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eurologist Constantin von Economo does not
have a clue. He thoughtfully touches his
thick, black moustache, looking at the very
sick patient, who has come to his clinic in the
Austrian capital of Vienna in 1917. The man
is undoubtedly critically ill, but his symptoms are highly
unusual and nothing like the other signs of disease that von
Economo usually observes.
The sick man is lying motionless in a chair, his head lolling
to the side, and his eyes are tiny holes in a dull face, in which
the mouth is half open. From the corners of his mouth, drool
flows down the man’s chin, and when von Economo asks the
patient how he is, there is only silence.
Constantin von Economo has been a doctor for many
years, and he has seen a thing or two. Coming from the
battlegrounds of World War I, broken down and wounded
soldiers approach him every day to be treated for war
neuroses and a wide range of brain injuries caused by shells,
bullets, and infection. Von Economo usually never has
trouble establishing a diagnosis, but this time, he is in doubt:
The drowsy patient never fought in the war, and his disease
pattern has never been described in any of the medical text
books, which fill the book-cases of the neurologist’s office.
Von Economo introduces his patient to a long series of
Austrian doctors, but nobody is able to find out what he is
suffering from.
And what is worse: More patients with similar symptoms
soon approach von Economo, making him fear that an
epidemic is under way.SICK HAVE HICCOUGHS, HALLUCINATE, AND SWEAR
The sick are children, young people, adults and elderly
people, women and men alike. Some are able to explain
themselves, complaining of headaches, joint pain, double
vision, fever, and nausea. Others are hardly conscious, so
family members speak for them, as they passively allow the
doctor to examine them. Some have hiccoughs and toss
their heads from side to side, and many are in a state of
mental unbalance, hallucinating, shouting out terms of
abuse, or repeating the same sentences over and over again.However, almost all of them
suffer from overwhelming,
chronic fatigue. One moment
they are eating, but the next- still with food in their
mouths – they are rolling their eyes and entering a coma-like
sleep, which can last for months. Many fall asleep, as they
are standing or walking, and their family members are very
anxious – with good reason, it turns out. Very soon, von
Economo learns that about half of his patients who suffer
from the strange disease have died.
THE DISEASE DISAPPEARS FOR A WHILE
Lacking medical literature, Constantin von Economo decides
to document the sleepy sickness himself, and on 17 April
1917, he publishes a scientific article about the disease,
which he names encephalitis lethargica, meaningCONSTANTIN VON ECONOMO
the first article describing the alarming published
disease encephalitis lethargica
in 1917.SCHRIFT & THE NATIONAL LIBRARY OF MEDICINESHUTTERSTOCK, WIENER KLINISCHE WOCHEN-By ByStine Overbye Lise Tønner