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A (0:00)
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Welcome to Aaron Menke's Cabinet of Curiosities, a production of iHeartRadio and Grim and mild. Our world is full of the unexplainable, and if history is an open book, all of these amazing tales are right there on display, just waiting for us to explore. Welcome to the Cabinet of Curiosities. Picture the scene with me. It's midwinter 1918. The hospital ward is packed this season. Row upon row of ailing patients lie trembling, unable to raise their heads, their faces fixed, eyes glazed, caught between sleep and waking in an unnatural half dream state. Each suffers from a disease that doctors have not yet understood Encephalitis lethargica, or simply el, an illness concurrent with the influenza just beginning to sweep the globe. But this disease, el affecting between 1 and 5 million people worldwide, manifests differently intense sleepwalking, ocular disturbances and a motor skill impairment. Many permanently develop Parkinson's like symptoms and they call it the sleeping sickness and it kills between 10 to 30% of people infected. The first documented cases came in 1916, when St. Petersburg, Paris and Vienna simultaneously reported an illness characterized by severe fatigue, fever and a disturbing ability to stay awake. It was thought that refugees and soldiers of the Great War helped to spread the disease across Europe. As cases rose, health officials issued advisories that newspapers amplified, prompting the creation of isolation wards to contain the influx of patients suffering and citywide quarantines. And naturally, the Doctors were baffled, thinking that it might be influenza or meningitis. Some even believed that it was a form of mass psychiatric catatonia. Yet the profound lethargy, involuntary eye rolling, muscle rigidity and tremors didn't point to any known illness. And so they prescribed what they rest, bromides and watchful care in the hospital. Into this confusion stepped Konstantin von Economo, a neurologist from the University of Vienna. His background in sleep research made him particularly adept at figuring out the problem of the epidemic. Through autopsies, he was able to discover inflammation of the basal ganglia, a region of the brain that regulates movement and behavior and causing tremors and difficulties in movement. Over the course of time, these acute symptoms progressed into a Parkinson's like chronic illness. Von Economo published a series of studies on the disease, finally putting a name to it, the one I gave you earlier, Encephalitis Lethargica. The work was crucial to not just understanding el, but also for future research into neuroinfectious diseases in General. In the mid-1920s, the influx of new cases had abruptly declined, and by the end of 1927, it had virtually disappeared from hospital wards. All over. And of course, many explanations were put forward for this decline in cases. Maybe it was possible that the population had acquired herd immunity, so the disease was finding it harder and harder to find a host. Another theory is that, like the Spanish influenza, it had mutated, creating less virulent strains. Many recovered, although 1% of patients did not, instead entering a chronic phase of the illness that lasted for years. Decades later, a small handful of these chronic sufferers remained in a catatonic sort of fugue state, unable to speak or move. At Beth Abraham Hospital in New York, a young neurologist named Oliver Sacks observed patients that seemed to exhibit the same basal ganglia condition that von Economo had first discovered. With more research at his back, he thought that perhaps the symptoms were caused by a deficiency of dopamine, a neurotransmitter that works as a sort of chemical messenger in the body. And so he gave his patients a drug called Levodopa to boost their dopamine. The results were almost instantaneous and absolutely shocking. Patients began waking up from the catatonia they had been experiencing for years. They were able to move, walk, speak, and express emotions. Although this was a temporary relief for sufferers of el, it revolutionized treatment and advanced the field's understanding of dopamine's role in the brain. Years later, Sachs would publish a book on the experiments called Awakenings which agreed with von Economos studies, adding more modern information into the mix, and the book was even made into a famous film of the same name, starring Robin Williams as Oliver Sacks and Robert De Niro as one of his patients. The film was nominated for Best Picture at the Oscars, scoring two statues for its writing and editing. The sleeping sickness has not returned in any real scale, although there have been a number of scattered cases over the years that very much resembled it. And advances in imaging things like MRIs and PET scans now allow doctors to actually see how el works on the brain in real time and try new medications to curb the possibility of long term effects. Scientists are also using modern virus detecting tools to hunt for any germs that may create a similar effect in the infected Honestly, science is utterly amazing. Encephalitis Lethargica stands as a singular strange episode in modern medical history, a pandemic that disappeared almost as quickly as it arrived. Of course, scientists today are still trying to fully understand the disease that affected so many, because illnesses may come and go. But as long as we have skilled and experienced scientists to protect us, all of us have hope.