Penn State researcher counts the ways poetess Browning may have had rare disease

Scholars have proposed a number of explanations for the muscle weakness and other ailments that plagued the Victorian poet Elizabeth Barrett Browning. But none of these after-the-fact diagnoses - from anxiety to tuberculosis - seemed to fit the symptoms perfectly.

Now Pennsylvania State University researcher Anne Buchanan thinks she has cracked the case, as the result of an intensely personal connection.

Her theory: The poet suffered from a rare condition called hypokalemic periodic paralysis, the same illness that plagues Buchanan's own daughter.

The researcher makes her case in the current issue of Perspectives in Biology and Medicine, based on clues in Barrett Browning's diary and letters, including those written to the man who would become her husband, the poet Robert Browning.

Buchanan said the evidence was not enough for absolute proof, but physicians and scientists who have read the manuscript find her theory compelling.

"There's no way to be really conclusive, but when I read it, I felt like it was one of my patients sitting here talking to me," said Willow Grove-based neurologist Stephen F. Lewis, who treats people from across the country with this paralysis.

The disease, which strikes fewer than 1 in 200,000 people, is marked by an impaired ability to regulate levels of potassium, which is essential for muscle contraction. Bouts of muscle weakness or paralysis can be brought on by extreme temperatures, exercise, and fasting, among other factors.

In her writings, Barrett Browning, who was born in 1806 and died in 1861, described feelings of overwhelming weakness after each of these triggers. In the diary she kept at age 25, she related her symptoms the day after a vigorous outdoor excursion:

"Very unwell - could scarcely get down stairs, my legs trembled so much."

Buchanan, a research associate in Penn State's anthropology department who studies genetics and epidemiology, is all too familiar with such symptoms.

She said her daughter, Ellen Weiss, now 30, suffered similar bouts of weakness starting during puberty. Like many with her disease, Weiss spent years going from doctor to doctor, seeking answers in vain, until she finally was diagnosed with periodic paralysis a few years ago.

Weiss recently read the letters that Barrett Browning had written to Robert Browning, and quickly became convinced that she and the ailing poet shared a disease. Her mother then took it further, studying the poet's diary and her correspondence with others.

Numerous scholars have attempted to explain the symptoms of long-dead celebrities, whether through historical clues or direct examination, as with CAT scans performed on Egyptian mummies.

England's King George III, for example, is thought by some to have suffered from a type of porphyria, a group of diseases with diverse symptoms, affecting the skin or the nervous system. And it has been theorized that President Abraham Lincoln had Marfan syndrome, a disorder of the connective tissue, though medical experts have expressed skepticism.

While some of these armchair diagnoses are more firm than others, they are useful in raising awareness for diseases that struggle to attract research funds, said Mary Dunkle, a spokeswoman for the nonprofit National Organization for Rare Disorders.

"It's something that gets it into the news and causes people to think about it," said Dunkle, whose organization has offices in Washington, D.C., and Connecticut.

Whatever her condition, Barrett Browning wrote poems that suggest a familiarity with chronic torment. A sample:

Joy, most changeful of all things,

Flits away on rainbow wings;

And when they look the gayest, know,

It is that they are spread to go!

There are several kinds of periodic paralysis, said Lewis, the neurologist, who is on the advisory board for two groups that conduct outreach for this family of diseases. The kind that Weiss has, and that Barrett Browning possibly had, is the least rare.

Some patients have Weiss' disease because of one of several genetic mutations, while in others the cause is unknown, he said. There is no cure, but it can be managed with a combination of short- and long-acting potassium, among other treatments.

Beside exercise and extreme temperatures, another trigger for paralysis in Weiss' form of the disease is a high-carbohydrate meal, which lowers the level of potassium in the blood. Barrett Browning wrote of an attack after consuming honey, which is high in carbs.

Though Barrett Browning's symptoms puzzled the poet, Buchanan hopes that today they will provide clarity to others.

"What we really hope," Buchanan said, "is that somebody who has this really strange body that they don't understand can read this and say, 'Oh my god, that's me!' "