WEBVTT - SYMHC Classics: Encephalitis Lethargica 0:00:02.360 --> 0:00:05.160 Happy Saturday, everybody. Today we have one of our most 0:00:05.320 --> 0:00:10.360 unintentionally terrifying episodes of all time. It is on encephalitis lethargica, 0:00:10.440 --> 0:00:14.440 and it originally came out We did not ever intend 0:00:14.560 --> 0:00:16.880 for this to be a Halloween episode, but it originally 0:00:16.920 --> 0:00:19.200 came out in October and we heard from a lot 0:00:19.280 --> 0:00:21.919 of listeners that it scared them more than anything else 0:00:21.960 --> 0:00:25.480 we have ever done. So this story of a frightening 0:00:25.560 --> 0:00:28.479 and mysterious illness is also a good segue into a 0:00:28.600 --> 0:00:31.200 new show on our network. It's The End of the 0:00:31.240 --> 0:00:33.880 World with Josh Clark, and Josh, one of the hosts 0:00:33.920 --> 0:00:36.720 of the other podcast Stuff You Should Know, is hosting 0:00:36.720 --> 0:00:39.879 a ten part series that explores all of the various 0:00:39.880 --> 0:00:44.239 ways that humanity could abruptly end. So stay tuned at 0:00:44.240 --> 0:00:46.640 the end of today's episode for the trailer to the 0:00:46.720 --> 0:00:51.920 End of the World with Josh Clark. Enjoy. Welcome to 0:00:52.360 --> 0:00:55.160 Stuff You Missed in History Class from how Stuff Works 0:00:55.200 --> 0:01:05.560 dot Com. Hello, and welcome to the podcast. I'm Tracy B. 0:01:05.720 --> 0:01:09.360 Wilson and I'm probably so. I did not intend for 0:01:09.520 --> 0:01:15.240 today to be a Halloween episode. Is scary? Yeah, due 0:01:15.240 --> 0:01:18.840 to some quirks in our publishing schedule. It happens to 0:01:18.880 --> 0:01:21.800 be coming out right before Halloween. It is a listener 0:01:21.840 --> 0:01:26.880 request from listener Ellen or perhaps Ellen, And in researching it, 0:01:27.040 --> 0:01:29.399 I realized it was the most frightening thing I had 0:01:29.440 --> 0:01:34.400 ever learned about. So, so buckle up. History has scared Tracy. 0:01:34.480 --> 0:01:37.520 History has scared me. So. From nineteen sixteen to about 0:01:37.600 --> 0:01:41.920 nine seven, this really bizarre epidemic spread around the world. 0:01:42.680 --> 0:01:45.160 It came to be known as sleepy sickness, and it 0:01:45.280 --> 0:01:47.960 is not to be confused with sleeping sickness, which is 0:01:48.000 --> 0:01:51.480 a tropical disease found in sub Saharan Africa. This is 0:01:51.520 --> 0:01:56.200 another name for a disease called encephalitis lethargica, and it 0:01:56.280 --> 0:02:01.400 caused this really weird variety of symptoms, from drastic behavior 0:02:01.480 --> 0:02:06.600 changes to unusual eye movements. Especially in the beginning years 0:02:06.640 --> 0:02:10.919 of it. Uh, the really common element was this deep, 0:02:11.120 --> 0:02:14.800 prolonged sleep that went on and on from days two months, 0:02:16.120 --> 0:02:19.959 and people just couldn't wake up. Between twenty and of 0:02:20.040 --> 0:02:23.400 the people who got this disease died, and of the 0:02:23.400 --> 0:02:27.399 ones who survived, only about a third really fully recovered. 0:02:28.080 --> 0:02:30.680 The rest developed what came to be known as post 0:02:30.680 --> 0:02:34.880 and syphilitic Parkinson ism, and some of these patients persisted 0:02:34.960 --> 0:02:40.200 in a semi comatose state for decades. It's extra terrifying. 0:02:41.000 --> 0:02:43.520 The next part is even more terrifying. Yeah, as if 0:02:43.560 --> 0:02:46.360 all of this were not enough to scare the pants 0:02:46.360 --> 0:02:49.480 off of you. While in this extremely deep sleep that 0:02:49.600 --> 0:02:52.520 was part of many of the cases, people appeared to 0:02:52.520 --> 0:02:56.960 be unconscious, but in reality they were actually alert. They 0:02:56.960 --> 0:02:59.200 were completely aware of what was going on, but they 0:02:59.200 --> 0:03:03.040 were unable to overspeaks, so it was a sort of paralysis. Really. Yeah, 0:03:03.240 --> 0:03:06.280 So people today may have heard about this whole disease 0:03:06.280 --> 0:03:11.720 from the movie Awakenings starring Robin Williams, or maybe from 0:03:11.800 --> 0:03:16.200 the first pages of Neil Gaiman's amazing comic book series Sandman, 0:03:16.400 --> 0:03:19.640 which starts off when a ritual that was meant to 0:03:19.720 --> 0:03:27.040 capture death instead captures dream and causes people to sleep endlessly. Otherwise, 0:03:27.360 --> 0:03:30.000 it's pretty far in the background of medical history most 0:03:30.000 --> 0:03:33.359 of the time. It's not something that people remember all 0:03:33.400 --> 0:03:36.760 that well today. But from its onset until about ten 0:03:36.840 --> 0:03:39.400 years after it faded away, there were more than nine 0:03:39.640 --> 0:03:42.760 thousand papers and books published on it, so at the 0:03:42.840 --> 0:03:46.560 time it was a big deal. Even though people don't 0:03:46.600 --> 0:03:50.160 necessarily come up with it immediately when thinking about huge 0:03:50.160 --> 0:03:55.320 epidemics today. Yeah, and I wonder why that is, um 0:03:55.640 --> 0:03:59.160 talk about some of that. Yeah, Prolonged sleep as an 0:03:59.160 --> 0:04:02.920 illness has been reported really really way back into history. 0:04:03.600 --> 0:04:06.600 There are written records as early as Hippocrates of this 0:04:06.680 --> 0:04:09.560 kind of incident happening. And then there are also, of course, 0:04:09.600 --> 0:04:13.720 in our cultural consciousness tales like sleeping beauty and these 0:04:13.720 --> 0:04:17.839 stories like rip van Winkle uh, and some people along 0:04:17.880 --> 0:04:20.680 the line have theorized that these were actually rooted to 0:04:20.720 --> 0:04:23.880 some degree in some kind of sleeping illness. In the 0:04:23.920 --> 0:04:26.120 real world, there had also been an outbreak of a 0:04:26.200 --> 0:04:29.839 similar condition in Italy in eighteen eighty nine and eighteen ninety, 0:04:30.240 --> 0:04:33.200 which came to be known as Landona, and it was 0:04:33.279 --> 0:04:36.120 thought at the time to be a complication of the flu. 0:04:36.520 --> 0:04:40.119 And around the world, other outbreaks of encephalitis had also 0:04:40.279 --> 0:04:45.640 followed behind other epidemics, particularly the flu. This particular one 0:04:45.760 --> 0:04:49.159 started just a couple of years before the nineteen eighteen 0:04:49.200 --> 0:04:53.640 Spanish flu epidemic, which killed between twenty and forty million people, 0:04:54.640 --> 0:04:58.039 and when it came to the encephalitis lethargica epidemic, the 0:04:58.080 --> 0:05:02.000 first reports came at about the same time in two 0:05:02.000 --> 0:05:05.240 different places, which were France in Austria. In nineteen six, 0:05:05.839 --> 0:05:09.240 in France, a doctor named Genre nee Cruche started to 0:05:09.279 --> 0:05:13.799 see six soldiers with this weird assortment of seemingly unrelated 0:05:13.880 --> 0:05:17.400 neurological symptoms, and the one common element was that the 0:05:17.400 --> 0:05:22.280 patients just slept, apparently peacefully and deeply, and that they 0:05:22.320 --> 0:05:25.080 could not be woken up, and he started to wonder 0:05:25.120 --> 0:05:28.080 whether there was some kind of new chemical weapon at work. 0:05:28.839 --> 0:05:31.480 At about the same time, a British doctor named A. J. 0:05:31.720 --> 0:05:35.680 Hall also reported similar symptoms, and other troops who were 0:05:35.720 --> 0:05:39.440 stationed in France. In Vienna, it came to the attention 0:05:39.600 --> 0:05:44.880 of Romanian Austrian psychiatrists Constantine von Economo after a sleepy, 0:05:44.960 --> 0:05:49.240 disoriented civilian wandered into the Wagner Jarre clinic where he worked. 0:05:49.960 --> 0:05:52.520 The doctors there had mostly been treating soldiers who were 0:05:52.520 --> 0:05:55.440 wounded in the war, so they really weren't prepared for 0:05:55.520 --> 0:05:59.760 this apparently uninjured civilian with nothing physically wrong that they 0:05:59.800 --> 0:06:03.839 could really point to. And then more and more patients 0:06:03.880 --> 0:06:08.359 with similar symptoms arrived at the clinic and there you know, 0:06:08.400 --> 0:06:14.159 they had the similar part of this uncontrollable sleepiness and sleep. 0:06:14.320 --> 0:06:16.560 But the rest of their symptoms were so strange and 0:06:16.600 --> 0:06:19.960 diverse that the doctors were really at a loss to 0:06:20.040 --> 0:06:24.800 figure out a cause or a treatment. These patients had fevers, malaise, 0:06:24.960 --> 0:06:29.200 double vision, they became lethargic. Sometimes they had sore throats. 0:06:29.720 --> 0:06:32.119 Their eye muscles would start working and their eyes would 0:06:32.200 --> 0:06:35.440 dart around or roll back in their heads. Some of 0:06:35.440 --> 0:06:38.960 them developed very strange eye and tongue movement movements, and 0:06:39.080 --> 0:06:44.440 this variety of other neurological and psychiatric symptoms. A few 0:06:44.480 --> 0:06:48.080 of them even had uncontrollable hiccups, and one died of that. 0:06:49.560 --> 0:06:53.440 How does that work? Well, if you can't stop hiccuping, 0:06:54.080 --> 0:06:59.080 you can't really eat or sleep, and then it can 0:06:59.120 --> 0:07:04.320 cause all kinds of other interesting Yeah. Once again, throughout 0:07:04.320 --> 0:07:07.080 all of this, the common element was this strange deep 0:07:07.160 --> 0:07:10.800 sleep from which they could not be woken. Vanni Conomos 0:07:10.800 --> 0:07:13.920 saw this common element and said, we're dealing with a 0:07:13.920 --> 0:07:15.920 sleeping sickness. Yeah. He was really the one that just 0:07:16.000 --> 0:07:20.120 laid that out there, and he's a character on his own. 0:07:20.640 --> 0:07:22.800 He was also a pilot who had been serving in 0:07:22.800 --> 0:07:25.560 the war, but he came back home to Vienna after 0:07:25.720 --> 0:07:29.120 his brother was killed and he really wanted to be flying, 0:07:29.680 --> 0:07:33.040 but reluctantly transferred to doing medical work instead to try 0:07:33.080 --> 0:07:35.600 to keep himself more out of danger and spare his 0:07:35.680 --> 0:07:39.040 family from further grief. On top of all that, he 0:07:39.080 --> 0:07:41.720 was also a baron, having been born to a family 0:07:41.760 --> 0:07:43.840 of Greek aristocrats and then married the daughter of an 0:07:43.840 --> 0:07:48.560 Austrian prince. As the patient started to die from sleep, 0:07:49.360 --> 0:07:52.360 Vonni Konomos started an intense research effort to find a 0:07:52.440 --> 0:07:56.560 cause and a cure. He studied autopsies of patients who 0:07:56.560 --> 0:07:59.480 had died of the disease, and he found common areas 0:07:59.520 --> 0:08:03.800 of damage to their brains, specifically in the hypothalamus, and 0:08:03.840 --> 0:08:06.720 he suspected that the differences and how much people slept 0:08:06.840 --> 0:08:10.080 was related to just how their hypothalamus was damaged. He 0:08:10.320 --> 0:08:14.320 also found that brain tissue could transmit the disease to monkeys, 0:08:14.560 --> 0:08:17.160 so he concluded that they were looking at something that 0:08:17.280 --> 0:08:21.560 was contagious. He publicly announced his conclusion that they were 0:08:21.600 --> 0:08:24.240 dealing with a new disease, probably a virus, before the 0:08:24.280 --> 0:08:28.320 Psychiatric Society in Vienna, on April seventeenth of nineteen seventeen. 0:08:29.120 --> 0:08:31.880 Uh Consequently, sometimes the disease has been referred to as 0:08:31.960 --> 0:08:36.319 von Economo's disease. His announcement was not at all well received. 0:08:37.040 --> 0:08:40.120 At the time. The prevailing view was that mental illnesses 0:08:40.160 --> 0:08:44.080 were all products of things like trauma and buried memories. 0:08:44.520 --> 0:08:47.520 Freud was really at the forefront of psychology at this point, 0:08:47.800 --> 0:08:50.000 so a lot of people just scoffed at the idea 0:08:50.040 --> 0:08:52.720 that there could be a virus or other disease process 0:08:52.840 --> 0:08:56.400 causing the kinds of behavior changes and psychological problems that 0:08:56.480 --> 0:09:00.080 some of the patients were exhibiting. The ongoing debate and 0:09:00.120 --> 0:09:02.760 this mystery of the whole thing kept much progress from 0:09:02.840 --> 0:09:06.440 being made in terms of treatment and prevention. But then, uh, 0:09:06.559 --> 0:09:10.080 the illness mostly disappeared from continental Europe. It really just 0:09:10.120 --> 0:09:13.520 fell off suddenly, and Spanish flew on the rise, took 0:09:13.520 --> 0:09:16.480 its place, and it became a much more pressing priority. 0:09:16.800 --> 0:09:20.560 Not long after that, though, the disease appeared in London 0:09:20.679 --> 0:09:23.000 and it followed much the same pattern as it had 0:09:23.040 --> 0:09:26.080 on the continent. There were, you know, all these patients 0:09:26.120 --> 0:09:29.520 who were suddenly having the strange collective collection of symptoms 0:09:29.520 --> 0:09:33.959 and sleeping constantly. The government in Britain quickly made it 0:09:34.000 --> 0:09:37.400 a reportable disease. The Ministry of Health had to be 0:09:37.520 --> 0:09:41.360 notified of all new cases and its appearance and spread 0:09:41.640 --> 0:09:43.800 UH in London was much like it had been in 0:09:43.840 --> 0:09:48.520 France and Austria. Strange symptoms and unending sleep uh you know, 0:09:48.679 --> 0:09:52.200 baffling the doctors. But in England the symptoms became even 0:09:52.240 --> 0:09:55.360 more alarming, with patients who could never sleep, or who 0:09:55.400 --> 0:09:59.480 couldn't stop laughing, or had other strange physical or emotional 0:09:59.520 --> 0:10:03.640 present sians It also seemed like fewer and fewer people 0:10:03.800 --> 0:10:08.160 were truly recovering. In Austria and France, there had been 0:10:08.160 --> 0:10:13.000 people that had gotten better, but as it's spread around England, 0:10:13.040 --> 0:10:16.200 a lot of people were becoming comatose or developing. As 0:10:16.200 --> 0:10:18.520 we mentioned at the beginning, what later it came to 0:10:18.559 --> 0:10:21.760 be known as post and syphilitic parkinson is um or PEP. 0:10:22.559 --> 0:10:26.000 Sometimes the onset of parkinson Is m happened years after 0:10:26.080 --> 0:10:30.120 people recovered, after they had apparently been healthy all that time. 0:10:31.280 --> 0:10:34.560 During the epidemic, the average age for the onset of 0:10:34.559 --> 0:10:39.360 Parkinson's dropped to thirty six years old. Today, while there 0:10:39.360 --> 0:10:42.679 are people who have early onset, the average age for 0:10:42.720 --> 0:10:46.560 people to start exhibiting Parkinson's is sixty. So this was 0:10:46.679 --> 0:10:51.040 really a significant and strange happening. Uh. Following the epidemic, 0:10:51.080 --> 0:10:55.960 two thirds of Parkinson's patients had previously had encephalitis, so 0:10:56.960 --> 0:11:00.200 it clearly was causing it. Right, this, this disease is 0:11:00.280 --> 0:11:04.800 was causing a drastic shift in who developed Parkinson's and when. 0:11:05.920 --> 0:11:08.520 And we're going to pause before we start talking about 0:11:08.520 --> 0:11:10.680 how then the rest of the world gets to be terrified. 0:11:19.679 --> 0:11:25.000 So to return to the story of encephalitis lethargica from England, 0:11:25.520 --> 0:11:29.160 the disease spread all over the globe, and the same 0:11:29.200 --> 0:11:32.480 story just played out over and over and over. People 0:11:32.559 --> 0:11:35.880 would start showing up with these strange symptoms that prevent 0:11:36.000 --> 0:11:39.000 that presented themselves in such different ways that it would 0:11:39.000 --> 0:11:41.640 take a while for doctors to realize what was happening. 0:11:42.200 --> 0:11:45.040 It really didn't help that the epidemic had started just 0:11:45.320 --> 0:11:48.079 at the end of World War One and just before 0:11:48.160 --> 0:11:51.320 the start of the nineteen eighteen Spanish flu epidemic, and 0:11:51.400 --> 0:11:55.400 so resources were just scarce and there were definitely bigger 0:11:55.480 --> 0:12:00.280 priorities going on. And this crazy, although terrifying disease, and 0:12:00.360 --> 0:12:03.320 as it spread, it started to prompt a variety of 0:12:03.360 --> 0:12:07.080 different sleep disorders. So while some patients would sleep for 0:12:07.160 --> 0:12:09.319 months at a time, others couldn't sleep at all, and 0:12:09.320 --> 0:12:12.560 they would actually die of exhaustion. The disease came to 0:12:12.559 --> 0:12:16.160 be known in some places as epidemic encephalitis rather than 0:12:16.240 --> 0:12:21.040 encephalitis lethargica, since not everyone could really be called lethargic anymore. 0:12:21.520 --> 0:12:24.400 As its spread, it also started to affect more and 0:12:24.440 --> 0:12:28.600 more children and young people. Children who contracted the disease 0:12:28.640 --> 0:12:32.280 developed impulse control issues that led to them having violent 0:12:32.360 --> 0:12:36.400 behavior in their adolescence. Some of them injured themselves or 0:12:36.440 --> 0:12:40.960 other people. One even removed her own eyes and several 0:12:41.040 --> 0:12:46.199 of her own teeth okay after unclenched. After that um, 0:12:46.240 --> 0:12:49.360 this behavior often would continue for the rest of these 0:12:49.360 --> 0:12:53.800 patients lives after they progress out of childhood, unless post 0:12:53.840 --> 0:12:57.480 and cephalitic parkinson is M made them physically unable to continue. 0:12:58.080 --> 0:13:00.880 For children with the disease, outbursts were so severe that 0:13:00.920 --> 0:13:04.960 many had to be institutionalized. Hospitals and asylums that were 0:13:05.000 --> 0:13:08.040 accustomed to providing care for adults suddenly had to develop 0:13:08.320 --> 0:13:11.720 new practices to care for children because there were so 0:13:11.720 --> 0:13:15.880 many suddenly having to move into institutions. Researchers theorized that 0:13:15.960 --> 0:13:19.840 the reason this encephalitis was causing behavior changes like this 0:13:19.920 --> 0:13:23.240 and young people was because their brains hadn't yet developed 0:13:23.320 --> 0:13:27.319 the capacity for self control that adults typically had by 0:13:27.360 --> 0:13:31.439 the time they were infected, and this tendency towards violent 0:13:31.520 --> 0:13:35.240 behavior and other erratic behavior even led to encephalitis lethargica 0:13:35.280 --> 0:13:39.120 being blamed for gangster behavior and lawlessness during the nineteen twenties. 0:13:39.760 --> 0:13:43.920 Once this disease spread to the United States, neurologist Frederick Tilney, 0:13:43.920 --> 0:13:46.560 who was known as Fred and had also been Helen 0:13:46.640 --> 0:13:51.120 Keller's neurologist, became the country's foremost authority on sleepy sickness. 0:13:51.679 --> 0:13:55.080 One of his most famous encephalitis patients was Jesse Morgan, 0:13:55.200 --> 0:13:58.079 who was the wife of Jack p Morgan, who himself 0:13:58.160 --> 0:14:01.520 was the son of banker and full anthropist John Pierpoint Morgan. 0:14:02.160 --> 0:14:07.120 She got the disease in After Jesse's death, Jack donated 0:14:07.160 --> 0:14:10.360 two hundred thousand dollars to the Neurological Institute to fund 0:14:10.440 --> 0:14:15.040 research into this disease. The Neurological Institute was behind most 0:14:15.080 --> 0:14:19.200 of the research into encephalitis lethargica that came from that point. 0:14:20.120 --> 0:14:23.080 Later on, William Matheson, who was the wealthy founder of 0:14:23.080 --> 0:14:27.200 a chemical company and an encephalitis patient started the Matheson 0:14:27.240 --> 0:14:30.920 Commission to fund research at the Neurological Institute, with Dr 0:14:31.040 --> 0:14:35.320 Josephine B. Neil, who was an encephalitis expert, helming the 0:14:35.360 --> 0:14:38.400 project and the commission's aim was to study the disease 0:14:38.560 --> 0:14:42.680 and eventually find a vaccine. Since nobody knew exactly what 0:14:42.800 --> 0:14:46.560 was causing the disease, they worked on three theories simultaneously. 0:14:47.200 --> 0:14:50.440 One was that it was being caused by an unknown virus, 0:14:51.160 --> 0:14:53.760 the next was that it was being caused by bacteria, 0:14:53.920 --> 0:14:57.120 possibly strapped UH, and the third was that it was 0:14:57.200 --> 0:15:01.040 being caused by herpes. This was a long shot to 0:15:01.200 --> 0:15:04.960 begin with because no causative agent had been found for 0:15:04.960 --> 0:15:09.520 this disease. They were basically operating in the dark based 0:15:09.520 --> 0:15:13.320 on best guesses. On top of that, there was a 0:15:13.360 --> 0:15:16.520 ton of infighting among the researchers. A lot of them 0:15:16.560 --> 0:15:21.280 were extremely prominent neurologists and scientists. Each of them really 0:15:21.320 --> 0:15:23.560 wanted to be the one to crack this case and 0:15:23.560 --> 0:15:26.480 figure out what's going on. Um that they were not 0:15:26.600 --> 0:15:29.360 working together very well. They were each trying to get 0:15:29.360 --> 0:15:32.400 the glory for themselves. And then there was another huge 0:15:32.440 --> 0:15:36.960 setback when Matheson himself died in nineteen thirty. That was 0:15:37.000 --> 0:15:39.440 in the middle of the Great Depression, and he had 0:15:39.440 --> 0:15:44.040 been providing the funding, so after his death there wasn't 0:15:44.040 --> 0:15:48.119 really other funding to be had, so the Matheson Commission 0:15:48.480 --> 0:15:53.720 ceased operations in ninety two and so no workable vaccine 0:15:53.800 --> 0:15:57.320 had been developed, and one of the things that doctors 0:15:57.360 --> 0:16:02.520 tried to treat post encephalitist patients of was lobotomies, which 0:16:02.520 --> 0:16:05.760 also did not work. There was a lot of ending 0:16:05.840 --> 0:16:09.440 that did not work. There were a few outlying successes 0:16:09.520 --> 0:16:11.640 during this time that would kind of give people false 0:16:11.680 --> 0:16:14.440 hope that maybe they were on the right track, but 0:16:14.640 --> 0:16:18.840 nothing led to an actual treatment or cure. Most of 0:16:18.880 --> 0:16:21.800 the medical care that the patients were receiving was really 0:16:21.880 --> 0:16:24.840 about just caring for their bodies and keeping them alive. 0:16:25.680 --> 0:16:28.720 The thirty or so percent who developed parkinson Is um 0:16:28.760 --> 0:16:30.880 generally wound up in long term care for the rest 0:16:30.880 --> 0:16:33.560 of their lives, and many of them were completely unable 0:16:33.600 --> 0:16:37.840 to move or take care of themselves. In the nineteen sixties, 0:16:37.880 --> 0:16:40.520 after the drug leve Adopa, or el dopa as it 0:16:40.600 --> 0:16:44.600 was called, was introduced for treating Parkinson's, New York doctor 0:16:44.680 --> 0:16:47.880 Oliver Sacks, who are some of our listeners may have 0:16:47.960 --> 0:16:51.920 heard of, administered it to some encephalitis lethargica patients who 0:16:51.960 --> 0:16:55.120 were in long term care. Some patients actually showed a 0:16:55.160 --> 0:16:59.200 limited recovery from their post and sephalitis lethargica parkinson symptoms. 0:17:00.160 --> 0:17:02.520 This is the story that's actually told in the movie Awakenings, 0:17:02.520 --> 0:17:04.679 which is why people may have heard of Olliver sex. 0:17:05.400 --> 0:17:09.360 But they all apparently developed a tolerance until the dosage 0:17:09.400 --> 0:17:12.199 was really just too much for the human body to handle, 0:17:12.680 --> 0:17:15.480 and then they would return to their semi comatose state 0:17:16.160 --> 0:17:19.480 in the end. This epidemic went on from nineteen sixteen 0:17:19.480 --> 0:17:23.359 to nineteen twenty seven, reaching its peak in nineteen twenty four, 0:17:23.400 --> 0:17:25.920 after which the number of cases started to drop off. 0:17:26.520 --> 0:17:30.200 The total numbers of people affected are really unclear. There 0:17:30.200 --> 0:17:32.840 are sources who say that a million people were killed, 0:17:33.320 --> 0:17:36.560 while others say that only half a million were affected 0:17:36.600 --> 0:17:40.960 in one way or another. Regardless, though the mortality rate 0:17:41.000 --> 0:17:44.480 was pretty serious in England, almost half of the cases 0:17:44.560 --> 0:17:48.399 in nineteen nineteen and nineteen twenty died. Although it was 0:17:48.520 --> 0:17:52.320 roughly concurrent with the Spanish flu pandemic, and flu came 0:17:52.359 --> 0:17:55.840 up frequently when looking at possible causes. Many doctors at 0:17:55.840 --> 0:17:58.920 the time didn't really think the disease was actually flu related. 0:17:59.400 --> 0:18:02.320 Only a small percentage of the patients had also had 0:18:02.400 --> 0:18:06.639 Spanish flu. In nineteen eighty two, however, doctors from the 0:18:06.640 --> 0:18:10.240 Centers for Disease Control published this list of connections between 0:18:10.280 --> 0:18:13.400 the two diseases. So for a little while. In more 0:18:13.520 --> 0:18:18.119 recent years, flu became a prime suspect for causing encephalitis lethargica. 0:18:18.960 --> 0:18:21.880 Uh there is, you know, especially since there have been 0:18:22.000 --> 0:18:26.919 other incidents of encephalitis that have followed outbreaks of the flu. Today, 0:18:26.960 --> 0:18:29.520 the idea that the flu was the culprit has pretty 0:18:29.600 --> 0:18:32.760 much been ruled out. Thanks to modern testing methods. They 0:18:32.760 --> 0:18:35.119 haven't turned up any sign of the flu virus in 0:18:35.160 --> 0:18:39.800 tissue samples from patients who died from encephalitis. Although it's 0:18:39.840 --> 0:18:44.040 never reached that same epidemic state again, isolated cases of 0:18:44.160 --> 0:18:48.280 encephalitis lethargica have continued to crop up even in recent years. 0:18:49.200 --> 0:18:53.840 Most recently in a twenty three year old named Becky 0:18:54.080 --> 0:18:57.080 Powell was diagnosed with the disease and it took her 0:18:57.160 --> 0:19:01.880 two years to recover. Several similar ass followed. In two 0:19:01.880 --> 0:19:04.840 thousand three, a team of doctors published a paper in 0:19:04.840 --> 0:19:07.520 the journal Brain that put forth a pretty good case 0:19:07.560 --> 0:19:11.200 that the cause of encephalitis lethargica is actually a massive 0:19:11.240 --> 0:19:15.960 autoimmune reaction to an unidentified pathogen. A strain of strep 0:19:16.040 --> 0:19:19.160 comes up in the discussion, but it's ultimately dismissed as unlikely. 0:19:19.800 --> 0:19:22.720 And their research was done on twenty different patients who 0:19:22.760 --> 0:19:27.240 developed the disease between two thousand two, and those patients 0:19:27.280 --> 0:19:30.119 had a much lower mortality rate than during the epidemic. 0:19:30.880 --> 0:19:33.359 Only one died, but five of them did have to 0:19:33.359 --> 0:19:36.560 be placed on a ventilator. Had those five patients lived 0:19:36.560 --> 0:19:38.760 in the ninety twenties, they probably would not have made it, 0:19:39.600 --> 0:19:41.880 but almost none of them had fully recovered a year 0:19:41.960 --> 0:19:44.919 or so later when the paper was published. They continued 0:19:44.960 --> 0:19:48.760 to have neurological and psychiatric symptoms. Yeah. If if there 0:19:48.800 --> 0:19:53.840 had been if today's ventilation technology had existed in the 0:19:53.920 --> 0:19:59.000 nineteen twenties, the mortality rate would have been sign Yeah, 0:19:59.040 --> 0:20:02.879 because people would get into this just deep uninterrupted sleep 0:20:03.119 --> 0:20:05.720 and their respiratory functions would fail, and there wasn't really 0:20:05.720 --> 0:20:07.720 anything that people could do about it. But now that 0:20:07.760 --> 0:20:12.399 we have ventilators, uh, that there are actual there's a 0:20:12.400 --> 0:20:14.640 treatment for that part of it that didn't exist back then. 0:20:15.480 --> 0:20:19.760 In a paper in the journal BMC Infectious Diseases reported 0:20:19.760 --> 0:20:23.040 that a team of researchers had found virus like particles 0:20:23.040 --> 0:20:28.200 in the brains of both epidemic encephalitis patients and modern patients, 0:20:28.320 --> 0:20:33.240 so people who had died either recently or during the epidemic. 0:20:34.000 --> 0:20:37.960 This supports the idea that the cause of encephalitis lethargica 0:20:38.119 --> 0:20:43.280 is an interarovirus, but exactly what interarovirus we still do 0:20:43.320 --> 0:20:55.800 you not know. So encephalitis lethargica has a some you know, 0:20:55.840 --> 0:20:58.720 a legacy today, even though a lot of people have 0:20:58.760 --> 0:21:02.119 not really heard of it as tragic and frightening as 0:21:02.200 --> 0:21:05.600 the disease was and is really. In the end, it 0:21:05.680 --> 0:21:10.280 helped doctors understand more about the brain. Von economos conclusion 0:21:10.400 --> 0:21:13.879 about the hypothalamus and its role in the patient's sleep, 0:21:14.000 --> 0:21:18.360 for example, was hugely unpopular at the time, but many 0:21:18.440 --> 0:21:21.399 years later it was proved to be true after we 0:21:21.520 --> 0:21:24.439 developed sorts of imaging technologies that we can use to 0:21:24.480 --> 0:21:27.840 look directly at the brain as it's working today. Neurologist 0:21:27.920 --> 0:21:31.879 Bernard Sacks also wrote that the epidemic of encephalitis quote 0:21:31.960 --> 0:21:36.080 revolutionized the practice of neurology, So it really changed the 0:21:36.119 --> 0:21:40.080 way that, uh, these things were examined from the get go. Yeah, 0:21:40.119 --> 0:21:44.439 it helped solidifying neurology as an actual field. In the 0:21:44.480 --> 0:21:48.120 early days, there was sort of this hodgepodge of neurology 0:21:48.200 --> 0:21:51.280 ideas and psychology ideas and all these things that were 0:21:51.320 --> 0:21:54.879 kind of together in one big pot. And in part 0:21:54.920 --> 0:21:58.399 because of encephalitis being spread the way that it was, 0:21:59.080 --> 0:22:04.439 a group of doctors branched off to study just neurology 0:22:04.560 --> 0:22:06.879 and it celf lightest lethargica was also one of the 0:22:06.880 --> 0:22:10.760 conditions that made it clear that disease processes can lead 0:22:10.760 --> 0:22:14.480 to mental illnesses. Uh, it's solidified the idea that mental 0:22:14.520 --> 0:22:17.200 illnesses were not solely in the realm of emotions or 0:22:17.240 --> 0:22:21.520 traumatic experiences. It's not always buried memories. Sometimes there can 0:22:21.560 --> 0:22:26.159 actually be a physical happening that causes mental illness. There 0:22:26.200 --> 0:22:29.119 are a couple of books that are out about this epidemic. 0:22:29.920 --> 0:22:33.760 The one that I read researching this podcast was called Asleep, 0:22:34.040 --> 0:22:37.600 The Forgotten Epidemic That Remains one of Medicine's Greatest Mysteries 0:22:37.680 --> 0:22:43.359 by Molly Caldwell Crosby and her grandmother survived sleepy sickness. 0:22:44.080 --> 0:22:47.080 It starts with sort of a case study of her grandmother. 0:22:47.119 --> 0:22:51.119 That's terrifying because it's about her grandmother being asleep for 0:22:51.160 --> 0:22:53.479 so long but also being aware of what was happening 0:22:53.480 --> 0:22:56.600 around her, which to me is just terrifying. The one 0:22:56.640 --> 0:22:58.800 caveat about this book is that it was written before 0:22:58.840 --> 0:23:02.200 the very most recent research about what might have caused 0:23:02.920 --> 0:23:07.040 this particular epidemic, which is going to be the case 0:23:07.080 --> 0:23:09.400 with just about every book now since the latest research 0:23:09.480 --> 0:23:11.720 is just from very new Yeah. Last year, as we 0:23:11.720 --> 0:23:16.600 were recording, I have read several papers that you know, 0:23:16.680 --> 0:23:20.639 and when the bird flu epidemic was was everybody was 0:23:20.720 --> 0:23:25.160 very frightened about bird flu. There were several articles that 0:23:25.160 --> 0:23:28.000 that came up where doctors were like, actually, what you 0:23:28.080 --> 0:23:31.120 really should be afraid of is a resurgence of this 0:23:31.440 --> 0:23:38.720 still unidentified encephalitis that sometimes that sometimes follows outbreaks of 0:23:38.720 --> 0:23:44.240 other diseases. I yeah, it's basically my worst nightmare. I mean, 0:23:44.280 --> 0:23:46.679 I have not a good relationship with sleep anyway. If 0:23:46.680 --> 0:23:48.560 I didn't have to do it, I wouldn't. So the 0:23:48.640 --> 0:23:52.239 idea of not having any control over the situation and 0:23:52.359 --> 0:23:55.520 just being asleep but not really because you're conscious of 0:23:55.520 --> 0:24:00.399 things happening. Is my worst nightmare. Yeah, not play on 0:24:00.680 --> 0:24:05.000 sleep jokes, but well, it's terrifying and the there are 0:24:05.000 --> 0:24:08.639 many things about this whole the epidemic and the illness 0:24:08.680 --> 0:24:10.639 itself that are are frightening to me, and one of 0:24:10.640 --> 0:24:14.160 them is that people would seem to recover and they 0:24:14.160 --> 0:24:18.000 would be fine for a long time, and then the 0:24:18.160 --> 0:24:22.239 developed fine developed parkinson symptoms um and once it had 0:24:22.280 --> 0:24:24.640 been established that that was a pattern, I can imagine 0:24:24.680 --> 0:24:27.280 like the people who had gotten better really being like 0:24:27.359 --> 0:24:30.960 I'm never going to be which I know that's the 0:24:31.040 --> 0:24:33.400 case with a lot of diseases that people have now, 0:24:33.440 --> 0:24:35.960 Like there are many cancer patients who never feel like 0:24:36.000 --> 0:24:40.000 they are in the clear because you can be in remission. 0:24:42.560 --> 0:24:45.200 So yeah, it's a scary thing to live with that 0:24:45.320 --> 0:24:54.640 kind of over you. Thank you so much for joining 0:24:54.720 --> 0:24:57.919 us on this Saturday. If you have heard an email 0:24:57.920 --> 0:25:00.320 address or a Facebook you are l or something similar 0:25:00.480 --> 0:25:02.920 over the course of today's episode, since it is from 0:25:02.920 --> 0:25:05.520 the archive that might be out of date now, you 0:25:05.560 --> 0:25:08.720 can email us at History Podcast at how Stuff Works 0:25:08.760 --> 0:25:10.800 dot com, and you can find us all over social 0:25:10.840 --> 0:25:14.040 media at missed in history, and you can subscribe to 0:25:14.080 --> 0:25:17.400 our show on Apple Podcasts, Google podcast, the I Heart 0:25:17.480 --> 0:25:24.639