the insect vectors of malaria and yellow fever can be used to explain the changes in extent of those diseases caused by drainage or urbanisation in historical times.[3]
Post-mortem diagnosis is considered a research tool, and also a quality control practice[9] and it allows to evaluate the performance of the clinical case definitions.[10] The term retrospective diagnosis is also sometimes used by a clinical pathologist to describe a medical diagnosis in a person made some time after the original illness has resolved or after death. In such cases, analysis of a physical specimen may yield a confident medical diagnosis. The search for the origin of AIDS has involved posthumous diagnosis of AIDS in people who died decades before the disease was first identified.[11] Another example is where analysis of preserved umbilical cord tissue enables the diagnosis of congenitalcytomegalovirus infection in a patient who had later developed a central nervous system disorder.[12]
There have been many published speculative retrospective diagnoses of autism of historical figures. English scientist Henry Cavendish is believed by some to have been autistic. George Wilson, a notable chemist and physician, wrote a book about Cavendish entitled The Life of the Honourable Henry Cavendish (1851), which provides a detailed description that indicates Cavendish may have exhibited many classic signs of autism.[23][24][25][26] The practice of retrospectively diagnosing autism is controversial. Professor Fred Volkmar of Yale University is not convinced; he claims that "There is unfortunately a sort of cottage industry of finding that everyone has Asperger's."[25]
^ abcdBurnham, John C. (2005). What is medical history?. Cambridge, UK: Polity. pp. 76–78. ISBN978-0-7456-3224-7.
^ abKevin P. Siena (2005). Sins of the flesh: responding to sexual disease in early modern Europe. Toronto: Centre for Reformation and Renaissance Studies. p. 12. ISBN978-0-7727-2029-0.
^ abcGetz, Faye M. Western Medieval Medicine in Greene, Rebecca (1988). History of medicine. New York, NY: Institute for Research in History. ISBN978-0-86656-309-3.
^S. Suryavanshi, J. D. Gomez, A. Mulla, J. Kalra, "Prevalence of diagnostic discordance: A retrospective analysis of autopsy findings and clinical diagnoses. Vol 30, No 4 (2007) Supplement – Royal College Abstracts, Official college of the canadian society for clinical investigation
^Ikeda S, Tsuru A, Moriuchi M, Moriuchi H (May 2006). "Retrospective diagnosis of congenital cytomegalovirus infection using umbilical cord". Pediatr. Neurol. 34 (5): 415–6. doi:10.1016/j.pediatrneurol.2005.10.006. PMID16648007.
^Murray ED.; Cunningham MG; Price BH. (2012). "The role of psychotic disorders in religious history considered". The Journal of Neuropsychiatry and Clinical Neurosciences. 24 (4): 410–26. doi:10.1176/appi.neuropsych.11090214. PMID23224447. S2CID207654711.