Wednesday, November 10, 2010

Another follow-up

From Alan Hawk, Collections Manager in the Historical Division:

"The problem with your diagnosis is that spinal muscular atrophy shows up in infancy and most patients die within the first couple of years of his or her life.

A couple of possibilities.

1) This might be an early case of polio, which would account for the sudden onset and “abruptly prevented matrimony.” On the other hand it is a highly infectious disease so one would think that other doctors would have seen other examples of these symptoms.

2) This could also be a psychological conversion reaction. If the patient was severely depressed, he or she could have become paralyzed. That would account for the normal muscle tissue as there would be nothing physically wrong with the patient other than the fact that he or she convinced herself that he or she was paralyzed. The triggering event could have been either the upcoming matrimony or its ‘prevention’ as the bride and the groom frequently had little say in who they ultimately married. This would also explain why the patient was apparently the only case.

While doctors of the time would not been able to diagnose either case, Polio existed as a diagnosis since 1840, but it cause would be unknown until 1908. While depression was recognized as a disorder (melancholia) since ancient times, it wasn’t until the late twentieth century that it symptoms, causes and effects were understood. However, physicians of the time had a good grasp of anatomy and, if the muscle appeared normal, the spinal cord was the next logical place to look. It sounds like the doctors intuitively understood the problem was psychological."

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