Encephalitis lethargica Felix Stern (1884–1941). Source: Universitätsarchiv, Göttingen. Paul Bernard Foley Encephalitis lethargica The mind and brain virus 123 Paul Bernard Foley Neuroscience Research Australia Sydney, NSW Australia and Unit for History and Philosophy of Science University of Sydney Sydney, NSW Australia ISBN 978-1-4939-0383-2 ISBN 978-1-4939-0384-9 (eBook) https://doi.org/10.1007/978-1-4939-0384-9 Library of Congress Control Number: 2016944489 Springer New York Heidelberg Dordrecht London © Springer Science+Business Media New York 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by SpringerNature 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 examination of this peculiar disorder might provide insights into the etiology of idiopathic Parkinson’s disease, and thus into potential new avenues for its management. I am no longer convinced that this is necessarily the case, but, on the other hand, a much broader, interesting picture developed in the course of my research, the picture of a multihued infectious neuropsychiatric disorder that presented an unprecedented coalescence of both neurologic and psychiatric symptoms that both underscored the unity of mind and movement in the CNS, and made clear the critical role played by subcortical 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 contemporary neurology and psychiatry is still evident to those with the eyes to recognize it. In order to even approach doing justice to the many sig- nificant facets of the phenomenon encephalitis lethargica, 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, Your face tomorrow. 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 Geschichte der Medizin in Würzburg, Germany), the Ramaciotti Foundation (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- ration of the book itself was facilitated by a two-year grant from the National 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). I am grateful for the discussions with friends and colleagues at these meetings that played an important role in clarifying details and concepts discussed in this book (as well as for providing encouragement that my efforts were at least intellectually worthwhile), and I am particularly grateful for the many fruitful exchanges with Joel Vilensky (Indiana University, Fort Wayne, USA), with whom I co-organized a symposium on encephalitis lethargica at the 2007 ISHN meeting in Los Angeles, and who invited me to 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! The assistance provided by Ulrich Hunger (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 show me around what was formerly the Kreischa Sanatorium and discussing with me the fate of Heinrich von Witzleben, pioneer of the Bulgarian treatment for encephalitis lethargica in Germany. I also thank Professor Glenda Halliday (POWMRI/NeuRA), who provided intellectual and material help throughout the project; Russell Dale (Children’s Hospital, Westmead, Australia), who shared with his experience with contemporary cases of encephalitis lethargica-syndrome; the Sydney Theatre Company; and Maaike 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 in the history of the neurosciences, for providing me with 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 xii Contents 3 1919–1924: The international epidemic. 83 The 1918/19 influenza pandemic . 83 The medical conception of ‘influenza’