The first American case of myasthenia gravis

Reported here is an account of the illness of Indian Chief Opechankanough (died 1644), which may represent the first recognized case of myasthenia gravis. Historical publications based on colonial correspondence with England are the sources for this article. To my knowledge, this is the first article in the medical historical literature to mention this famous and influential Indian. Historical accounts state that Opechankanough was so weak as to be unable to walk, making it necessary that he be carried about on a litter. Moreover, his eyelids were so weak they had to be raised by his attendants. Additionally, a hint of improvement in this weakness after rest is suggested by one historical account. The differential diagnosis of Chief Opechankanough's weakness is discussed. The historical setting of this famous chief in Colonial America and Colonial Virginia is described, as well.