Exploring an Explorer's Illness:

UT Arthritis Expert Re-Examines Death of Christopher Columbus

By Meredith Raine

In 1492, Columbus sailed the ocean blue. His destination was the East Indies, but he inadvertently docked on New World soil, going down in history as the famed explorer who discovered America.

A rheumatologist at The University of Texas Medical School at Houston believes that what immediately followed this historical event may have ultimately led to Columbus' demise.

Based on clues dotted throughout historical documents, Frank Arnett, M.D., professor of internal medicine and holder of the Elizabeth Bidgood Chair in Rheumatology, has deduced that Columbus most likely developed a progressively debilitating form of arthritis upon his return home from that maiden voyage.

The University of Maryland School of Medicine invited Dr. Arnett to review Columbus' symptoms and propose theories about his illness and death during its annual historical clinicopathological conference. Last spring, he presented his findings there and at the UT Medical School.

Before Columbus' death 500 years ago this month, his symptoms were described as gout. A more plausible diagnosis, Dr. Arnett says, is reactive arthritis – a potentially crippling disease that wouldn't be described for centuries to come.

From the time Columbus was in his 40s until he died just short of his 55th birthday, he suffered from relapsing arthritis that began in lower extremities and became progressively disabling. He also had an old wound that reopened.

Other recurring symptoms were bleeding eyes and periods of blindness. Dr. Arnett says these conditions were key to his differential diagnosis that Columbus had reactive arthritis, also known at Reiter's syndrome.

There is evidence Columbus may have even had a fused spine, a symptom of ankylosing spondylitis, which is a cousin of reactive arthritis.

Dr. Arnett theorizes that bouts of food poisoning and a gene that would have made him susceptible to this now-rare form of arthritis most likely triggered Columbus' skin ulceration and inflammation of the joints and eyes.

Based on the known symptoms, Dr. Arnett used process of elimination in an attempt to unravel the mystery of Columbus' disease.

Columbus didn't fit the classic description of someone with gout, Dr. Arnett says. He was not portly. Rather he was fit and muscular. Columbus also wasn't known to imbibe in alcohol or rich foods.

Stereotypical gout profile aside, even if Columbus had been genetically predisposed to gout, his symptoms didn't match the disease. Gout attacks usually last seven to 10 days before joint pain and swelling subside. "The durations of Columbus' attacks were simply too long to be gout," Dr. Arnett says.

For the same reason, Columbus couldn't have suffered rheumatic fever, Dr. Arnett says. At times, Columbus was bedridden for months. On one voyage, sailors had to construct shelter for him on the poop deck because he was so sick. With rheumatic fever, he would have recovered within a matter of weeks.

Dr. Arnett ruled out rheumatoid arthritis because it appears the arthritis didn't cripple Columbus' hands until the end of his battle with disease, which rendered him unable to write. Rheumatoid arthritis would have affected his hands much earlier, Dr. Arnett says.

The bleeding eyes and re-opened wound could have been signs of scurvy, a deficiency of vitamin C, Dr. Arnett says, but the length of Columbus' four voyages to the New World didn't match up with scurvy's 100-day rule. Sailors at sea for at least 100 days were at risk for scurvy, but Columbus' voyages never lasted longer than two months.

Columbus could have had Behcet's syndrome, a chronic condition that causes mouth ulcers, eye inflammation, skin problems, and arthritis.