Did Sejong the Great have ankylosing spondylitis? The oldest documented case of ankylosing spondylitis.

AIM: Sejong the Great (May 7, 1397-March 30, 1450), a king during Korea's Choson Dynasty, is the most respected historical figure in South Korean society, and consequently, many studies have been conducted on his achievements and the disease he suffered. The dominant trend of scholarship claims that Sejong suffered from diabetic retinopathy. However, this interpretation has not been medically verified. The present analysis aimed to demonstrate that Sejong's is the oldest documented case of ankylosing spondylitis.

METHODS

The Annals of the Choson Dynasty (hereafter, The Annals) are daily records of the king. The Annals were recorded for 472 years (1392-1865) and contain 49 646 667 Chinese characters. Records in The Annals on Sejong span 1418-1450; the present study author reviewed these records.

RESULTS

Sejong's medical records are mentioned 40 times in the source text. The king first experienced musculoskeletal pain in his knee at the age of 22 years. Sejong's knee pain is mentioned 3 times, and his back pain, which he described as "stiff and immobile", is mentioned 6 times. He complained most frequently of ocular symptoms described as "prickly or tingling," which are mentioned 12 times.

CONCLUSIONS

Based on the analysis of official documentation, the author argues that there is a high probability that Sejong suffered from ankylosing spondylitis, making this the oldest officially documented case of the disease.