The Epidemics of the Middle Ages

by J. F. C. Hecker; John Caius

In the above examples, nervous disorders bearing a strong resemblance to those of the middle ages, are shown to exist in an epidemic form, both in Europe and America, at the present time; but in these instances some general cause of mental excitement—and none is more powerful than religious enthusiasm—seems to have been requisite for their propagation. Their appearance, however, in single cases, is occasionally independent of any such origin, which leads to a belief, not without support in the experiments of modern physiologists, that they occasionally proceed from physical causes, and that it is therefore not necessary to consider them in all cases as the offspring of a disordered imagination.

A well marked case of a disease approximating to the original Dancing Mania, is related by Mr. Kinder Wood, in the 7th volume of the Medico-Chirurgical Transactions, p. 237. The patient, a young married woman, is described to have suffered from headache and sickness, together with involuntary motions of the eyelids, and most extraordinary contortions of the trunk and extremities, for several days, when the more remarkable symptoms began to manifest themselves, which are thus recorded:—

“February 26. Slight motions of the limbs came on in bed. She arose at nine o’clock, after which they increased, and became unusually severe. She was hurled from side to side of the couch-chair upon which she sat, for a considerable time, without intermission; was sometimes instantaneously and forcibly thrown upon her feet, when she jumped and stamped violently. She had headache; the eyelids were frequently affected, and she had often a sudden propensity to spring or leap upwards. The affection ceased about eleven o’clock in the forenoon, the patient being very much fatigued; but it returned about noon, and a third time in the afternoon, when she was impelled into every corner of the room, and began to strike the furniture and doors violently with the hand, as she passed near them, the sound of which afforded her great satisfaction. The fourth attack was at night; was very violent, and ended with sickness and vomiting. She went to bed at half-past eleven. Her nights were invariably good. The last three attacks were more violent than the former ones, but they continued only half an hour each.

“February 27. The attack commenced in bed, and was violent, but of short duration. When she arose about ten, she had a second attack, continuing an hour, except an interval of five minutes. She now struck the furniture more violently and more repeatedly. Kneeling on one knee, with the hands upon the back, she often sprang up suddenly and struck the top of the room with the palm of the hand. To do this, she rose fifteen inches from the floor, so that the family were under the necessity of drawing all the nails and hooks from the ceiling. She frequently danced upon one leg, holding the other with the hand, and occasionally changing the legs. In the evening, the family observed the blows upon the furniture to be more continuous, and to assume the regular time and measure of a musical air. As a strain or series of strokes was concluded, she ended with a more violent stroke or a more violent spring or jump. Several of her friends also at this time noticed the regular measure of the strokes, and the greater regularity the disease was assuming; the motions being evidently affected, or in some measure modified by the strokes upon the surrounding bodies. She chiefly struck a small slender door, the top of a chest of drawers, the clock, a table, or a wooden screen placed near the door. The affection ceased about nine o’clock, when the patient went to bed.

“February 28. She arose very well at eight. At half-past nine the motions recommenced; they were now of a more pleasant nature; the involuntary actions, instead of possessing their former irregularity and violence, being changed into a measured step over the room, connected with an air, or series of strokes, and she beat upon the adjacent bodies as she passed them. In the commencement of the attack, the lips moved as if words were articulated, but no sound could be distinguished at this period. It was curious indeed to observe the patient at this time, moving around the room with all the vivacity of the country dance, or the graver step of the minuet, the arms frequently carried, not merely with ease, but with elegance. Occasionally all the steps were so directed as to place the foot constantly where the stone flags joined to form the floor, particularly when she looked downwards. When she looked upwards, there was an irresistible impulse to spring up to touch little spots or holes in the top of the ceiling; when she looked around, she had a similar propensity to dart the forefinger into little holes in the furniture, &c. One hole in the wooden screen received the point of the forefinger many hundred times, which was suddenly and involuntarily darted into it with an amazing rapidity and precision. There was one particular part of the wall to which she frequently danced, and there placing herself with the back to it, stood two or three minutes. This by the family was called ‘the measuring place.’

“In the afternoon the motions returned, and proceeded much as in the morning. At this time a person present, surprised at the manner in which she beat upon the doors, &c., and thinking he recognised the air, without further ceremony began to sing the tune; the moment this struck her ears, she turned suddenly to the man, and dancing directly up to him, continued doing so till he was out of breath. The man now ceased a short time, when commencing again, he continued till the attack stopped. The night before this, her father had mentioned his wish to procure a drum, associating this dance of his daughter with some ideas of music. The avidity with which she danced to the tune when sung as above stated, confirmed this wish, and accordingly a drum and fife were procured in the evening. After two hours of rest, the motions again reappeared, when the drum and fife began to play the air to which she had danced before, viz. the ‘Protestant Boys,’ a favourite popular air in this neighbourhood. In whatever part of the room she happened to be, she immediately turned and danced up to the drum, and as close as possible to it, and there she danced till she missed the step, when the involuntary motions instantly ceased. The first time she missed the step in five minutes; but again rose, and danced to the drum two minutes and a half by her father’s watch, when, missing the step, the motions instantly ceased. She rose a third time, and missing the step in half a minute, the motions immediately ceased. After this, the drum and fife commenced as the involuntary actions were coming on, and before she rose from her seat; and four times they completely checked the progress of the attack, so that she did not rise upon the floor to dance. At this period the affection ceased for the evening.

“March 1. She arose very well at half-past seven. Upon my visit this morning, the circumstances of the preceding afternoon being stated, it appeared clear to me, that the attacks had been shortened. Slow as I had seen the effects of medicine in the comparatively trifling disease of young females, I was very willing that the family should pursue the experiment, whilst the medical means were continued.

“As I wished to see the effect of the instrument over the disease, I was sent for at noon, when I found her dancing to the drum, which she continued to do for half an hour without missing the step, owing to the slowness of the movement. As I sat counting the pulse, which I found to be 120, in the short intervals of an attack, I noticed motions of the lips, previous to the commencement of the dance, and placing my ear near the mouth I distinguished a tune. After the attack of which this was the beginning, she informed me, in answer to my inquiry, that there always was a tune dwelling upon her mind, which at times becoming more pressing, irresistibly impelled her to commence the involuntary motions. The motions ceased at four o’clock.

“At half-past seven the motions commenced again, when I was sent for. There were two drummers present, and an unbraced drum was beaten till the other was braced. She danced regularly to the unbraced drum, but the moment the other commenced she instantly ceased. As missing the time stopped the affections, I wished the measure to be changed during the dance, which stopped the attack. It also ceased upon increasing the rapidity of the beat, till she could no longer keep time; and it was truly surprising to see the rapidity and violence of the muscular exertion, in order to keep time with the increasing movement of the instrument. Five times I saw her sit down the same evening, at the instant that she was unable to keep the measure; and in consequence of this I desired the drummers to beat one continued roll, instead of a regular movement. She arose and danced five minutes, when both drums beat a continued roll: the motions instantly stopped, and the patient sat down. In a few minutes the motions commencing again, she was suffered to dance five minutes, when the drums again began to roll, the effect of which was instantaneous; the motions ceased, and the patient sat down. In a few minutes the same was repeated with the same effect. It appeared certain that the attacks could now be stopped in an instant, and I was desirous of arresting them entirely, and breaking the chain of irregular associations which constituted the disease. As the motions at this period always commenced in the fingers, and propagated themselves along the upper extremities to the trunk, I desired the drummers, when the patient arose to dance, to watch the commencement of the attack, and roll the drums before she arose from the chair. Six times successively the patient was hindered from rising, by attending to the commencement of the affection; and before leaving the house, I desired the family to attend to the commencement of the attacks, and use the drum early.

“March 2. She arose at seven o’clock, and the motions commenced at ten; she danced twice before the drummer was prepared, after which she attempted to dance again four several times; but one roll of a well-braced drum hindered the patient from leaving her seat, after which the attacks did not recur. She was left weakly and fatigued by the disease, but with a good appetite. In the evening of this day an eruption appeared, particularly about the elbows, in diffused patches of a bright red colour, which went off on the third day.”