page_title: Health of Samuel Johnson
section_title: Tourette syndrome
hierarchical_section_title: Health of Samuel Johnson / Posthumous diagnosis / Tourette syndrome
caption_attribution_description: English: Portrait of en:Samuel Johnson
context_page_description: The health of Samuel Johnson has been a focus of the biographical and critical analysis of his life. His medical history was well documented by Johnson and his friends, and those writings have allowed later critics and doctors to infer diagnoses of conditions that were unknown in Johnson's day.
  His health and conditions had "damaging effects on Johnson's personal and professional lives" likely causing him to lose opportunities to teach at prominent schools, while leading him "towards the invisible occupation of authorship".
context_section_description: Johnson displayed signs consistent with several diagnoses described in the Diagnostic and Statistical Manual of Mental Disorders, and it is widely accepted that Johnson had Tourette syndrome (TS), a condition unknown during Johnson's lifetime. Johnson displayed signs of TS as described by the writings of Boswell:
  ... while talking or even musing as he sat in his chair, he commonly held his head to one side towards his right shoulder, and shook it in a tremulous manner, moving his body backwards and forwards, and rubbing his left knee in the same direction, with the palm of his hand. In the intervals of articulating he made various sounds with his mouth; sometimes giving a half whistle, sometimes making his tongue play backwards from the roof of his mouth, as if clucking like a hen, and sometimes protruding it against his upper gums in front, as if pronouncing quickly under his breath, 'Too, too, too.' All this accompanied sometimes with a thoughtful look, but more frequently with a smile. Generally when he had concluded a period, in the course of a dispute, by which time he was a good deal exhausted by violence and vociferation, he used to blow out his breath like a whale.
  There are many similar accounts; in particular, Johnson was said to act in such a manner at the thresholds of doors, and Frances Reynolds claims that, "with poor Mrs Williams, a blind lady who lived with him, he would quit her hand, or else whirl her about on the steps as he whirled and twisted about to perform his gesticulations". When asked by Christopher Smart's niece, a young child at the time, why he made such noises and acted in that way, Johnson responded: "From bad habit."
  He had a number of tics and other involuntary movements; the signs described by Boswell and others suggest that Johnson had Tourette syndrome (TS). In 1994, J. M. S. Pearce analysed—in a Journal of the Royal Society of Medicine report—the details provided by Boswell, Hester Thrale, and others, in an attempt to understand Johnson's physical and mental condition. Based on their anecdotal evidence, Pearce compiled a list of movements and tics which Johnson was said to have demonstrated. From that list, he determined it was possible that Johnson was affected by Tourette syndrome as described by Georges Gilles de la Tourette. Pearce concluded that the "case of Dr Johnson accords well with current criteria for the Tourette syndrome; he also displayed many of the obsessional-compulsive traits and rituals which are associated with this syndrome".
  Pearce was not alone in diagnosing Johnson as having Tourette syndrome; in 1967 Lawrence C. McHenry Jr was the first to diagnose Johnson with the syndrome but in passing. It was not until Arthur K. Shapiro's Gilles de la Tourette Syndrome that the diagnosis was made clear through a comprehensive study, with Shapiro declaring, "Samuel Johnson ... is the most notable example of a successful adaptation to life despite the liability of Tourette syndrome". T. J. Murray had come to the same conclusion in a 1979 British Medical Journal paper. Murray based his diagnosis on various accounts of Johnson displaying physical tics, "involuntary vocalisations" and "compulsive behaviour".
  In a 2007 analysis, Thomas Kammer discusses the "documented evidence" of Johnson's tics, saying that Johnson was "known to have suffered from TS". According to neurologist Oliver Sacks, "the case for Samuel Johnson having the syndrome, though [...] circumstantial, is extremely strong and, to my mind, entirely convincing". He continues by generally describing the "enormous spontaneity, antics, and lightning quick wit" that featured prominently in Johnson's life. However, Pearce goes further into Johnson's biography and traces particular moments in Johnson's life which reinforced his diagnosis, concluding:
  It is not without interest that periodic boundless mental energy, imaginative outbursts of inventiveness and creativity, are, characteristic of certain Tourette patients. It may be thought that without this illness Dr Johnson's remarkable literary achievements, the great d
caption: Reynolds' 1769 portrait depicting Johnson's "odd gesticulations"[37]
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