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Charles Darwin: A New Biography by John Bowlby, Hutchinson, pp 511,
Pounds sterling 19.95

INTERPRETATIONS of a poem are in a prose that is verbose by comparison
with the verse. Similarly, symptoms of illness take longer to interpret
or explain than to recite, and longer still if they are emotional in origin.
That is because the ‘meaningfulness’ of an illness is embedded in biographical
events, and the links among these events, in the life of the ill person.

More books and articles are published about Charles Darwin than any
other biologist, living or dead, and five times more than about Freud, according
to an acquaintance of mine who has contributed both to Darwinian and Freudian
scholarship. Unlike many works on Darwin, however, this new biography concentrates
less on his scientific work and more on his personal life. In particular,
John Bowlby tries to answer why, for more than 30 years, Darwin suffered
ill health.

Darwin, in his Diary, had noted that at age 22, when the sailing of
the Beagle was delayed two months, he suffered an upset stomach (mainly
seasickness during two attempts to sail) and depression. In the last years
of his life, in his Autobiography, he said that before the sailing he had
been ‘troubled with palpitations and pain around the heart’ and had been
‘convinced’ he had heart disease.

He had not, however, consulted a doctor as he had ‘fully expected to
hear the verdict’ that he was unfit for the voyage, whereas he had ‘resolved
to go at all hazards’. Once the voyage actually began, his symptoms abated.
During the voyage, his health was generally good, and he was active and
energetic.

Some two years after the return of the Beagle, a few weeks before turning
30, Darwin married. During the ensuing year, he several times recorded being
‘unwell’. Something was wrong with his ‘stomach’, he said. Eleven months
after his marriage, and three days before his first child was born, he fell
into a languid state during which he ‘felt the smallest exertion most irksome’
and ‘had no spirits to do anything’; he also suffered ‘periodic vomiting’.

When in this state he could not work properly, and more than a year
after its onset wrote that he could ‘see scarcely anybody’. He was ‘in despair’
and expecting to pass his ‘whole life as a miserable useless valetudinarian’.
At about the age of 32, he began to look for a home outside London, hoping
that this might improve his health.

After moving, though, he found he had to limit his conversation with
scientific acquaintances, because the ‘excitement’ led to ‘violent shivering
and vomiting attacks’. He had ‘lost the power of becoming deeply attached
to anyone’. At 36, he wrote that he believed that for three years he ‘had
not had one whole day, or rather night’ without his stomach having been
‘greatly disordered’, that most days he had felt ‘great prostration of health’,
and that he believed many of his friends thought him ‘a hypochondriac’.

His symptoms exacerbated and remitted until about age 60, after which,
until his death at 73, his health was generally better. Besides these symptoms,
he also suffered, he wrote at 54, ‘dying sensations (or half faint)’, ‘ringing
in ears’, ‘treading on air and vision (focus and black dots)’. In his Autobiography,
he brooded about all the time he had lost in life through illness.

Darwin consulted in the course of his life many of the leading doctors
of his day, but none found an organic illness. What, then, was wrong with
him? Several authors have speculated about the reasons for Darwin’s ill
health. In Bowlby’s bibliography, I counted nine publications, including
one full-length book, devoted to the topic.

One explanation, put forward by Saul Adler, an Israeli parasitologist,
and championed by Peter Medawar, is that Darwin had Chagas’s disease. This
is an infectious disease, caused by a protozoan parasite that lives only
in the western hemisphere, and can produce chronic symptoms similar to Darwin’s.
The parasite responsible was not discovered until 27 years after Darwin’s
death, so such a diagnosis could not have been made in his lifetime.

Bowlby rejects this diagnosis, because Darwin was ill before the Beagle
sailed and, therefore, before possible exposure to the parasite.

Another explanation put forward is that Darwin’s illnesses were an illness,
that he was indeed a hypochrondriac. A further explanation, or group of
explanations, which Medawar made short and witty shrift of, are psychoanalytic.

Bowlby is a psychoanalyst, as well as a psychiatrist, but more than
most psychoanalysts he has researched the links between real events, especially
childhood events, and psychopathology. Now 83, Bowlby has been a towering
figure in English psychiatry. His biography of Darwin, in its breadth and
depth, as well as in its theme, is what one might expect from him – Bowlby’s
explanation is complex and does require a long book to expound. Reduced
to its essentials, it is this.

Darwin’s ill health was psychological in origin. His mother became seriously
ill within a few years of his birth and died when he was eight years old.
In Bowlby’s view, and there is considerable supporting evidence, Darwin
never properly grieved her death. This, Bowlby argues, made Darwin vulnerable
as an adult to real or threatened losses of family members, and Bowlby shows
how his adult symptoms can thus be explained.

Bowlby’s view here is consistent with recent research, some of which
he carried out himself, into the long-term effects of childhood bereavement.
Further, and again there is much evidence, Darwin had a difficult relationship
with his father in childhood and adolescence which, Bowlby believes, rendered
him vulnerable to criticism from emotionally important senior colleagues.

How, then, to explain Darwin’s specific symptoms? Here Bowlby exploits
the speculations of Douglas Hubble and George Pickering. Their view, and
his, is that Darwin suffered from the hyperventilation syndrome.

It is known that arousal of various sorts, including anxiety, can quicken
and deepen breathing; that overbreathing leads to excessive carbon-dioxide
loss; that this renders the blood alkaline; and that respiratory alkalosis,
as the state is called, can cause tenseness, faintness, dizziness, visual
disturbances, palpitations, chest pains and other symptoms. Hence, the hyperventilation
syndrome.

All symptoms, especially those of mental origin, are surrounded by dark
thoughts and worries. These worries in turn can aggravate anxieties, which
affect breathing and so on. The physiologic consequences of hyperventilation
are real. Yet current diagnostic disease classifications omit the hyperventilation
syndrome, because its signs and symptoms are indistinguishable from those
of an anxiety disorder.

Bowlby’s explanations are plausible, though whether Darwin’s vomiting
can be ascribed to hyperventilation seems questionable. If Darwin were alive,
and his doctor explained the symptoms in Bowlby’s terms, there would be
doubters as well as believers. As Darwin is dead, hypotheses cannot be tested.

Nevertheless, this is a major contribution to Darwin studies. We are
fortunate that Bowlby, like Darwin, opted for industrious, rather than idle,
retirement.

Morton Schatzman is an American psychiatrist working in London as a
psychotherapist.