Or, What You Will

What ailed Sir Andrew Aguecheek? Shakespeare made it clear that this improbable character in Twelfth Night had emotional problems and intellectual limitations: "I am a fellow o' the strangest mind i' the world." Again: "Many do call me fool." But why? Surely not for the reason that Aguecheek himself offered: "I am a great eater of beef, and I believe that does harm to my wit."

In last week's Lancet, London's Dr. William H. J. Summerskill indulged in a tour de force of long-range diagnosis came to the conclusion that the fool may have been right. Physician Summerskill worked it out this way: Aguecheek was drunk every night. His tippling could easily have caused cirrhosis of the liver Even Sir Toby Belch, no pathologist but a fellow tosspot, suspected this: "For Andrew, if he were opened, and you find so much blood in his liver as will clog the foot of a flea, I'll eat the rest of the anatomy." A cirrhotic liver is relatively bloodless.

Modern medicine now goes to the mind of the matter. A cirrhotic liver may fail to filter some nitrogen compounds which the body makes in the process of digesting protein foods such as meat. These compounds so affect the nervous system that a diet rich in protein will play hob with the intellectual power of such a patient.

True, this was not known until recent years. But to Dr. Summerskill that is no obstacle. Shakespeare, he suggests, was so astute in his medical observations that he could be 350 years ahead of his time with a case report of "chronic dementia in liver disease due to intolerance of nitrogenous substances."

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