From the available evidence and retrospective diagnosis, Young
[D.A.B. Young, Ramanujan's illness, Current Science, 67
(1994) 967-972] makes out the case for hepatic amoebiasis, a tropical
disease contacted by Ramanujan in 1906, as the cause of his terminal
illness. His reason as to why this was not recognized at that
time is best recounted in his own words:Hepatic amoebiasis was
regarded in 1918 as a tropical disease ('tropical liver abscess'),
and this would have had important implications for successful
diagnosis, especially in provincial medical centers. Furthermore,
the specialists called in were experts in either tuberculosis
or gastric medicine. Another major difficulty is that a patient
with this disease would not, unless specifically asked, recall
as relevant that he had had two episodes of dysentery 11 and 8
years before. Finally, there is the very good reason that, because
of the great variability in physical findings, the diagnosis was
difficult in 1918 and remains so today: hepatic amoebiasis 'presents
a severe challenge to the diagnostic skills … [and] should
be considered in any patient with fever and an abnormal abdominal
examination coming from an endemic area'.
