150 years since the death of Charles Dickens: the great observer


On Thursday 9 June 1870, the celebrated novelist Charles Dickens died at his home at Gad's Hill Place in Kent at the age of 58 years, a day after suffering a stroke.

Perhaps unusually for someone with no clinical qualifications, notices of his death were promptly published in both the British Medical Journal (18 June) and The Lancet (21 June), the former noting, among many other achievements, his facility in the description of medical disorders.

Perhaps the most fa- miliar such example of 'Dickensian diagnosis' is that of Joe the fat boy, who appears in one of Dickens's earliest works, the Posthumous Papers of the Pickwick Club (published 1837, and subsequently known generally as the Pickwick Papers): Joe's obesity, ruddy complexion, daytime hyper- somnolence, and dropsy later prompted use of the term 'Pickwickian syndrome' to describe similar cases, termin- ology now superseded by 'obstructive sleep apnoea-hypopnoea syndrome'.

Dickens's interests were very extensive, and these encompassed science as well as literature.

Certainly, he was familiar with a variety of clinicians, since many 'types' appear in his fiction, as later catalogued by another clinician, the radiotherapist Sir David Waldron Smithers.

Unsurprisingly then, Dickens's works have proved of enduring interest for many clinicians, including such distin- guished neurologists as Lord Brain (1895-1966) and Macdonald Critchley (1900-97), both of whom published on Dickens (Brain, 1960; Critchley, 1979) as have John Cosnett (1925-2012), Varun Singh (1948-2019), and David Perkin in more recent times.