ASLEEP

The engaging story of the outbreak of a bizarre disease.

In 1917, a young neurologist named Dr. Constantin von Economo was faced with a sudden influx of unusual patients at a clinic in Vienna, Austria. They exhibited a bizarre array of symptoms, including uncontrollable blinking, twitching, salivating or other tics—or even psychotic behavior. Others were locked in a catatonic state. All the patients had one symptom in common—difficulty staying awake. Indeed, some patients fell deeply asleep and never woke up. Autopsies showed that patients had swelling in the section of the brain that controls sleep. Von Economo identified the disease, which became known as encephalitis lethargica—sleeping sickness—but neither he nor anyone else could pinpoint what was causing it. It became a worldwide epidemic during the next few years, affecting millions—but after 1927, the epidemic tapered off, and new cases became rare. Crosby (The American Plague: The Untold Story of Yellow Fever, the Epidemic that Shaped Our History, 2006) relates the history of encephalitis lethargica by using several case studies. They range from a New York girl who had violent seizures and then fell into a sleep from which she never awoke, to a woman whose disease drove her to grotesque self-harm—including tearing out her own eyes. Some of the catatonic victims of the disease became the subject of Oliver Sacks’s book Awakenings (1973) which was later made into a film. Crosby is a fine storyteller, peppering her case studies with facts about the history of neurology and details about 1910s New York. She also provides fully realized portraits of not only her case studies’ patients, but also the brilliant doctors who treated them, such as Frederick Tilney, a neurologist who later gained fame for his study of Helen Keller, and Josephine B. Neal, a rare female bacteriologist, neurologist and encephalitis expert in a male-dominated profession. Crosby also provides the latest theories of the causes of this strange disease, the origins of which are still elusive.

A capable, readable account of a medical mystery.