Diagnosis Made in Historical Conference Sponsored by the University of Maryland School of Medicine and the VA Maryland Health Care System
The man known for discovering the New World in his famed ocean voyage of 1492 suffered from a serious form of arthritis that left him crippled, with high fevers and bleeding from the eyes. After years of intense pain and puzzling symptoms, mariner and explorer Christopher Columbus succumbed to reactive arthritis at the relatively young age of 54 in 1506.
The death of Christopher Columbus is the focus of this year’s historical clinicopathological conference (CPC) sponsored by the University of Maryland School of Medicine and the Veterans Affairs (VA) Maryland Health Care System in Baltimore.
The 2005 historical CPC will be held Friday, May 6, from 1:30 to 3:00 p.m., in Davidge Hall (522 W. Lombard Street) at the University of Maryland School of Medicine. Davidge Hall is the oldest medical school building in continuous use in the United States. More than 300 faculty members, students and alumni are expected to attend the CPC, where the case of an unnamed but famous historical person is presented for discussion in an academic setting.
“While literature indicates that physicians of the day diagnosed Christopher Columbus with gout, it is my belief that Columbus was plagued by reactive arthritis, a form of arthritis that follows an infection,” says Frank C. Arnett, M.D., a rheumatologist and professor of internal medicine, pathology and laboratory medicine and the Elizabeth Bidgood Chair in Rheumatology at the University of Texas Medical School at Houston. Dr. Arnett will present his case study of Christopher Columbus at the CPC and outline his diagnosis.
According to historical records, Columbus’ first sign of illness began abruptly at age 41 with an attack of “the gout” during a violent storm on his return from the first of four voyages of discovery. In subsequent years, he suffered from what is believed to be influenza, other fevers, bleeding from the eyes, and recurrent and prolonged attacks of the suspected gout. “Columbus doesn’t embody the stereotypical portly man inclined toward rich foods and alcohol, too much of which can lead to gout,” says Dr. Arnett. “A stronger argument against his having gout is the duration of the attacks. Gout flare-ups usually last 7-10 days and then completely resolve, but Columbus experienced many months of debilitation on several occasions before becoming completely bedridden.”
Dr. Arnett believes that reactive arthritis is a more accurate diagnosis of what ailed Columbus. “Reactive arthritis is an inflammation of certain joints that occurs several weeks after intestinal bacterial infections or after acquiring a sexually transmitted disease like Chlamydia,” he says. “It seems likely that he acquired reactive arthritis from food poisoning on one of his ocean voyages because of poor sanitation and improper food preparation.”
Current medical literature shows that there is also a strong genetic contribution to both the susceptibility and severity of the disease. “The major gene associated with reactive arthritis is HLA-B27, which can be detected in about 75 percent of patients who have it,” says Dr. Arnett. “In Europe, the highest concentrations of the disease are found in the most northern countries. Since Columbus was tall, fair skinned and blue-eyed, he may have been of northern European ancestry and had a reasonable likelihood that he inherited the biomarker for reactive arthritis.”
Widely believed to have been born in Genoa, Italy, in 1451, Christopher Columbus was the son of a wool merchant and a weaver. He moved to Spain in 1485 and was commissioned by Spain’s King Ferdinand and Queen Isabella in 1492 for the first of his four voyages of discovery. He set sail for Asia that year and is believed to have found America soon after. Subsequent voyages led to the discovery of South America and a year of isolation on the island of Jamaica after his ship was beached. Columbus returned to Spain for the last time in 1504 and died in 1506.
As part of the historical clinicopathological conference, historians Charles Merrill, P.h.D., language professor at Mt. St. Mary’s Seminary, and Francesc Albardaner, a historical researcher and member of the Columbus Study Center of the Omnium Cultural Foundation in Barcelona, Spain, will discuss Columbus’ supposed ancestry because of growing evidence to support the argument that Columbus was from Catalonia, an independent country during the Middle Ages, but now part of Spain and France.
The historical clinicopathological conference is presented as part of the 130th annual reunion of the Medical Alumni Association of the University of Maryland School of Medicine. “This conference is unique in its approach to the history of medicine,” says Philip A. Mackowiak, M.D., professor and vice chair of the Department of Medicine at the University of Maryland School of Medicine and director of medical care at the VA Maryland Health Care System. The historical CPC is the brainchild of Dr. Mackowiak, who adds, “No other conference I know of brings together some of the world’s brightest clinicians and most knowledgeable historians to dissect and debate history’s great medical mysteries.”
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