Table Of ContentPaul Bernard Foley
Encephalitis
lethargica
The mind and brain virus
Encephalitis lethargica
FelixStern(1884–1941).Source:Universitätsarchiv,Göttingen.
Paul Bernard Foley
Encephalitis lethargica
The mind and brain virus
123
PaulBernardFoley
NeuroscienceResearchAustralia
Sydney,NSW
Australia
and
Unit forHistoryandPhilosophyofScience
UniversityofSydney
Sydney,NSW
Australia
ISBN978-1-4939-0383-2 ISBN978-1-4939-0384-9 (eBook)
https://doi.org/10.1007/978-1-4939-0384-9
LibraryofCongressControlNumber:2016944489
SpringerNewYorkHeidelbergDordrechtLondon
©SpringerScience+BusinessMediaNewYork2018
Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeor
part of the material is concerned, specifically the rights of translation, reprinting, reuse of
illustrations,recitation,broadcasting,reproductiononmicrofilmsorinanyotherphysicalway,
andtransmissionorinformationstorageandretrieval,electronicadaptation,computersoftware,
orbysimilarordissimilarmethodologynowknownorhereafterdeveloped.
Theuseofgeneraldescriptivenames,registerednames,trademarks,servicemarks,etc.inthis
publicationdoes not imply, even in the absence of a specific statement, that such names are
exemptfromtherelevantprotectivelawsandregulationsandthereforefreeforgeneraluse.
Thepublisher,theauthorsandtheeditorsaresafetoassumethattheadviceandinformationin
thisbookarebelievedtobetrueandaccurateatthedateofpublication.Neitherthepublisher
northeauthorsortheeditorsgiveawarranty,expressorimplied,withrespecttothematerial
containedhereinorforanyerrorsoromissionsthatmayhavebeenmade.
Printedonacid-freepaper
ThisSpringerimprintispublishedbySpringerNature
Dedicated to the memory of Felix Stern, and for Kay and Max
Acknowledgements
As with my previous book, I commenced the work for this volume in
ignorance of the dimensions of the story I wished to tell. I had indeed
discovered encephalitis lethargica during my exploration of the history
of therapy for parkinsonism, and was tempted by the thought that a closer
examinationofthispeculiardisordermightprovideinsightsintotheetiology
ofidiopathicParkinson’sdisease,andthusintopotentialnewavenuesforits
management.Iamnolongerconvincedthatthisisnecessarilythecase,but,
on the other hand, a much broader, interesting picture developed in the
courseofmyresearch,thepictureofamultihuedinfectiousneuropsychiatric
disorder that presented an unprecedented coalescence of both neurologic
and psychiatric symptoms that both underscored the unity of mind and
movementintheCNS,andmadeclearthecriticalroleplayedbysubcortical
structures in the elaboration of consciousness and other higher mental
functions formerly attributed to the soul and more recently presumed to be
localized to the human cerebral cortex. Encephalitis lethargica exerted a
greater influence on clinical and theoretic neuroscientific thought between
the two World Wars than any other single disorder, and its impact upon
contemporaryneurologyandpsychiatryisstillevidenttothosewiththeeyes
to recognize it. In order to even approach doing justice to the many sig-
nificantfacetsofthephenomenonencephalitislethargica,however,required
more time than initially envisaged: “one book always leads to another and
another, and they all have something to say, there is something unhealthy
about curiosity, not for the reasons usually given, but because it leads inex-
orably to exhaustion” (Javier Marías, Yourfacetomorrow. I.Fever and spear
[Vintage Books, London, 2006], p. 119). Or, to paraphrase Bob Dylan, I
needed to know my song well before I started singing.
My research into the history of encephalitis lethargica and related dis-
orders was funded successively by the Prince of Wales Medical Research
Institute (POWMRI; now Neuroscience Research Australia, NeuRA), a
Post-Doctoral Research Fellowship from the Alexander von Humboldt
Foundation (during which I was a guest researcher at the Institut für die
GeschichtederMedizin inWürzburg,Germany),theRamaciottiFoundation
(Australia), the Australian Research Council (Postdoctoral Research Fel-
lowship and Discovery Project (DP0451188), and the University of New
vii
viii Acknowledgements
South Wales (Vice-Chancellor’s Postdoctoral Research Fellow). The prepa-
rationofthebookitselfwasfacilitatedbyatwo-yeargrantfromtheNational
Library of Medicine (NLM Grants for Scholarly Works in Biomedicine and
Health; 1G13LM009863-01).
Aspects of this work have been individually presented at scientific con-
ferences throughout the course of my research, particularly at the annual
meetings of the International Society for the History of the Neurosciences
(ISHN).Iamgratefulforthediscussionswithfriendsandcolleaguesatthese
meetings that played an important role in clarifying details and concepts
discussed in this book (as well as for providing encouragement that my
effortswereatleastintellectuallyworthwhile), andIamparticularlygrateful
forthemanyfruitfulexchanges withJoelVilensky(Indiana University, Fort
Wayne, USA), with whom I co-organized a symposium on encephalitis
lethargicaatthe2007ISHNmeeting inLosAngeles,andwhoinvitedmeto
contribute the chapter on historical encephalitis lethargica-like disorders to
his volume on the disorder.
I will not attempt a comprehensive listing of all those who have helped
along the way (for fear of overlooking anyone at this late stage), but a few
deserve special thanks. A number of libraries and archives provided
invaluable assistance in locating and supplying material throughout the
course of my research. I am particularly grateful to the Staatsbibliothek zu
Berlin, both for its prompt and helpful replies to my many e-mailed
enquiries, as well as for the friendly assistance I always received during my
annual visits to the Unter den Linden library. I enjoyed visiting the new
reading rooms in 2014, but somehow missed the labyrinthine corridors and
musty smells that had become familiar on the way from the old entrance
from Unter den Linden!
TheassistanceprovidedbyUlrichHunger(Universitätsarchiv Göttingen)
and the Council for Assisting Refugee Academics (UK) in my search
for information concerning Felix Stern is very much appreciated; a brief
Stern biography is in preparation. The welcome afforded me by the Staats-
archiv Chemnitz during my search for information on the former pediatric
encephalitis lethargica made from a very pleasant and fruitful stay in their
city, whereby the information provided by the SFZ Förderzentrum (Chem-
nitz) maximized the value of this visit. I am also grateful to Hermine Hof-
mann and Carola Lorenz (Klinika Bavaria, Kreischa) for taking the time to
showmearoundwhatwasformerlytheKreischaSanatoriumanddiscussing
with me the fate of Heinrich von Witzleben, pioneer of the Bulgarian
treatment for encephalitis lethargica in Germany. I also thank Professor
GlendaHalliday(POWMRI/NeuRA),whoprovidedintellectualandmaterial
help throughout the project; Russell Dale (Children’s Hospital, Westmead,
Australia), who shared with his experience with contemporary cases of
encephalitislethargica-syndrome;theSydneyTheatreCompany;andMaaike
Mintjes (POWMRI), who was of great assistance during the early stage of
material analysis and organization. I also thank my Berlin colleague
Acknowledgements ix
Reinhard Horowski, who for many years has shared and supported my
interest inthe history ofthe neurosciences, for providing mewith reprinted
copies of many of the important EL monographs of the 1920s.
Feci quod potui, faciant meliora potentes.
Paul Bernard Foley
Sydney, January 2013
Contents
1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
The fascination of encephalitis lethargica. . . . . . . . . . . . . . . . . . 2
The ‘sleeping disorder’. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
The protean disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
The world into which encephalitis lethargica was born . . . . . 5
The significance of encephalitis lethargica for the biomedical
sciences of the 1920s. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Learning from the previous epidemic . . . . . . . . . . . . . . . . . . . . 9
The historical analysis of encephalitis lethargica . . . . . . . . . . . . 9
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2 1915–1918: The origins of encephalitis lethargica. . . . . . . . . . 15
The winter of 1916/17 in Vienna . . . . . . . . . . . . . . . . . . . . . . . 15
Wiesner’s streptococcus: the encephalitis pathogen
identified? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Other reports from Vienna. . . . . . . . . . . . . . . . . . . . . . . . . . 19
Not all quiet on the Western Front: René Cruchet
and ‘epidemic encephalomyelitis’. . . . . . . . . . . . . . . . . . . . . 21
Was encephalitis lethargica really present in France before
1918?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Other neurologic disorders on the Western Front . . . . . . . . . 28
The priority debate: Cruchet v. Economo . . . . . . . . . . . . . . . 30
Was encephalitis lethargica seen elsewhere before 1918? . . . . . . 34
Did encephalitis lethargica come from the Far East? . . . . . . . 36
The first red herring: Australian X disease . . . . . . . . . . . . . . . . 37
1918: Breakout in France . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Encephalitis lethargica crosses the Channel. . . . . . . . . . . . . . . . 43
‘Epidemic stupor’. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
‘Epidemic encephalitis’. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
The first English overview: Report of an enquiry into
an obscure disease, encephalitis lethargica. . . . . . . . . . . . . 50
Encephalitis lethargica and epidemic polio . . . . . . . . . . . . . . 55
Crookshank and the question of ‘influenzas’. . . . . . . . . . . . . 59
Encephalitis lethargica in France at the close of 1918. . . . . . . . . 63
Situation report: Europe, Christmas 1918 . . . . . . . . . . . . . . . . . 65
Appendix: Early cases of encephalitis lethargica and purported
encephalitis lethargica-like disease, 1890–1918. . . . . . . . . . . . 67
xi
