WEBVTT - Encephalitis Lethargica 0:00:01.120 --> 0:00:04.080 Welcome to Stuff You missed in History Class from how 0:00:04.120 --> 0:00:14.040 Stuff Works dot Com. Hello, and welcomed to the podcast. 0:00:14.160 --> 0:00:17.159 I'm Tracy B. Wilson and I'm probably from So. I 0:00:17.200 --> 0:00:20.720 did not intend for today to be a Halloween episode. 0:00:22.400 --> 0:00:26.800 Is scary. Yeah, due to some quirks in our publishing schedule, 0:00:27.640 --> 0:00:30.400 it happens to be coming out right before Halloween. It 0:00:30.480 --> 0:00:34.320 is a listener request from listener Ellen or perhaps Ellen, 0:00:34.720 --> 0:00:37.760 And in researching it, I realized it was the most 0:00:37.800 --> 0:00:42.040 frightening thing I had ever learned about. So, so buckle up. 0:00:42.640 --> 0:00:45.559 History has scared Tracy. History has scared Meat. So. From 0:00:45.760 --> 0:00:50.000 nineteen sixteen to about nine seven, this really bizarre epidemic 0:00:50.159 --> 0:00:53.120 spread around the world. It came to be known as 0:00:53.200 --> 0:00:56.120 sleepy sickness, and it is not to be confused with 0:00:56.200 --> 0:00:59.000 sleeping sickness, which is a tropical disease found in sub 0:00:59.040 --> 0:01:03.080 Saharan Africa. This is another name for a disease called 0:01:03.480 --> 0:01:08.959 encephalitis lethargica, and it caused this really weird variety of symptoms, 0:01:09.000 --> 0:01:14.920 from drastic behavior changes to unusual eye movements. Especially in 0:01:14.959 --> 0:01:18.640 the beginning years of it. Uh, the really common element 0:01:19.560 --> 0:01:22.840 was this deep, prolonged sleep that went on and on 0:01:23.000 --> 0:01:27.000 from days two months, and people just couldn't wake up. 0:01:27.720 --> 0:01:31.399 Between twenty and of the people who got this disease died, 0:01:32.080 --> 0:01:35.240 and of the ones who survived, only about a third 0:01:35.400 --> 0:01:39.080 really fully recovered. The rest developed what came to be 0:01:39.160 --> 0:01:42.960 known as post and syphilitic parkinson ism, and some of 0:01:43.000 --> 0:01:47.560 these patients persisted in a semi comatose state for decades. 0:01:48.480 --> 0:01:52.639 It's extra terrifying. The next part is even more terrifying. Yeah, 0:01:52.680 --> 0:01:55.440 As if all of this were not enough to scare 0:01:55.440 --> 0:01:58.760 the pants off of you. While in this extremely deep sleeps, 0:01:58.880 --> 0:02:01.880 it was part of many of the aces. People appeared 0:02:01.880 --> 0:02:06.160 to be unconscious, but in reality they were actually alert. 0:02:06.280 --> 0:02:08.480 They were completely aware of what was going on, but 0:02:08.520 --> 0:02:10.440 they were unable to move or speak, so it was 0:02:10.480 --> 0:02:14.079 a sort of paralysis. Really. Yeah, So people today may 0:02:14.120 --> 0:02:17.880 have heard about this whole disease from the movie Awakenings 0:02:18.040 --> 0:02:22.520 starring Robin Williams, or maybe from the first pages of 0:02:22.760 --> 0:02:27.480 Neil Gaiman's amazing comic book series Sandman, which starts off 0:02:27.520 --> 0:02:31.079 when a ritual that was meant to capture death instead 0:02:31.160 --> 0:02:37.000 captures dream and causes people to sleep endlessly. Otherwise, it's 0:02:37.040 --> 0:02:39.519 pretty far in the background of medical history most of 0:02:39.560 --> 0:02:43.000 the time. It's not something that people remember all that 0:02:43.080 --> 0:02:46.560 well today, but from its onset until about ten years 0:02:46.560 --> 0:02:49.560 after it faded away, there were more than nine thousand 0:02:49.680 --> 0:02:52.680 papers and books published on it, So at the time 0:02:52.760 --> 0:02:56.760 it was a big deal, even though people don't necessarily 0:02:57.520 --> 0:03:02.119 come up with it immediately when thinking about huge epidemic today. Yeah, 0:03:02.400 --> 0:03:05.720 and I wonder why that is ull talk about some 0:03:05.800 --> 0:03:09.480 of that. Yeah, Prolonged sleep as an illness has been 0:03:09.520 --> 0:03:13.680 reported really really way back into history. There are written 0:03:13.680 --> 0:03:17.320 records as early as Hippocrates of this kind of incident happening. 0:03:17.680 --> 0:03:20.160 And then there are also, of course in our cultural 0:03:20.160 --> 0:03:23.920 consciousness tales like sleeping beauty and these stories like ripped 0:03:23.960 --> 0:03:27.800 van Winkle uh, and some people along the line have 0:03:27.880 --> 0:03:30.760 theorized that these were actually rooted to some degree in 0:03:30.880 --> 0:03:34.160 some kind of sleeping illness. In the real world, there 0:03:34.160 --> 0:03:36.680 had also been an outbreak of a similar condition in 0:03:36.760 --> 0:03:40.160 Italy in eighteen eighty nine and eighteen ninety, which came 0:03:40.200 --> 0:03:43.160 to be known as Landona, and it was thought at 0:03:43.160 --> 0:03:46.040 the time to be a complication of the flu. And 0:03:46.120 --> 0:03:50.240 around the world other outbreaks of encephalitis had also followed 0:03:50.280 --> 0:03:55.600 behind other epidemics, particularly the flu. This particular one started 0:03:55.640 --> 0:03:59.040 just a couple of years before the nineteen eighteen Spanish 0:03:59.080 --> 0:04:03.080 flu epidemic, which killed between twenty and forty million people, 0:04:04.120 --> 0:04:07.520 and when it came to the encephalitis lethargica epidemic, the 0:04:07.560 --> 0:04:11.280 first reports came at about the same time in different 0:04:11.280 --> 0:04:14.480 two different places, which were France in Austria. In nineteen 0:04:14.520 --> 0:04:18.719 six in France, a doctor named Genrene Cruche started to 0:04:18.720 --> 0:04:23.280 see six soldiers with this weird assortment of seemingly unrelated 0:04:23.320 --> 0:04:26.840 neurological symptoms, and the one common element was that the 0:04:26.880 --> 0:04:31.760 patients just slept, apparently peacefully and deeply, and that they 0:04:31.760 --> 0:04:34.520 could not be woken up, and he started to wonder 0:04:34.600 --> 0:04:37.559 whether there was some kind of new chemical weapon at work. 0:04:38.279 --> 0:04:40.960 At about the same time, a British doctor named A. J. 0:04:41.160 --> 0:04:45.120 Hall also reported similar symptoms, and other troops who were 0:04:45.160 --> 0:04:48.919 stationed in France. In Vienna, it came to the attention 0:04:49.080 --> 0:04:54.320 of Romanian Austrian psychiatrists Constantine von Economo after a sleepy, 0:04:54.400 --> 0:04:58.680 disoriented civilian wandered into the Wagner Jarre clinic where he worked. 0:04:59.400 --> 0:05:02.000 The doctor's there had mostly been treating soldiers who were 0:05:02.000 --> 0:05:04.919 wounded in the war, so they really weren't prepared for 0:05:04.960 --> 0:05:09.320 this apparently uninjured civilian with nothing physically wrong that they 0:05:09.320 --> 0:05:13.280 could really point to. And then more and more patients 0:05:13.320 --> 0:05:17.800 with similar symptoms arrived at the clinic, and there you know, 0:05:17.880 --> 0:05:23.600 they had the similar part of this uncontrollable sleepiness and sleep, 0:05:23.760 --> 0:05:26.000 but the rest of their symptoms were so strange and 0:05:26.040 --> 0:05:29.400 diverse that the doctors were really at a loss to 0:05:29.480 --> 0:05:34.240 figure out a cause or a treatment. These patients had fevers, malaise, 0:05:34.440 --> 0:05:38.640 double vision, they became lethargic. Sometimes they had sore throats. 0:05:39.200 --> 0:05:41.520 Their eye muscles would start working and their eyes would 0:05:41.640 --> 0:05:44.880 dart around or roll back in their heads. Some of 0:05:44.920 --> 0:05:48.400 them developed very strange eye and tongue movement movements, and 0:05:48.520 --> 0:05:53.880 this variety of other neurological and psychiatric symptoms. A few 0:05:53.920 --> 0:05:57.520 of them even had uncontrollable hiccups and one died of that. 0:05:59.000 --> 0:06:03.599 How that work. Well, if you can't stop pickuping, you 0:06:03.640 --> 0:06:08.800 can't really eat or sleep, and then it can cause 0:06:08.839 --> 0:06:14.159 all kinds of other Yeah. Once again, throughout all of this, 0:06:14.279 --> 0:06:17.560 the common element was this strange deep sleep from which 0:06:17.600 --> 0:06:21.120 they could not be woken. Vanni Conomos saw this common 0:06:21.160 --> 0:06:24.520 element and said, we're dealing with a sleeping sickness. Yeah, 0:06:24.560 --> 0:06:26.280 he was really the one that just laid that out there, 0:06:26.680 --> 0:06:30.640 and he's a character on his own. He was also 0:06:30.680 --> 0:06:33.120 a pilot who had been serving in the war, but 0:06:33.200 --> 0:06:35.839 he came back home to Vienna after his brother was 0:06:35.920 --> 0:06:40.120 killed and he really wanted to be flying, but reluctantly 0:06:40.200 --> 0:06:42.840 transferred to doing medical work instead to try to keep 0:06:42.920 --> 0:06:45.839 himself more out of danger and spare his family from 0:06:45.839 --> 0:06:48.880 further grief. On top of all that, he was also 0:06:48.960 --> 0:06:51.479 a baron, having been born to a family of Greek 0:06:51.520 --> 0:06:54.160 aristocrats and then married the daughter of an Austrian prince. 0:06:55.080 --> 0:06:59.560 As the patient started to die from sleep, Vonni Konomos 0:06:59.600 --> 0:07:02.560 started an intense research effort to find a cause and 0:07:02.880 --> 0:07:06.400 a cure. He studied autopsies of patients who had died 0:07:06.440 --> 0:07:09.560 of the disease, and he found common areas of damage 0:07:09.600 --> 0:07:13.960 to their brains, specifically in the hypothalamus, and he suspected 0:07:14.000 --> 0:07:16.840 that the differences and how much people slept was related 0:07:16.880 --> 0:07:20.560 to just how their hypothalamus was damaged. He also found 0:07:20.680 --> 0:07:24.160 that brain tissue could transmit the disease to monkeys, so 0:07:24.200 --> 0:07:27.560 he concluded that they were looking at something that was contagious. 0:07:28.520 --> 0:07:31.400 He publicly announced his conclusion that they were dealing with 0:07:31.400 --> 0:07:34.920 a new disease, probably a virus, before the Psychiatric Society 0:07:35.000 --> 0:07:39.400 in Vienna, on April seventeenth of nineteen seventeen. UH. Consequently, 0:07:39.440 --> 0:07:42.679 sometimes the disease has been referred to as von Economo's disease. 0:07:43.120 --> 0:07:46.720 His announcement was not at all well received. At a 0:07:46.800 --> 0:07:50.200 time the prevailing view with that mental illnesses were all 0:07:50.440 --> 0:07:54.560 products of things like trauma and buried memories. Freud was 0:07:54.640 --> 0:07:57.360 really at the forefront of psychology at this point, so 0:07:57.440 --> 0:07:59.560 a lot of people just scoffed at the idea that 0:07:59.600 --> 0:08:02.720 there could be a virus or other disease process causing 0:08:02.720 --> 0:08:06.040 the kinds of behavior changes in psychological problems that some 0:08:06.120 --> 0:08:09.720 of the patients were exhibiting. The ongoing debate and this 0:08:09.840 --> 0:08:12.480 mystery of the whole thing kept much progress from being 0:08:12.480 --> 0:08:15.880 made in terms of treatment and prevention. But then UH, 0:08:16.000 --> 0:08:19.520 the illness mostly disappeared from continental Europe. It really just 0:08:19.560 --> 0:08:23.000 fell off suddenly, and Spanish flu on the rise took 0:08:23.000 --> 0:08:25.600 its place and it became a much more pressing priority. 0:08:26.280 --> 0:08:30.000 Not long after that, though, the disease appeared in London 0:08:30.120 --> 0:08:32.439 and it followed much the same pattern as it had 0:08:32.480 --> 0:08:35.559 on the continent. There were, you know, all these patients 0:08:35.559 --> 0:08:38.920 who were suddenly having this strange collective collection of symptoms 0:08:39.000 --> 0:08:43.440 and sleeping constantly. The government in Britain quickly made it 0:08:43.480 --> 0:08:46.880 a reportable disease. The Ministry of Help had to be 0:08:46.960 --> 0:08:50.800 notified of all new cases, and its appearance and spread 0:08:51.080 --> 0:08:53.280 uh in London was much like it had been in 0:08:53.280 --> 0:08:58.000 France and Austria. Strange symptoms and unending sleep uh, you know, 0:08:58.120 --> 0:09:01.680 baffling the doctors. But in England the symptoms became even 0:09:01.720 --> 0:09:04.839 more alarming, with patients who could never sleep, or who 0:09:04.840 --> 0:09:10.000 couldn't stop laughing, or had other strange physical or emotional presentations. 0:09:10.360 --> 0:09:14.479 It also seemed like fewer and fewer people were truly recovering. 0:09:15.360 --> 0:09:18.240 In Austria and France, there had been people that had 0:09:18.240 --> 0:09:22.800 gotten better, but as it's spread around England, a lot 0:09:22.800 --> 0:09:26.280 of people were becoming comatose or developing. As we mentioned 0:09:26.280 --> 0:09:28.480 at the beginning, what later came to be known as 0:09:28.520 --> 0:09:32.600 post en syphilitic parkinson is um or PEP. Sometimes the 0:09:32.640 --> 0:09:36.520 onset of parkinson is um happened years after people recovered, 0:09:37.000 --> 0:09:41.000 after they had apparently been healthy all that time. During 0:09:41.000 --> 0:09:44.719 the epidemic, the average age for the onset of Parkinson's 0:09:44.840 --> 0:09:48.959 dropped to thirty six years old. Today, while there are 0:09:48.960 --> 0:09:52.480 people who have early onset, the average age for people 0:09:52.480 --> 0:09:56.480 to start exhibiting Parkinson's is sixties. So this was really 0:09:56.520 --> 0:10:00.760 a significant and strange happening. Uh following the epidemic, two 0:10:00.800 --> 0:10:06.520 thirds of Parkinson's patients had previously had encephalitis, so it 0:10:06.600 --> 0:10:10.240 clearly was causing it right, This disease was causing a 0:10:10.360 --> 0:10:15.920 drastic shift in who developed Parkinson's and when. So, to 0:10:16.000 --> 0:10:21.480 return to the story of encephalitis Letharctica from England, the 0:10:21.679 --> 0:10:25.400 disease spread all over the globe, and the same story 0:10:25.520 --> 0:10:28.679 just played out over and over and over. People would 0:10:28.679 --> 0:10:31.920 start showing up with these strange symptoms that prevent that 0:10:32.000 --> 0:10:35.000 presented themselves in such different ways that it would take 0:10:35.000 --> 0:10:38.160 a while for doctors to realize what was happening. It 0:10:38.200 --> 0:10:41.360 really didn't help that the epidemic had started just at 0:10:41.360 --> 0:10:44.120 the end of World War One and just before the 0:10:44.160 --> 0:10:47.400 start of the nineteen eighteen Spanish flu epidemic, and so 0:10:47.600 --> 0:10:52.040 resources were just scarce and there were definitely bigger priorities 0:10:52.080 --> 0:10:56.400 going on, and this crazy although terrifying disease, and as 0:10:56.440 --> 0:10:59.560 it spread it started to prompt a variety of different 0:10:59.600 --> 0:11:03.280 sleep disorders, so while some patients would sleep for months 0:11:03.280 --> 0:11:05.320 at a time, others couldn't sleep at all, and they 0:11:05.320 --> 0:11:08.520 would actually die of exhaustion. The disease came to be 0:11:08.559 --> 0:11:13.520 known in some places as epidemic encephalitis rather than encephalitis lethargica, 0:11:13.880 --> 0:11:17.600 since not everyone could really be called lethargic anymore. As 0:11:17.600 --> 0:11:20.560 it spread, it also started to affect more and more 0:11:20.679 --> 0:11:24.960 children and young people. Children who contracted the disease developed 0:11:25.000 --> 0:11:28.760 impulse control issues that led to them having violent behavior 0:11:28.840 --> 0:11:32.920 in their adolescence. Some of them injured themselves or other people. 0:11:33.600 --> 0:11:37.160 One even removed her own eyes and several of her 0:11:37.200 --> 0:11:42.160 own teeth okay after I unclenched after that um, this 0:11:42.320 --> 0:11:45.640 behavior often would continue for the rest of these patients 0:11:45.720 --> 0:11:49.760 lives after they progressed out of childhood, unless post and 0:11:49.800 --> 0:11:53.120 cephalitic parkinson is M made them physically unable to continue. 0:11:53.960 --> 0:11:56.760 For children with the disease, outbursts were so severe that 0:11:56.800 --> 0:12:00.840 many had to be institutionalized. Hospitals and asylums that were 0:12:00.840 --> 0:12:03.920 accustomed to providing care for adults suddenly had to develop 0:12:04.200 --> 0:12:07.560 new practices to care for children because there were so 0:12:07.600 --> 0:12:12.160 many suddenly having a movement institutions. Researchers theorized that the 0:12:12.200 --> 0:12:15.840 reason this encephalitis was causing behavior changes like this and 0:12:15.920 --> 0:12:19.280 young people was because their brains hadn't yet developed the 0:12:19.320 --> 0:12:23.360 capacity for self control that adults typically had by the 0:12:23.360 --> 0:12:27.800 time they were infected, and this tendency towards violent behavior 0:12:27.840 --> 0:12:31.360 and other erratic behavior even led to encephalitis lethargica being 0:12:31.400 --> 0:12:35.000 blamed for gangster behavior and lawlessness during the nineteen twenties. 0:12:35.640 --> 0:12:39.800 Once this disease spread to the United States, neurologist Frederick Tilney, 0:12:39.800 --> 0:12:42.440 who was known as Fred and had also been Helen 0:12:42.520 --> 0:12:47.000 Keller's neurologist, became the country's foremost authority on sleepy sickness. 0:12:47.559 --> 0:12:50.960 One of his most famous encephalitis patients was Jesse Morgan, 0:12:51.080 --> 0:12:53.959 who was the wife of Jack p Morgan, who himself 0:12:54.040 --> 0:12:57.400 was the son of banker and philanthropist John Pierpoint Morgan. 0:12:58.040 --> 0:13:02.079 She got the disease in ninety five. Five. After Jesse's death, 0:13:02.240 --> 0:13:05.920 Jack donated two hundred thousand dollars to the Neurological Institute 0:13:05.960 --> 0:13:10.160 the fund research into this disease. The Neurological Institute was 0:13:10.200 --> 0:13:14.280 behind most of the research into encephalitis authargica that came 0:13:14.320 --> 0:13:18.040 from that point. Later on, William Matheson, who was the 0:13:18.080 --> 0:13:21.520 wealthy founder of a chemical company and an encephalitis patient, 0:13:22.080 --> 0:13:26.079 started the Matheson Commission to fund research at the Neurological Institute, 0:13:26.360 --> 0:13:30.160 with Dr Josephine B. Neil, who was an encephalitis expert, 0:13:30.760 --> 0:13:33.720 helming the project, and the commission's aim was to study 0:13:33.760 --> 0:13:37.959 the disease and eventually find a vaccine. Since nobody knew 0:13:37.960 --> 0:13:40.920 exactly what was causing the disease, they worked on three 0:13:41.000 --> 0:13:44.920 theories simultaneously. One was that it was being caused by 0:13:44.960 --> 0:13:48.400 an unknown virus, the next was that it was being 0:13:48.440 --> 0:13:52.520 caused by bacteria, possibly strap uh, and the third was 0:13:52.600 --> 0:13:55.960 that it was being caused by herpes. This was a 0:13:56.000 --> 0:14:00.240 long shot to begin with because no causative agent had 0:14:00.240 --> 0:14:03.920 been found for this disease. They were basically operating in 0:14:03.960 --> 0:14:08.400 the dark based on best guesses. On top of that, 0:14:08.440 --> 0:14:11.880 there was a ton of infighting among the researchers. A 0:14:11.920 --> 0:14:16.400 lot of them were extremely prominent neurologists and scientists. Each 0:14:16.440 --> 0:14:18.679 of them really wanted to be the one to crack 0:14:18.800 --> 0:14:21.720 this case and figure out what's going on um that 0:14:21.920 --> 0:14:24.680 they were not working together very well. They were each 0:14:24.720 --> 0:14:27.400 trying to get the glory for themselves. And then there 0:14:27.440 --> 0:14:31.920 was another huge setback when Matheson himself died in nineteen thirty. 0:14:32.480 --> 0:14:34.720 That was in the middle of the Great Depression, and 0:14:34.880 --> 0:14:38.880 he had been providing the funding, so after his death 0:14:39.320 --> 0:14:42.880 there wasn't really other funding to be had, so the 0:14:42.920 --> 0:14:49.000 Matheson Commission ceased operations in two and so no workable 0:14:49.040 --> 0:14:52.480 vaccine had been developed, and one of the things that 0:14:52.640 --> 0:14:57.400 doctors tried to treat post and cephalitis patients with was lobotomies, 0:14:58.120 --> 0:15:01.360 which also did not work. There was a lot of 0:15:01.440 --> 0:15:04.600 ending that did not work. There were a few outlying 0:15:04.720 --> 0:15:07.160 successes during this time that we kind of give people 0:15:07.200 --> 0:15:09.400 false hope that maybe they were on the right track, 0:15:10.240 --> 0:15:14.600 but nothing led to an actual treatment or cure. Most 0:15:14.640 --> 0:15:17.280 of the medical care that the patients were receiving was 0:15:17.360 --> 0:15:20.720 really about just caring for their bodies and keeping them alive. 0:15:21.560 --> 0:15:24.600 The thirty or so percent who developed parkinson is um 0:15:24.640 --> 0:15:26.760 generally wound up in long term care for the rest 0:15:26.760 --> 0:15:29.400 of their lives, and many of them were completely unable 0:15:29.440 --> 0:15:33.720 to move or take care of themselves in the nineteen sixties, 0:15:33.760 --> 0:15:36.400 after the drug love Adopa or el dopa as it 0:15:36.440 --> 0:15:40.480 was called, was introduced for treating Parkinson's. New York doctor 0:15:40.560 --> 0:15:43.760 Oliver Sachs, who are some of our listeners may have 0:15:43.800 --> 0:15:47.800 heard of, administered it to some encephalitis lethargica patients who 0:15:47.800 --> 0:15:51.000 were in long term care. Some patients actually showed a 0:15:51.000 --> 0:15:55.960 limited recovery from their post and sephalitis lethargica Parkinson symptoms. Uh. 0:15:56.000 --> 0:15:58.360 This is the story that's actually told in the movie Awakenings, 0:15:58.400 --> 0:16:00.600 which is why people may have heard of all over sex. 0:16:01.280 --> 0:16:05.240 But they all apparently developed a tolerance until the dosage 0:16:05.280 --> 0:16:08.080 was really just too much for the human body to handle, 0:16:08.520 --> 0:16:11.320 and then they would return to their semi comatose state 0:16:12.040 --> 0:16:15.360 in the end. This epidemic went on from nineteen sixteen 0:16:15.360 --> 0:16:19.200 to nineteen twenty seven, reaching its peak in nineteen twenty four, 0:16:19.280 --> 0:16:21.800 after which the number of cases started to drop off. 0:16:22.400 --> 0:16:26.040 The total numbers of people affected are really unclear. There 0:16:26.080 --> 0:16:28.720 are sources who say that a million people were killed, 0:16:29.200 --> 0:16:32.440 while others say that only half a million were affected 0:16:32.440 --> 0:16:36.800 in one way or another. Regardless, though the mortality rate 0:16:36.840 --> 0:16:40.360 was pretty serious in England, almost half of the cases 0:16:40.440 --> 0:16:44.280 in nineteen nineteen and nineteen twenty died. Although it was 0:16:44.400 --> 0:16:48.200 roughly concurrent with the Spanish flu pandemic, and flu came 0:16:48.240 --> 0:16:51.680 up frequently when looking at possible causes, many doctors at 0:16:51.720 --> 0:16:54.800 the time didn't really think the disease was actually flu related. 0:16:55.320 --> 0:16:58.200 Only a small percentage of the patients had also had 0:16:58.240 --> 0:17:02.480 Spanish flu, and teen eighty two, however, doctors from the 0:17:02.520 --> 0:17:06.120 Centers for Disease Control published this list of connections between 0:17:06.160 --> 0:17:09.280 the two diseases. So for a little while. In more 0:17:09.400 --> 0:17:14.000 recent years, flu became a prime suspect for causing encephalitis lethargica. 0:17:14.840 --> 0:17:17.760 Uh there is, you know, especially since there have been 0:17:17.880 --> 0:17:22.800 other incidents of encephalitis that have followed outbreaks of the flu. Today, 0:17:22.840 --> 0:17:25.399 the idea that the flu was the culprit has pretty 0:17:25.440 --> 0:17:28.600 much been ruled out thanks to modern testing methods. They 0:17:28.640 --> 0:17:31.000 haven't turned up any sign of the flu virus in 0:17:31.040 --> 0:17:35.680 tissue samples from patients who died from encephalitis, Although it's 0:17:35.720 --> 0:17:39.879 never reached that same epidemic state again, isolated cases of 0:17:40.040 --> 0:17:44.159 encephalitis lethargica have continued to crop up even in recent years, 0:17:45.080 --> 0:17:49.720 most recently in a twenty three year old named Becky 0:17:49.960 --> 0:17:52.919 Powell was diagnosed with the disease and it took her 0:17:53.040 --> 0:17:57.760 two years to recover. Several similar cases followed. In two 0:17:57.760 --> 0:18:00.720 thousand three, a team of doctors public a paper in 0:18:00.720 --> 0:18:03.400 the journal Brain that put forth a pretty good case 0:18:03.440 --> 0:18:07.040 that the cause of encephalitis lethargica is actually a massive 0:18:07.119 --> 0:18:11.840 autoimmune reaction to an unidentified pathogen. A strain of strap 0:18:11.920 --> 0:18:15.040 comes up in the discussion, but it's ultimately dismissed as unlikely. 0:18:15.680 --> 0:18:18.600 And their research was done on twenty different patients who 0:18:18.640 --> 0:18:23.119 developed the disease between two thousand two, and those patients 0:18:23.160 --> 0:18:26.000 had a much lower mortality rate than during the epidemic. 0:18:26.720 --> 0:18:29.240 Only one died, but five of them did have to 0:18:29.240 --> 0:18:32.440 be placed on a ventilator. Had those five patients lived 0:18:32.440 --> 0:18:34.640 in the ninety twenties, they probably would not have made it, 0:18:35.480 --> 0:18:37.760 but almost none of them had fully recovered a year 0:18:37.800 --> 0:18:40.800 or so later when the paper was published. They continued 0:18:40.840 --> 0:18:44.640 to have neurological and psychiatric symptoms. Yeah. If if there 0:18:44.680 --> 0:18:49.720 had been if today's ventilation technology had existed in the 0:18:49.800 --> 0:18:55.240 nineteen twenties, the mortality rate would have been Yeah, because 0:18:55.280 --> 0:18:59.080 people would get into this just deep uninterrupted sleep and 0:18:59.119 --> 0:19:01.919 their respiratory functions would fail, and there wasn't really anything 0:19:01.920 --> 0:19:03.720 that people could do about it. But now that we 0:19:03.800 --> 0:19:08.639 have violators UH, that there are actual there's a treatment 0:19:08.680 --> 0:19:10.520 for that part of it that didn't exist back then. 0:19:11.320 --> 0:19:15.680 In paper in the journal BMC Infectious Diseases reported that 0:19:15.720 --> 0:19:19.000 a team of researchers had found virus like particles in 0:19:19.040 --> 0:19:24.080 the brains of both epidemic encephalitis patients and modern patients, 0:19:24.200 --> 0:19:28.359 so people who had died UH either recently or during 0:19:28.480 --> 0:19:32.399 the epidemic. This supports the idea that the cause of 0:19:32.600 --> 0:19:37.800 encephalitis lethargica is an interarovirus, but exactly what interovirus we 0:19:37.960 --> 0:19:43.400 still do not know. And on that note, so encephalitis 0:19:43.520 --> 0:19:46.880 lethargica has a some you know, a legacy today, even 0:19:46.880 --> 0:19:49.520 though a lot of people have not really heard of 0:19:49.560 --> 0:19:53.200 it as tragic and frightening as the disease was and 0:19:53.520 --> 0:19:57.160 is really. In the end, it helped doctors understand more 0:19:57.200 --> 0:20:02.000 about the brain. Von economist conclude Usian about the hypothalamus 0:20:02.040 --> 0:20:04.919 and its role in the patients sleep, for example, was 0:20:05.200 --> 0:20:09.080 hugely unpopular at the time, but many years later it 0:20:09.160 --> 0:20:12.440 was proved to be true after we developed sorts of 0:20:12.560 --> 0:20:15.200 imaging technologies that we can use to look directly at 0:20:15.240 --> 0:20:19.119 the brain as it's working today. Neurologist Bernard Sacks also 0:20:19.160 --> 0:20:23.280 wrote that the epidemic of encephalitis quote revolutionized the practice 0:20:23.280 --> 0:20:27.280 of neurology. So it really changed the way that, uh, 0:20:27.359 --> 0:20:30.119 these things were examined from the get go. Yeah, it 0:20:30.200 --> 0:20:34.960 helped solidifying neurology as an actual field. In the early days, 0:20:35.000 --> 0:20:38.840 there was sort of this hodgepodge of neurology ideas and 0:20:38.960 --> 0:20:41.640 psychology ideas and all these things that were kind of 0:20:41.920 --> 0:20:45.359 together in one big pot. And in part because of 0:20:45.760 --> 0:20:49.960 encephalitis being spread the way that it was, a group 0:20:50.000 --> 0:20:55.360 of doctors branched off to study just neurology and encephalitis. 0:20:55.400 --> 0:20:57.919 Lethargica was also one of the conditions that made it 0:20:57.960 --> 0:21:02.800 clear that disease process says, can lead to mental illnesses. Uh, 0:21:03.000 --> 0:21:05.880 it's solidified the idea that mental illnesses were not solely 0:21:05.960 --> 0:21:09.480 in the realm of emotions or traumatic experiences. It's not 0:21:09.560 --> 0:21:12.720 always buried memories. Sometimes there can actually be a physical 0:21:12.760 --> 0:21:16.880 happening that causes mental illness. There are a couple of 0:21:16.920 --> 0:21:20.479 books that are out about this epidemic. The one that 0:21:20.640 --> 0:21:24.600 I read researching. This podcast was called Asleep, The Forgotten 0:21:24.640 --> 0:21:28.200 Epidemic that remains one of Medicine's greatest mysteries by Molly 0:21:28.240 --> 0:21:34.800 Caldwell Crosby and her grandmother survived Sleepy Sickness. It starts 0:21:34.800 --> 0:21:37.240 with sort of a case study of her grandmother. That's 0:21:37.320 --> 0:21:41.480 terrifying because it's about her grandmother being asleep for so long, 0:21:41.600 --> 0:21:43.879 but also being aware of what was happening around her, 0:21:43.960 --> 0:21:47.280 which to me is just terrifying. The one caveat about 0:21:47.280 --> 0:21:49.280 this book is that it was written before the very 0:21:49.320 --> 0:21:55.400 most recent research about what might have caused this particular epidemic, 0:21:56.000 --> 0:21:57.560 which is going to be the case which just about 0:21:57.600 --> 0:22:00.880 every book now since the latest research is just very new. Yeah. 0:22:00.960 --> 0:22:03.840 Last year, as we were recording, I have read several 0:22:03.880 --> 0:22:07.880 papers that, uh, you know, and when the bird flew 0:22:07.960 --> 0:22:12.439 epidemic was was everybody was very frightened about bird flu. 0:22:12.560 --> 0:22:16.720 There were several articles that that came up where doctors 0:22:16.720 --> 0:22:19.240 were like, actually, what you really should be afraid of 0:22:19.480 --> 0:22:26.640 is a resurgence of this still unidentified encephalitis that sometimes 0:22:26.680 --> 0:22:33.040 sometimes follows outbreaks of other diseases. I yeah, it's basically 0:22:33.080 --> 0:22:35.240 my worst nightmare. I mean, I have not a good 0:22:35.240 --> 0:22:37.439 relationship with sleep anyway. If I didn't have to do it, 0:22:37.480 --> 0:22:40.199 I wouldn't. So the idea of not having any control 0:22:40.280 --> 0:22:44.200 over the situation and just being asleep but not really 0:22:44.200 --> 0:22:49.320 because you're conscious of things happening around is my worst nightmare. Yeah, 0:22:49.600 --> 0:22:53.360 not to play on sleep jokes, but well, it's terrifying 0:22:53.560 --> 0:22:57.320 and the there are many things about this whole, the 0:22:57.600 --> 0:23:00.199 epidemic and the illness itself that are are frightening to me, 0:23:00.240 --> 0:23:03.280 And one of them is that people would seem to 0:23:03.320 --> 0:23:06.520 recover and they would be fine for a long time, 0:23:07.080 --> 0:23:11.600 and then they developed, yeah, developed parkinson symptoms um and 0:23:11.680 --> 0:23:13.840 once it had been established that that was a pattern, 0:23:13.920 --> 0:23:16.120 I can imagine like the people who had gotten better 0:23:16.600 --> 0:23:20.440 really being like I'm never going to be which I 0:23:20.520 --> 0:23:22.679 know that's the case with a lot of diseases that 0:23:22.680 --> 0:23:25.199 people have now, Like there are many cancer patients who 0:23:25.320 --> 0:23:29.080 never feel like they are in the clear because you 0:23:29.119 --> 0:23:34.480 can be intermission. So yeah, it's a scary thing to 0:23:34.600 --> 0:23:39.960 live with that kind of over you cheerful it is. 0:23:40.040 --> 0:23:42.359 Do you have listener mail? The cheer aside, do have 0:23:42.480 --> 0:23:44.960 listener mail? And actually the first listener mail that I 0:23:45.000 --> 0:23:47.359 have is very cheerful. I have two of them. One 0:23:47.400 --> 0:23:50.080 of them is short. The first one is from Vince, 0:23:50.240 --> 0:23:52.280 and he says, Dear Tracy, thank you for helping me 0:23:52.359 --> 0:23:55.560 through some boring work days. During your recent podcast on 0:23:55.640 --> 0:23:59.000 Louis Alvarez, you mentioned all the Berkeley Nobel laureates from 0:23:59.000 --> 0:24:01.800 its past. Being a proud alum, I had recently had 0:24:01.800 --> 0:24:04.360 a chance to visit Berkeley, and strolling around the campus, 0:24:04.800 --> 0:24:08.720 I noticed this cute photo op between the two physics buildings, 0:24:09.200 --> 0:24:13.119 and basically he attached a picture of this row of 0:24:13.320 --> 0:24:16.280 prime parking spaces that all are like this space is 0:24:16.320 --> 0:24:20.920 for a novel, a Nobel laureate. So Nobel laureates get 0:24:20.960 --> 0:24:24.320 awesome reserved parking at Berkeley. They deserve it. They've probably 0:24:24.359 --> 0:24:26.480 lost a lot of time in their lives to work 0:24:26.720 --> 0:24:29.240 very hard on very difficult problems. Yeah. There there are 0:24:29.320 --> 0:24:31.360 a lot of spaces, and they are right by building. 0:24:31.760 --> 0:24:35.240 Says for me. It truly illustrates how good Berkeley research 0:24:35.359 --> 0:24:38.280 really is. Thanks again, Vince, Thank you, Vince. I love 0:24:38.320 --> 0:24:42.439 that picture. Yes, okay, the other one is from Sarah, 0:24:42.440 --> 0:24:44.679 and I'm going to just start with a confession that 0:24:44.760 --> 0:24:47.480 I worried that when we were talking about Luis Alvarez 0:24:47.600 --> 0:24:51.080 that we were talking too much about how hard a 0:24:51.119 --> 0:24:53.760 lot of his discoveries are to understand if you are 0:24:53.760 --> 0:24:56.720