Williams syndrome, a disorder caused by a genetic deletion and characterized by moderate intellectual disability with relatively strong language skills and a hypersocial personality, was first described in the medical literature in 1961. However, 120 years earlier, Charles Dickens wrote the novel Barnaby Rudge, which follows an "idiot" through London's Gordon Riots of 1780. We propose that Dickens based this character on a person he knew with Williams syndrome. Common features include an "elfin" face, decreased cognitive ability and dependence on a caretaker, strong language skills with emphatic and perseverative speech, anxiety, and an empathetic, overly trusting personality. In the novel, these traits lead the character Barnaby to be duped into actively participating in the riots, which nearly results in his hanging. This example of fiction providing a description of a disorder more detailed than that of medical journals more than a century later should encourage physicians to look to sources beyond traditional scientific articles for valuable clinical information.
Attention-deficit/hyperactivity disorder (ADHD) was added to the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised in 1987. Similar disorders had appeared earlier, and many consider the first description of ADHD to be a lecture in 1902 about children with an "abnormal defect in moral control" but normal intelligence. This definition of ADHD is more alarming than the current one. Anne Shirley, the protagonist of the novel Anne of Green Gables (written by Lucy Maude Montgomery and published in 1908), shares the hyperactive and inattentive qualities that fit the current definition of ADHD. She also lacks the menacing characteristics of the 1902 description. This indicates that ADHD, by its modern definition, was probably present in the early 1900s. Furthermore, the character of Anne Shirley shares many biographical similarities with her author, suggesting that Montgomery herself may have had ADHD. Thus, looking at literature from the past not only provides insight into the timeline of ADHD, but also into the thought process of an individual with ADHD. By viewing literary classics through a medical lens, we may gain insight into other diseases as well. [Pediatr Ann. 2017; 46(7):e270-e272.].
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