Rheumatism strikes hard

October 13th, 14th, 15th, 16th, 1823 – [The first intimation of a serious affliction for Douglas]. When at Albany I was seized with rheumatism in my knees, which almost reduced me from being able to do anything. Here I became lame for two days I can never forget the attention paid to me by General Lewis and family. 

On Wednesday and Thursday I was able to crawl about a little. I went with Mr Lewis over the greater part of his estate. He pays great attention to agriculture and gardening; he has all the newest modes of tillage and many of the newest and most-improved implements.  [Douglas then goes on at great length about Gov. Lewis's garden, perhaps subconsciously repaying the kindly treatment he had received there]

 

This is Douglas's first serious bout of a malady which was to recur regularly throughout the rest of his life. With hindsight, and as a result of a retrospective diagnosis commissioned by Jack Nisbet from Doctors Meredith Heick and Jon Stevenson in the Pacific North West, we think it likely he was suffering from reactive inflammatory arthritis. 

The two doctors agreed that the sudden onset of Douglas’s knee problem, his age at that first incident, and the way it affected both of his joints makes some form of inflammatory arthritis a likely candidate. Further indications often include bouts of flu-like symptoms that can immobilize a patient. Depression is certainly a common side effect. With hindsight we can see elements of depressive behaviour in Douglas around New Year 1826 ["In all probability, if a change does not take place, I will shortly be consigned to the tomb."]

The many forms of the disease make it very unpredictable, and serious flareups can be triggered by anything from a sudden change in the weather to a bodily infection. It is possible he had Reiter's syndrome, characterised by sharp pain confined to one or more joints. Flare-ups in different areas of the body recur sporadically in about half of the patients affected. Almost 40 per cent of Reiter’s patients experience conjunctivitis in their eyes, with the inflammation ranging from mild to severe. 

Douglas, as is well known, had serious problems with his eyes from around 1827 onwards. As Jack has pointed out in his 2014 North Columbia Boundaries Column, we can identify all these features of Douglas's health. It makes it even more impressive that he achieved as much as he did while suffering from this debilitating condition.