Infectious Madness, the Well Curve and the Microbial Roots of Mental Disturbance

3cfce0fe054a12627f41292ec26e6b22Today’s guest post is written by Harriet Washington, a science writer, editor and ethicist. She is  the author of several books, including Medical Apartheid: The Dark History of Experimentation from Colonial Times to the Present. On Wednesday, March 15 at 6pm, Washington will discuss: “Infectious Madness, the Well Curve and the Microbial Roots of Mental Disturbance.” In this talk, based on her book Infectious Madness: The Surprising Science of How We “Catch” Mental Illness, Washington traces the history, culture and some disturbing contemporary manifestations of this ‘infection connection.” To read more about this lecture and to register, go HERE.

“Mind, independent of experience, is inconceivable.” —Franz Boas

Psychological trauma, stress, genetic anomalies and other experiences that limit the healthy functioning of the mind and brain are widely recognized as key factors in the development of schizophrenia, major depression, and bipolar disorder.  However, despite a plethora of examples and evidence of microbial disorders from rabies to paresis, infection has been slow to join the pantheon.  This aversion persists largely because the perceived causes of mental disorders have evolved not only with our scientific knowledge of medicine but also with our tenacious cultural beliefs and biases.  Instead, we have long clung to what  Robert Sapolsky calls a “primordial muck” of attribution that includes broken taboos, sin—one’s own or one’s forbears’— and even bad mothering.


Representation of the dancing mania by Flemish painter Pieter Brueghel the Younger.Source.

Flemish painter Pieter Brueghel the Younger (1564–1636) painted the above representation of the dancing mania known as choreomania or St. Anthony’s Fire, which has seized a pilgrimage of epileptics en route to the church at Molenbeek. Such compulsive dancing was originally ascribed to satanic influence such as bewitchment, and later to a collective hysterical disorder, but is now ascribed to ergotism— the  infection of rye and other grains by the fungus Claviceps purpurea.  When people ate the tainted bread, their symptoms included compulsive dancing. Some have ascribed the mass hysteria of the Salem witch trials to ergotism.  Streptoccocal infections have also produced cases called Sydenham’s chorea.

Not all traditional “causes” of mental illness are confined to the past.  As late as the 1980s, the alternating rage, coldness and oppressive affection of domineering “schizophrenogenic mothers” was taught in psychology classes as the root of schizophrenia, just as Tourette’s syndrome initially was laid to poor parenting.

For Infectious Madness: The Surprising Science of How We “Catch” Mental Illness, I interviewed scientists working on the effects of infections on mental health such as Susan Swedo, chief of the pediatrics and developmental neuroscience branch at the National Institute of Mental Health, who studies the role of Group A strep (GAS) infections in children in rapid-onset cases of obsessive compulsive disorder, anorexia, and Tourette syndrome. Other visionary researchers, such as E. Fuller Torrey, executive director of Maryland’s Stanley Medical Research Institute, and Robert Yolken, director of developmental neurovirology at Johns Hopkins University, have for decades investigated the role of microbes in mental illness and have traced the path of viruses such as influenza, herpes simplex and Toxoplasma  gondii, among other microbes, in schizophrenia and bipolar disorder.

There are a myriad of ways in which infections cause or encourage mental disease. In order to suit its own need to reproduce within the stomach of a cat, the unicellular parasite Toxoplasma gondii changes the behavior of rodents — and incidentally, use it to gain entry. This seems strange, but changing the behavior of a host to suit its own needs is a common stratagem of parasites. The Cordyceps fungus, for example, manipulates an ant in the Amazon into climbing a tree where the fungal spores can be more widely disseminated. The spore- bearing branches extend from the corpse of the ant pictured below.


The Cordyceps fungus manipulates an ant in the Amazon into climbing a tree where the fungal spores can be more widely disseminated. The spore-bearing branches extend from the corpse of the ant.Photograph © Gregory Dimijian, MD.

Infection, redux

“Everything has been thought of before, but the problem is to think of it again.” —Goethe

There is a long, all but forgotten history of infectious theories of mental illness. In his 1812 psychiatry text Medical Inquiries and Observations upon the Diseases of the Mind, for example, Benjamin Rush, MD, included a first detailed taxonomy of mental disorders, each with its own physical cause. He cited disruptions of blood circulation and  sensory overload as the basis of mental illness, and he treated his patients with devices meant to improve circulation to the brain, including such Rube Goldberg designs as a centrifugal spinning board, or to decrease sensory perceptions, such as a restraining chair with a head enclosure.

Restraining Chair

Pictured here is the “tranquilizing chair” in which patients were confined. The chair was supposed to control the flow of blood toward the brain and, by lessening muscular action or reducing motor activity, reduce the force and frequency of the pulse.Photograph © 2008 Hoag Levins.

Paresis, an infectious mental disorder

In 1857, Drs. Johannes Friedrich Esmark and W. Jessen suggested a biological cause for paresis: syphilis. Many researchers started to view paresis as the tertiary stage of syphilis, which often attacked the brain indiscriminately, and they began referring to it as neurosyphilis. This theory held out hope that if syphilis was ever cured, paresis could be too.

Nineteenth-century asylum keepers, however, persisted in viewing paresis as wholly mental in character. The long-standing insistence on divorcing physical illnesses from mental ones had to do with religious philosophy and culture but also with the politics of the asylum, which remained a battleground between physicians and religious and philosophical healers.

Matters were complicated by the fact that most physicians, despite the evidence that paresis was the mental manifestation of a physical disease, continued to treat paretics with the same ineffectual therapeutics given other mentally ill patients. Traditional treatments such as “douches, cold packs, mercury, blistering of the scalp, venesection, leeching, sexual abstinence, and holes drilled into the skull [trephination]” continued—without positive results. Even when toxic mercury-based treatments for syphilis were replaced by Paul Ehrlich’s safer, more effective arsenic-based Salvarsan (also called arsphenamine and compound 606), it was not used against paresis.

But in June 1917, Professor Julius Wagner-Jauregg of the University of Vienna Hospital for Nervous and Mental Diseases undertook a radical approach. He had noticed that some paretic patients improved markedly after contracting an infectious illness that gave them fevers. He decided to fight fire with fire by turning one disease against another: he sought to suppress the symptoms of paresis by infecting its sufferers with malaria.

Before Wagner-Jauregg won the Nobel and Freud forged the future of psychiatry, a paradigm shift had already taken place that transformed science’s approach to the nature of disease. It is the very framework that supports the role of infection in mental illness—germ theory. Developed by Louis Pasteur and Robert Koch, germ theory posits that specific microbes such as bacteria, viruses, and prions (infectious proteins) cause illness.

For more on this fascinating topic, join Harriet Washington on Wednesday, March 15 at 6pm.  More information can be found here

New Acquisitions at the Library

By Jarlin Espinal, Technical Services Assistant

Below is a selection of some of our recently acquired secondary sources in the history of medicine, along with blurbs about each book. Make an appointment to come and use them!

Nine of the library’s new acquisitions. Click to enlarge.

Nine of the library’s new acquisitions. Click to enlarge.

Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case – Debbie Nathan

Sybil Exposed isn’t only an exposé of a blockbuster that pulled the wool over 6 million readers’ eyes … Riveting, thought-provoking and a quick read, Sybil Exposed is impossible to put down.” – The Oregonian

Representing Argentinian Mothers: Medicine, Ideas and Culture in the Modern Era, 1900–1946 – Yolanda Eraso

“Through detailed examination of a rich selection of sources including medical texts, newspapers, novels, photojournalism, and paintings, Representing Argentinian Mothers adopts an interdisciplinary approach and an innovative framework based on categories and notions drawn from the history of ideas and cultural history. By enquiring about the influence of medicine in the field of ideas, beliefs and images, Yolanda Eraso elaborates new insights to understand their interaction, which will appeal to anyone with an interest in the Medical Humanities.”

The Making of Mr. Gray’s Anatomy: Bodies, Books, Fortune, Fame – Ruth Richardson

“It is the story of changing attitudes in the mid-19th century; of the social impact of science, the changing status of medicine; of poverty and class; of craftsmanship and technology. And it all unfolds in the atmospheric milieu of Victorian London—taking the reader from the smart townhouses of Belgravia, to the dissection room of St. George’s Hospital, and to the workhouses and mortuaries where we meet the friendless poor who would ultimately be immortalised in Carter’s engravings.”

Life Writing and Schizophrenia: Encounters at the Edge of Meaning – Mary Elene Wood

“Challenging the romanticized connection between literature and madness, Life Writing and Schizophrenia explores how writers who hear voices and experience delusions write their identities into narrative, despite popular and medical representations of schizophrenia as chaos, violence, and incoherence. The study juxtaposes these narratives to case histories by clinicians writing their encounters with those diagnosed with schizophrenia, encounters that call their own narrative authority and coherence into question.”

Before Bioethics: A History of American Medical Ethics from the Colonial Period to the Bioethics Revolution – Robert Baker

“Before Bioethics narrates the history of American medical ethics from its colonial origins to current bioethical controversies over abortion, AIDS, animal rights, and physician-assisted suicide. This comprehensive history tracks the evolution of American medical ethics over four centuries, from colonial midwives and physicians’ oaths to medical society codes, through the bioethics revolution.”

Cannabis Nation: Control and Consumption in Britain, 1928-2008 – James H. Mills

“Overall, anyone with an interest in cannabis and indeed, illicit drugs more widely would find the book of interest. The meticulous research challenges commonly held perceptions. … an amusing and eminently readable piece of work.” – Mark Monaghan, Journal of Social Policy

American Pandemic: The Lost Worlds of the 1918 Influenza Epidemic – Nancy K. Bristow

“A richly detailed picture of American society as it experienced an extraordinary trauma—one that shook a newly established confidence in the efficacy of medicine and the responsiveness of civil society. Doctors, nurses, the friends and families of the sick all play a part in this carefully and imaginatively researched and lucidly written account of America’s last great epidemic.” – Charles Rosenberg, Harvard University

How Cancer Crossed the Color Line – Keith Wailoo

“A model of how to seamlessly weave together the complex intersectionality of class, gender and race. How Cancer Crossed the Color Line is a masterful account of how the reward structures of science funding, the profession of medicine, era-specific cultural stereotypes of women’s ‘proper place,’ and shifting notions of racialized bodies have all converged to shape our views of who is at risk for cancer, and why.” – Troy Duster, New York University

Medical Visions: Producing the Patient through Film, Television, and Imaging Technologies – Kirsten Ostherr

“Kirsten Ostherr shows us how we might learn to see—and to experience—health and illness differently. Medical Visions is crucial reading for anyone who practices medicine and for anyone who is, has been, or will be a patient—which is to say, all of us.” – Priscilla Wald, author of Contagious


Program Announcement: The Beginning of the Ends

CenterforBookendScholarship_logoThe Center for the History of Medicine and Public Health is excited to announce the founding of its newest program, the Center for Bookend Scholarship. Through the Center for Bookend Scholarship, we aim to foster knowledge and appreciation of the most underappreciated object in the history of the book. We will encourage scholarly and public interest in the bookend through exhibitions, public programs, and research opportunities.

Book storage methods as shown in Fasciculus Medicinae, published in 1495.

Book storage methods as shown in our 1509 edition of Fasciculus Medicinae. Click to enlarge.

Early libraries did not need bookends. People arranged books horizontally into the 16th century (and perhaps longer). Only once enough books existed to fill up a bookshelf—which only started to resemble the furniture of today in the 16th century—without falling over did libraries begin to store books vertically.1

It took even longer for people to shelve books spine-out. Many Medieval and Renaissance libraries chained books to lecterns and shelves; in order to attach the chain without causing damage, these libraries stored books fore-edge out. In the 16th century, books began to include authors and titles on their spines, though not universally, a sign that shelving practices included spine-out configurations. By the next century, nearly all books had bibliographic information on their spines.1

Bookends are a relatively new technology. The familiar L-shaped metal kind were first patented in the 1870s.1 It took some decades before the term became common parlance: the Oxford English Dictionary records 1907 as the first year the term “book end” appeared in print.2

The New York Academy of Medicine Library has long held an interest in the bookend. Since our founding in 1847, we have intentionally amassed thousands of bookends. Strengths of the collection include American and functional bookends, but we are beginning to add to our European and decorative holdings. Through the Center for Bookend Scholarship, we will now dedicate more time and attention to these objects as we move forward in building the world’s preeminent collection.

Below is a selection of bookends from our collection.

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1. Petroski, H. (2000). The book on the bookshelf. New York: Vintage Books.

2. book, n. (2014). OED Online. Oxford University Press. Retrieved from

New Acquisitions at the Library

By Jarlin Espinal, Technical Services Assistant

Below is a selection of some of our recently acquired secondary sources in the history of medicine, along with blurbs about each book. Make an appointment to come and use them!

Nine of the library's new acquisitions.

Nine of the library’s new acquisitions. Click to enlarge.

Making Women’s Medicine Masculine: The Rise of Male Authority in Pre-Modern GynaecologyMonica H. Green

“Green has painstakingly studied the content and circulation of medieval texts on women’s medicine…[and] disproves popular ideas of the Middle Ages as a Golden Age for women’s control over their own bodies.” – Medical History

The Sick Child in Early Modern England, 1580–1720 – Hannah Newton

The Sick Child in Early Modern England is a powerful exploration of the treatment, perception, and experience of illness in childhood from the late sixteenth to the early eighteenth century. At this time, the sickness or death of a child was a common occurrence—over a quarter of young people died before the age of fifteen—and yet this subject has received little scholarly attention.”

Vernacular Bodies: The Politics of Reproduction in Early Modern England – Mary E. Fissell

“Making babies was a mysterious process in early modern England. Mary Fissell employs a wealth of popular sources—ballads, jokes, witchcraft pamphlets, Prayer Books, popular medical manuals—to produce the first account of women’s productive bodies in early-modern cheap print.”

Headache: Through the Centuries – Mervyn J. Eadie

“Nobody is better suited to provide a history of headache than Mervyn Eadie, a distinguished neurologist, historian and established author. Here he provides a beautifully written, lucid account of headaches from the time of ancient Greece and Egypt to 2000 A.D.”– J. M. S. Pearce, MD, FRCP, Emeritus Consultant Neurologist, Hull Royal Infirmary, Yorkshire, England

The Perils of Peace: The Public Health Crisis in Occupied Germany – Jessica Reinisch

“In The Perils of Peace, Jessica Reinisch considers how the four occupiers—Britain, France, the Soviet Union, and the United States—attempted to keep their own troops and the ex-enemy population alive. While the war was still being fought, German public health was a secondary consideration for them: an unaffordable and undeserved luxury. But once fighting ceased and the occupation began, it rapidly turned into an urgent priority. Public health was then recognized as an indispensable component of creating order, keeping the population governable, and facilitating the reconstruction of German society.”

William Harvey: A Life in Circulation – Thomas Wright

“Thomas Wright’s book opens brilliantly and bloodily and continues in the same vein … a captivating, intellectually gripping journey into [England’s] scientific past.” – Druin Burch, Mail on Sunday

Medicine’s Michelangelo: The Life & Art of Frank H. Netter, MD – Francine Mary Netter

“This delightful book traces the extraordinary career of Frank Netter, who gave his gift of unparalleled medical knowledge to generations of medical student and their preceptors. This memoir, by his daughter Francine, helps us appreciate his lucid, lifelike art, from which we build our growing knowledge of the healing arts.” – Joseph B. Martin, PhD, MD, Edward R. and Anne G. Lefler Professor of Neurobiology, Harvard Medical School

Virus Hunt: The Search for the Origin of HIV – Dorothy H. Crawford

“This is not a book about AIDS as a disease. Rather, Dorothy H. Crawford gives us a scientific detective story. She tells how, over the past 20 years or so, scientists tracked down the origin of HIV, the virus that causes AIDS.”

Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination – Alondra Nelson

“In Body and Soul, Alondra Nelson combines careful research, deep political insight, and passionate commitment to tell the little-known story of the Black Panther Party’s health activism in the late 1960s. In doing so, and in showing how the problems of poverty, discrimination, and access to medical care remain hauntingly similar more than forty years later, Nelson reminds us that the struggle continues, particularly for African Americans, and that social policies have profound moral implications.” Rebecca Skloot, author of The Immortal Life of Henrietta Lacks

Biblioclasts & Bibliosnitches Beware

By Arlene Shaner, Acting Curator and Reference Librarian for Historical Collections

Dr. Henry Pelouze de Forest's bookplate

Dr. Henry Pelouze de Forest’s bookplate

Book owners, even generous ones, worry about what might happen to their books if they loan them to others who might not treat them with the same degree of care. Dr. Henry Pelouze de Forest, a lover of books and of bookplates, had this “Caudal Bookplate,” meant to be inserted at the end of a book, made as a warning to unscrupulous borrowers in 1933. De Forest (1864-1948) graduated from Cornell in 1884 and from Columbia’s College of Physicians and Surgeons in 1890. He was associate professor of obstetrics at the Post-Graduate Hospital and Medical School from 1903 to 1921, but is probably best remembered today for his interest in personal identification. While working as a surgeon for the New York City Police Department (1902-1912), he established what is said to be the first fingerprint file in the United States and invented a dactyloscope for fingerprint examination.

Dr. Henry Pelouze de Forest

Dr. Henry Pelouze de Forest *

De Forest had several bookplates made for his own books and he sent examples of them to Frank Place, who was a librarian here at NYAM. Place collected bookplates and we have three small loose-leaf notebooks full of those he received both as gifts and by sending copies of ours in trade. This bookplate and its accompanying letter were found in the first of those small volumes. We’ll never know how many of de Forest’s friends took advantage of his offer to print up extra batches of his poetic plea that borrowers mind their manners.

Letter from Henry Pelouze de Forest to NYAM librarian Frank Place.

Letter from Henry Pelouze de Forest to NYAM librarian Frank Place. Click to enlarge.

* From the Columbia Alumni News 22:18 (Feb. 13, 1931), p. 10.