A LESSON FROM HISTORY...

As epidemiologists warn that the world is overdue for another deadly flu pandemic similar to the one that killed millions in 1918, physicians Sarah Cheyette and Jeffrey Cummings note that a previous world-wide epidemic taught us much about the biological roots of many "mental" ailments.

Between 1917 and 1926, five million children and adults came down with a mysterious disorder dubbed "encephalitis lethargica" (possibly, but not definitely, stemming from the 1918 flu pandemic). Of the adults who contracted the disorder, many died, many recovered completely, and still others developed long-term symptoms resembling Parkinson's disease. But Cheyette and Cummings note that thousands of children who contracted encephalitis lethargica-children who had, in general, exhibited no psychiatric problems before their illness-exhibited far different sequelae:

"They became disobedient and quarrelsome, often leading to expulsion from school. Emotional lability, irritability, and temper tantrums were common. Many children committed destructive and harmful acts on people or animals; self-destructive behavior was also common. Kleptomania, pyromania, coprolalia [swearing], sexual precocity, exhibitionism, sexual aggression, and paraphilias [fetishism, sadism, voyeurism, etc.] were manifestations of the behavioral disorder. Many children felt compelled to perform these acts even though they recognized them as `bad' behavior.. The children were hyperactive and impulsive, and they appeared to lack empathy; they were often called `moral imbeciles'."

Cheyette and Cummings note that "Encephalitis lethargica temporarily opened a window to allow investigation of the extensive repertoire of behavioral disorders associated with subcortical brain dysfunction."

"Encephalitis lethargica: lessons for contemporary neuropsychiatry," Sarah R. Cheyette and Jeffrey L. Cummings, Journal of Neuropsychiatry and Clinical Neurosciences, Vol. 7, No. 2, Spring 1995, pp. 125-134.