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Darwin's contribution to psychiatry

  • Edward Shorter (a1)

This November we celebrated the sesquicentennial of the Origin of Species, a landmark in the history of biology. Yet Darwin's chief contribution to psychiatry appears in The Expression of the Emotions in Man and Animals (1872), where he describes ‘the grief muscles', later identified as a sign of melancholic illness.

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1 Darwin, C. On the Origin of Species. John Murray, 1859.
2 Mora, G. Historical and theoretical trends in psychiatry. In Comprehensive Textbook of Psychiatry (eds Freedman, AM, Kaplan, HI, Saddock, BJ), vol. 1: 174. Williams and Wilkins, 1975.
3 Colp, R Jr. Darwin's Illness. University Press of Florida, 2008.
4 Pickering, G. Creative Malady. George Allen & Unwin, 1974.
5 Darwin, C. The Expression of the Emotions in Man and Animals. Originally published 1872. Quotations from University of Chicago Press, 1965 reprint: 176–7, 179, 195.
6 Shorter, E, Fink, M. Endocrine Psychiatry: Solving the Riddle of Melancholia. Oxford University Press, 2010 (in press).
7 Schüle, H. Handbuch der Geisteskrankheiten: 439. Vogel, 1878.
8 Bumke, O. Lehrbuch der Geisteskrankheiten (2nd edn). Bergmann, 1924.
9 Greden, JF, Genero, N, Price, HL. Agitation-increased electromyogram activity in the corrugator muscle region: a possible explanation of the ‘Omega Sign’? Am J Psychiatry 1985; 142: 348–51.
10 Taylor, MA, Fink, M. Melancholia: the Diagnosis, Pathophysiology, and Treatment of Depressive Illness: 87. Cambridge University Press, 2006.
11 Veraguth, O. Die klinische Untersuchung Nervenkranker. Bergmann, 1911.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Darwin's contribution to psychiatry

  • Edward Shorter (a1)
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Darwin’s contribution to psychiatry

Temi Metseagharun, Locum Staff Grade Psychiatrist
07 December 2009

Charles Darwin will always remain a giant on whose shoulder any evolutionary biologist must climb. It is therefore important for his worksto be remembered. However, in this editorial I perceive a form of idealisation of a truly great individual, but not for his contributions tothe field of psychiatry. Edward shorter made the statement “yet apart from these few quickenings of interest, it would be fair to say that in psychiatry today, curiosity about Darwin’s grief muscles – about the omega sign – does not go beyond antiquarianism�.1 Indeed, beyond antiquarianism, the pictures shown were reminiscent of physiognomy and phrenology – pseudosciences abandoned because of the obvious racial and other forms of prejudice that they foster. Negative contributions to psychiatry may be inferred in criticisms or attempts at falsification of the theory or principle of “natural selection� as the only mechanism of evolution. Psychiatry is essentially social and Evolution relevant to psychiatry must be about social evolution and the neurobiology of socialisation. Much of human social evolution embodies what could be regarded as “unnatural selection� with the development and holding on to man-made laws for our evolved type of socialisation, otherwise called “civilisation�. Here we come across human-specific principles such as kindness, compassion and altruism that are opposites of the harsh “natural selection� in the world of lower animals where “survival ofthe fittest� operates. Any call for a “time for truly biological psychiatry� 2 using purely Darwinian principles can only remind us of social Darwinism – a misguided philosophy already tried, but observed tobe clearly against the human spirit that perceives the (controversial) concept of good and evil and indentified social Darwinism as unacceptable.Can anyone advocate “survival of the fittest� to a service-user? Is the whole of psychiatric practice especially diagnostic constructs not theresult of highly unnatural (human) selection? I’m afraid I have to be blunt and state that I see no contribution from Darwin, or the principle of natural selection to mental health practice or treatment and that if our understanding of mind will progress, we must ignore Darwinism and neo-Darwinism.

1.Shorter, E. Darwin’s contribution to psychiatry. Br J Psychiatry(2009) 195: 473-474.2.Nesse RM. Evolution at 150: time for truly biological psychiatry.Br J Psychiatry (2009) 195: 471-2.

Author's current appointment: Locum Staff Grade Psychiatrist, TenAcres Centre, Birmingham and Solihull Mental Health NHS Foundation Trust,Dogpool Lane Stirchley Birmingham B30 2XHcontact telephone: 0121 6782800 and fax: 0121 6782801
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Conflict of interest: None Declared

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Darwin's Illness � an End in Sight

John A Hayman, pathologist
04 December 2009

Charles Darwin suffered a chronic disabling illness for most of his adult life, an illness that has been the subject of much speculation. This is more than a cottage industry; at least four books have been written on the subject and at least one more is on the way.

Darwin suffered from the Cyclic (or Cyclical) Vomiting Syndrome, a little known but well defined disorder associated with mitochondrial DNA abnormalities. Although regarded as a childhood disorder the complaint may

persist into adulthood and my appear for the first time in an adult.

Like Darwin, sufferers today experience a range of psychiatric symptoms including panic, anxiety and depression. These symptoms may be associated with sweating, dizziness, palpitations and extreme lethargy. Neurological symptoms also occur with headache, muscle weakness and tremor. Gastrointestinal symptoms are an essential component of the syndrome, the most disabling being episodes of nausea, vomiting, retching and flatulence.

Episodes of the illness may be brought on by stress, both physical and mental and characteristically these include pleasurable events. Sufferers are prone to motion sickness (as was Darwin) and eczema (atopic dermatitis). Many obtain relief by water exposure.

Patients with the disorder today, suffered as Darwin suffered from misdiagnosis, unnecessary investigations, inappropriate treatment and even

surgery (cholecystectomy). Darwin was spared the latter but he did suffer greatly. He would be pleased to know the true nature of his illness.


Hayman, J., Darwin's Illness Revisited. British Medical Journal, 2009. manuscript no. 2009/647727: accepted for Christmas edition.

Hayman, J., Charles Darwin in New Zealand and Australia: insights into Darwin's illness and his developing Ideas on evolution. Medical Journal of

Australia, 2009. manuscript no. MJA-2009-10991: accepted for Christmas edition.

Fleisher, D.R., et al., Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med, 2005. 3: p. 20.
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Conflict of interest: None Declared

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