The Dancing Plague of 1518

John Waller. The Dancing Plague: The Strange, True Story of an Extraordinary Illness. Sourcebooks, 2009 (paperback). Previously published as A Time to Dance, A Time to Die: The Extraordinary Story of the Dancing Plague of 1518 (Icon books, hardback, 2008).

Topic: Dancing Mania, choreomania

Time and Place: Strasbourg, Holy Roman Empire, 1518

Audience: General

Discussion:

This was a good book to wrap up 2011 with – from the Arab Spring, to summer revolutions and the fall’s occupy movement – conditions are approaching those of 1518. Among the peasants of Strasbourg, life in the early 16th century had become miserable. The church and monasteries left the peasants spiritually desolate and literally starving while their tithes of grain were sold at prices they couldn’t afford. Poor harvests and high inflation made famine a real possibility. There were several peasant revolts leading up to 1518 that were brutally put down with public executions and massacres. Ancient ties between the nobility, church and common people had broken down such that secular and ecclesiastic office holders no longer seemed to care for the welfare of the common people.

In July 1518 Frau Toffea was outdoors in the street of Strasbourg when she began to dance. There was no music or joy in her dancing. The spectacle soon became horrifying as it became apparent that she could not stop. Eventually she collapsed from the heat and exhaustion. When she woke up, she began to dance again in the same frenzy. Soon other people in Strasbourg began their trance-like dancing ignoring the heat and the need for food and water. When they were able to speak, they begged bystanders to make them stop. Before long in the July heat, people began dropping not to get up again – did they dance to an exhausted death or was there a pathological cause?

The people of Strasbourg didn’t see this as a psychological disorder but either physical or spiritual. At first they turned to the newly respected, university trained physicians who strangely proscribed more dancing as a cure. They assigned people to make sure the afflicted kept dancing even when they were capable of stopping. It became very apparent that this was not helping the death rate. Before long physicians and townspeople agreed that this was a spiritual ailment that required a pilgrimage to the local shrine of St Vitas. Fascinatingly the people believed that a saint patronized by epileptics could/would also curse people to uncontrolled movements like the dancing if they were displeased. Throughout this region of Germany and the Netherlands there are shrines to Vitas and other saints to prevent epilepsy and the dancing plague. Late medieval people greatly feared epilepsy and similar disorders because it could be perceived as demonic possession or a curse (by victim as well as bystander). Waller argues that this was something like a case of spiritual post traumatic stress disorder. His argument is too complicated for me to explain here but it is a worthwhile and thought provoking discussion.

Narrative: B+ The narrative was well written and kept me eager to continue reading. This is no small feat without a central cast of characters to follow through the book. He tries to use Frau Troffea as a continuing theme but just doesn’t have enough information to really flesh out her life.  There were places that I wished for more scientific context. I wish he had not saved so much of the science for the last chapter.

Historical Content: A- This is not a time period that I am very familiar so it is hard to assess how well he covered the historical questions. While he discussed actions of the church, he apparently didn’t have sources from within the church. This seems strange as the church usually has better resources than secular courts. The discussion of the religious context was good and mostly from the lay viewpoint.

Scientific Content: B-/C+ He seems to be reaching too far in some of the psychological parallels he tries to draw to the choreomania (dancing plague). Practices that intentionally create trances or mystical dancing are not good matches to the unintentional and unwanted dancing in 1518. The contagious nature of the dancing of 1518 is based at least partially upon the fear of the mania. Waller describes all mystical experiences in terms of pathology, which seems unwarranted. His brief discussion of an outbreak of uncontrollable laughing in Tanzania in 1963 left me wanting to know more (p. 216). A recent Ugandan outbreak of “nodding syndrome” where youths display uncontrollable nodding when they try to eat has been associated with a parasite that causes river blindness. In all three outbreaks, these may be related to epileptic-like behavior. My point here is that we can’t jump to the conclusion that initial cases are all psychological, even if some of the contagious nature does seem psychological (people being effected by watching etc).

I also have to take issue with a reviewers quote the publisher put on the back of the book. A quote from New Scientist stated “It’s a book to make you grateful for the historical increase in human sanity.” Part of the author’s argument is that manifestations of stress and PTSD are culturally dependent and that we express stress differently today. When we consider how many people today take medication for anxiety/stress, depression, PTSD or other psychological conditions it is questionable if there has been a “historical increase in human sanity” – not that manifestations of stress are necessarily measures of sanity anyway.

References and Usability: B The bibliography and notes are integrated together. This makes the bibliography much more difficult to use. The notes are consecutively numbered for the entire book and were a little sparse.  There are 238 notes for 231 pages of text. There were plenty of places I would have liked to have seen that he had a reference for a fact.

Illustrations:  B The maps and illustrations included were okay. It could have used a map of the local Strasbourg area that included the shrine of St Vitas.

Overall, I did enjoy the book and it is a very interesting episode in medical history. Community reaction to the outbreak is as interesting and influential as the disorder itself.  The power of the brain is almost always underestimated. Even if it wasn’t completely psychological, it manifested in ways that were surely under the control of the brain.

A tangent:  one of my favorite quotes from Waller’s book is not on the dancing mania at all. “Syphilis was the flagellum Dei, God’s whip, a stark warning about the sinfulness of adultery and fornication.” If it was the flagellum Dei before the invention of the microscope, imagine how they would have reacted to seeing a spirochete!

A Book Review Rubric

I hope to do more book reviews in the near future. I’m planning on posting these reviews naturally to share my ideas  but also as a record of my notes. One of the best pieces of advice I’ve received in the last year or so is that to become a better writer, especially long form writing, you have to read a lot of other people’s work; study what works and doesn’t work.

I’ve never been a big fan of rubrics but it could be useful here. Using a rubric will force me to consider all of these aspects of the book. I’m not particularly interested in coming up with a final grade. For some books, it may be OK to get a poor grade on one aspect. For example, the degree of referencing will depend on the target audience and the niche the book is looking to fill in the market as much as the author’s preference. Likewise, some books don’t attempt much of a narrative.

This is for non-fiction monographs only! I expect that it will be primarily for history of science/medicine and perhaps some science.

Book Review Format

Book Citation:

Topic:

Time and Place:

Audience:

Discussion:

Narrative grade

A = Hooked me from the beginning. Constructed a compelling narrative with good informative structure. Context and background does not break the flow. There is a logical flow from chapter to chapter.

B = Sections of good narrative and a logical flow between topics; context and background may not be well-integrated into the narrative.

C = Narrative doesn’t pull you through the book. Context or background chapters disrupt the narrative flow. Context and background information may be missing.

D = No attempt at narrative, reads like an interesting textbook or spliced together blog.

F = Reads like a boring textbook more concerned with packing in facts than story or argument.

Historical Content grade

A =  Addresses the primary historical questions on the topic or event without unnecessary tangents. Clear thesis statement or discussion supported by sections of the book.  Uses primary sources, artifacts, or data to support their topic/argument; primary sources are translated. Makes appropriate and relevant comparisons to modern life.

B = Addresses the primary historical questions with some unnecessary tangents. Thesis statement or discussion that is not as well supported as it could be. Uses primary sources, artifacts or data; primary sources are translated. Makes inappropriate comparisons to modern life.

C = Gaps in the topic coverage with little use of primary sources. Tangents  distract from the main topic or argument and tax the patience of the reader.  A few inaccurate facts or improbable interpretations. Makes inappropriate comparisons to modern life.

D = Thesis discussion is vague and unsupported by the text.  Large gaps in coverage and/or many inaccurate facts. Uses primarily secondary sources. Tangents seriously distract the reader from the main topic of the book indicating poor structure.

F = No thesis statement or main argument. Structure is poorly planned and executed. Uses only non-academic secondary sources with inaccurate interpretations of facts. Cherry picking sources to only support their argument.

Scientific Content grade

A = Correct, up-to-date scientific information with logical interpretations presented at the appropriate reading level for the audience.  If an argument is being made, science is correctly used to support the argument without bias.

B = Correct modern scientific information and conventional interpretations. Most of the information is presented at the right reading level.

C = A few incorrect scientific statements or improbable interpretations. Much of the information is not at the target reading level. Unnecessary scientific facts inserted into a historical narrative.

D = Some incorrect scientific statements and interpretations.  Incorrect scientific interpretations used to support a historical argument. Inconsistent reading level.

F = Incorrect scientific statements and interpretations used to support biased positions. Pseudoscience, uses some poor ‘science’ studies to support their position.

References and Usability grade

A = Full references with footnotes/endnotes and a complete bibliography. Appropriate historic or scientific sources. The footnotes/endnotes and bibliography are easily usable. Maps and figures are located within the text where they are most useful. Fully indexed.

B= Bibliography with only a few footnotes/endnotes on the most important facts. Footnotes/endnotes are available but not easily usable. Appropriate historic or scientific sources. Figures and maps are located all together (front or separate section) rather than within text. Could have used more maps or figures. Selectively indexed.

C = Selected bibliography or suggested reading list. No footnotes/endnotes and little or no index. Not enough maps or figures.

D = Slim or incomplete selected bibliography or suggested reading list. Little or no index.

F = No references or reading list, little or no index.

(Ironically I can see that books with poor referencing could have good maps and figures based on different audiences or targeted niches)

Illustrations

A = Plenty of maps and figures to aid the reader. Maps, figures and photos are well labeled with clear legends and referenced. Color illustrations if color aids understanding. Tables are professionally produced and easily read, complicated data is presented in tables.

B = Enough maps and figures for the reader follow the text. Maps, figures and photos are labeled and referenced. No color illustrations. Tables may be overly complicated and figures have difficult legends. Complicated data is not incorporated into table.

C = Not enough maps or figures for the reader to easily follow the argument of the book. Maps and figures are minimally labeled and with poor references. Tables not used to present data.

D = Lacks enough maps and figures to understand the text. Maps and figures have insufficient labels and legends to understand the illustration. No references on the illustrations.

F = Lacks (enough) maps and figures. Labels or legends are confusing or incorrect.

This rubric is obviously evolving. I could use some suggestions and criticisms. Do you seen any inconsistencies? Something that is missing? I’d love some feedback from authors and avid readers!

(Edited Dec 26, 2011)

Holly Tucker’s Blood Work

Holly Tucker, Blood Work: A Tale of Murder and Medicine in the ‘Scientific Revolution’. Norton, 2011.

I picked up this book at just the right time. I read it a few weeks ago just before I started teaching my summer anatomy course. Its always a good to be reminded of all of the work and drama that went into what seems like dull facts and standard procedures today. In this case there really was a lot of blood, sweat and tears by the medical establishments of two countries intensely throughout the 1660s before the work was banned for over a century. Holly Tucker’s Blood Work is centered on the century when the quest to understand blood went from counter-productive procedures based on medieval philosophy to the beginning of scientific understanding and experimentally based medicine.

Pride and glory drove the main protagonists of the story. For Jean-Baptiste Denis, the physician at the center of Blood Work,  the need to overcome his humble origins by proving his worth and more to the gentlemen physicians of France was a driving force. His benefactor Henri-Louis Habert de Montmor wanted to be the patron of the most brilliant, the most significant scientists of France, to be the Lorenzo de’ Medici to a scientific Michaelangelo. Add in an Anglo-French medical society rivalry and some pirates for good measure, and you have a page-turner of a history. I have to admit chuckling every few pages. Some of their experiments were like watching a train-wreck in slow motion. Holly Tucker is no doubt right that they were saved from causing much more damage by their inefficiency at transfusion.

I won’t give away any of the main plot or the murder, but there were some memorable sidelines. This description of ‘heroic medicine’ will stay with me for a while.

Claude arranged for a barber-surgeon to administer numerous bleedings to his brothers arms and legs. When bleeding seemed no longer to have any effect, they tried to place leeches behind Jean’s ears, but blistering there from other treatments with warming salves kept the leeches from doing their work. Bouillons, enemas, and purgings accompanied each bleeding in a desperate attempt to save Jean’s life. And to these were added chest rubs with concoctions of ground pearls mixed with extracts of hyacinth bulbs to warm Jean’s blood, as well as placement of gutted pigeons on his scalp to create heat to stave off the shivering. Despite Claude’s heroic attempts to save his brother (or perhaps because of them), Jean died a few weeks later. (p. 105-6)

Claude Perrault was one of the best trained physicians in France, and  a founding member of King Louis XIV’s Academy of Science. He held a prominent position in the Paris Faculty of Medicine and he used all learning to try to save his brother Jean. The idea of keeping your brother warm with a gutted pigeon on his head is priceless.

If you think that today’s publish or perish environment is tough, you should read what it did to Henry Oldenburg, who nearly single-handed published the Philosophical Transactions for the Royal Society of London. He volunteered his own time and talent, published at his own considerable expense for printing and postage, was accused to treason for gathering scientific news from France, and landed in the Tower of London for his troubles (where he had to pay rent for his prison cell). He then got out and worked even harder for the Royal Society (still for free) to reestablish his reputation. His treatment is enough to keep freelance science writers, bloggers, and researchers up nights.

I do have to say that I’m not bothered by the fact that the transfusion experiments were stopped. While Holly Tucker is no doubt right that other equally dangerous experiments and treatments were being done at the same time, the paradigm shift from blood letting to blood transfusion was too great, too fast. They didn’t understand even the basics of what they were transfusing and they were doing it for the wrong scientific and philosophical reasons. Simply stopping the blood letting would have improved survival significantly!

As memorable as the information and stories in Blood Work will be, perhaps more importantly it has made me think about the importance of narrative in books on history. So many of the history books I read are organized and written like textbooks, academic in their boredom as much as their content. I read them for their information rather than for entertainment. Its nice to have both!