Philosophy

Philip A. Mackowiak in his book, Post Mortem Solving Historys Great Medical Mysteries, has discussed at great length the mysterious deaths of the past and how with the help of todays science we can solve those mysteries which in other words is retrospective diagnosis any illness of a historical figure identified after death using recent methodologies. The author discusses at length twelve famous people, their historical setting and background, disease symptoms, myths, probable causes and syndromes associated with death and arriving at the best fit. The book serves to comprehend a vast knowledge of medical terms and is written in a simple yet engrossing way that a person not related to the field of medicine may appreciate it fully.

Post Mortem
Dr. Philip A. Mackowiak is a distinguished professor of medicine. For a span of fourteen years, Mackowiak has presented challenging historical medical mysteries in form of case studies in front of an awed audience in Baltimore. This book contains twelve such case studies presented in those Clinicopathological Conferences (Baltimore). As the name suggests, the book is really a thorough evaluation of each historical figure and the inexplicable deaths which ensued them, some lost in time and some left in the middle of the process of being solved. Science in all its forms has continued to amaze humans, providing reasons well aligned with the brain to make believe, explained and unexplained phenomenas in this universe. In Philip A. Mackowiaks book, Post Mortem Solving Historys Great Medical Mysteries, there are such evaluations and assessments of the past aligned with what we have learned today with the advancement of medicine and genetic study, that they unravel mysteries which have boggled minds and are yet to be resolved. The deaths and the mysterious ailments that would have caused them, of historic figures (who of course intrigue us the most), and an analysis following those mysteries, Mackowiak has attempted to satisfy our curiosity giving a detailed and in depth analysis of what might have been. The book ultimately serves to guide us to at least consider, if not believe, and link other cases as a challenge to the past and present unidentified ailments. The concept of retrospective diagnosis is brought into light which is itself the application of modern methods, processes and techniques in order to recognize or resolve an unidentifiable case of disease or ailment of a historical figure after hisher death. The symptoms of the patient which are recorded as a matter of safe keeping of historical interests are focused and matched against a variety of present known diseases where the best match is approved of. Mackowiak in this book applies the same notion and extends our knowledge to match the most basic question  are those same diseases a bigger threat to us today than they had been in the past and, if so, what better options are there The book links all the evidences available to us and talks on the basis of pure fact and logic.

Mackowiaks Insights Analysis and Review
Post mortem has twelve chapters in all, each dedicated to a separate controversial famous historical figure who contributed to the past, leaving their prints on the sands of time mortals vanishing, while their origin and life events can be traced, their deaths have become a mystery which to the great dismay of historians have yet to be accounted for. Such is the human nature if something is defined by a beginning then it has to have an ending and this is why we are not just satisfied with the words as in the book
The cause of Alexanders death remains a mystery even today, after over two millennia of scrutiny and speculation.

There has to be an answer and as Mackowiak points out  there are many. He has discussed twelve people namely Egyptian pharaoh Akhenaten, Greek statesman and General Pericles, Alexander the Great, King Herod, Beethoven, Mozart, Florence Nightingale, Booker T. Washington, Joan of Arc, Christopher Columbus, the Roman Emperor Claudius, and Edgar Allan Poe. Each chapter starts in an intriguing way designating the famous figure as a patient  a case under study, laying out hisher background and worth in history, and then disclosing the identity. The title of each chapter has been thoughtfully kept, hinting about its case like, The Human Praying Mantis as Akhenatens appearance resembled one. There are recorded accounts, heard details or painted representations, some very accurate and some eroded away or misplaced, these evidences are the only basis of the research carried out in the quest to solve the mysterious deaths of the named above. He has also stated what the most famous and influential physicians back then had concluded of the possible ailment and what sort of treatment had been carried out for 3500 years that this book covers. He has sometimes confirmed their diagnosis, taken help from it and further rejected some ideas which the modern science has found to be different from the ones in ancient times. Author starts with the Egyptian pharaoh Akhenaten from the 14th century BCE who ruled Egypt for the next seventeen years, turning away from the ways of his ancestors and establishing the sun-disc god. Akhenaten is pictured to be rather ugly with a serpentine neck, elongated head, large ears, pot belly and spider shaped feet and hands. There is a debate starting from a variety of syndromes from Frhlich syndrome to Marfan syndrome and Schistosomal cirrhosis. He pointed out the most suitable answer to be Klinefelter syndrome  genetic disorder. Next is Athens in 490 BCE and its General  Pericles. Known to be one of the most significant cases linked to epidemics calling it a holocaust because of the number of lives it claimed, its diagnosis is evaluated from the work of Thucydides and Hippocrates. The epidemic still remained undiagnosed two millennia later to which the author attributes certain causes. Debate ensued from typhus, pneumonia, influenza, measles, scurvy, bubonic plague and anthrax. The epidemic was concluded to be outbreak of smallpox also saying that Thucydides record might have been biased when he was affected by the disease.

And so the other figures, their histories, their medical records and contemporary physicians treatments, roll out systematically in front of us where the author debates and argues and links and then again argues about what possibly is or might have been. Alexander the Great is identified with the first case of typhoid fever ever against which, some believed, including himself, that he was poisoned. The Jewish Roman Client Kind of Israel, King Herod is diagnosed with a gangrenous penis and worm-afflicted death. Emperor Claudius of Rome was concluded to have movement complexities as well as personality ones leading to Tourette syndrome. Christopher Columbuss case of reactive arthritis is attributed to be caught from an infected parrot by the bacterium Chlamydia psittaci after his return from the famous sea voyage to Portugal. Presence of a DNA test would have confirmed a different birth place even for Columbus as Mackowiak believes but sadly the distant past doesnt offer us that authority. Joan of Arc, a brave rebel, is questioned on her sanity during her presence in the heresy trial. Was she mentally ill Evidently Mackowiak takes us through a convincing journey of diagnosis of the patients acts of mind. The author talks about Wolfgang Amadeus Mozart, the famous composer who died mysteriously at the age of 35 years, reportedly the summit of his fame. He is said by some to have died of rheumatic fever while others suggest influenza and mercury or arsenic poisoning.

Author concludes that he died due to a case of poststreptococcal glomerulonephritis, nephritic syndrome based on the patients symptoms of intolerable body scent and edema (collection of fluid under skin as a result of uncontrolled homeostasis). Along with Mozart, Ludwig van Beethovens long illness and controversial death is debated about. Again there might be several cases. Lead poisoning or liver cirrhosis because of huge amount of alcohol consumption is believed upon as indicated by his autopsy but what Mackowiak pursues is syphilis. Edgar Allan Poe is focused, who was a great American writer and poet of the Romantic Movement. His death remains a mystery till today which Mackowiak tries to resolve convincing us that his repetitive spells of delirium tremens occurred due to excessive intake of alcohol. Delirium tremens is known as the withdrawal symptom of addiction to alcohol. But there have been many other theories including rabies, meningeal inflammation and epilepsy. Florence Nightingale, the leading figure in the history of nursing, is identified as the Lady with the Lamp for her constant tending to soldiers at night during her service in the Crimean war. From the period of 1857, Florence was confined to bed for more than thirty years of her life. The mysterious question is why The diagnosis lead Mackowiak to explain that it was probably due to her contraction of brucellosis which would have been due to her consumption of goat raw milk and meat goods during her service in war. Further in her life the author suggests her illness to be post-traumatic stress disorder along with bipolar disorder. War, a depressive time might also have been the cause for it.

Philip A. Mackowiak has done a fascinating and marvelous work. He has not left out any aspects ever recorded in history and calculated against them his own arguments based upon profound knowledge, concise and clear. They satisfy the reader to the fullest. Some of the records are missing while others been documented right down to their minute details the deaths still remain a mystery but one that can be pondered upon now. The experts have done their best in identifying what has us in doubt for centuries. The most important aspect, apart from dissemination of very interesting information, of this book is that the historical figures serve as classical case studies to follow up and study upon. Many questions arise from this work like whys and hows of what these historical figures did as they did and how are their deaths significantly related to their life events. Also at what, did physicians, at that time, erred in their treatment and why What could they have done that would have saved their patients There are footnotes and references at the end of each chapter which I strongly recommend each reader to further refer as they are excellent reads. This book is bound to hold captive its readers figure by figure and is a must guide for medical students.