Asleep: The Forgotten Epidemic That Remains One of Medicine's Greatest Mysteries (32 page)

For accounts of the stock market crash, I relied on three main sources: John K. Galbraith’s
The Great Crash
1929 (1997); “The Crash of 1929,”
The American Experience;
and Maury Klein’s
Rainbow’s End
(2003).

Wall Street’s $30 billion loss was mentioned in Burns and Sanders’s book, page 376. And Galbraith’s book, pages 128-29, reported that, contrary to popular belief, there was
not
a run on the banks. The first suicide from the top of the Statue of Liberty was reported by the
New York Times
(May 14, 1929), several months prior to the crash.

Information about the drought came from “Surviving the Dust Bowl,”
The American Experience.

New York was
arguably
the city hardest hit by the Depression. It may have been a close second to Detroit. The auto industry, like banking, suffered huge losses and declining sales.

The quote from Bernard Sachs appeared in August Wimmer’s
Further Studies upon Chronic Epidemic Encephalitis
(1929).

Early history about the Neurological Institute was taken from archives at Columbia’s Augustus C. Long Health Sciences Library and Pool’s book, which is held in that collection as well as at the NYAM. Additional details about the new building and Tilney’s vision came from an article entitled “Unique Three-fold Study of Mental Ills Begins,”
New York Times
(September 15, 1929). Tilney’s quotes came from that article as well.

CASE HISTORY SIX

Chapter 18: The Matheson Commission

All biographical information about William J. Matheson came from
www.keyhistory.org/matheson
and his obituary in the
New York Times
(May 16, 1930). Like Jessie Morgan, since Matheson was a public figure whose case of encephalitis lethargica was covered in newspapers, his name was not changed for this book. In using his personal medical files, held in the Charles Loomis Dana Papers (volume 4, case #62) in the Rare Book Room of the New York Academy of Medicine, I used discretion, relying on pertinent medical information and excluding some of the personal family details that physicians of the time period typically included in case studies. Matheson was under Dana’s care from 1921 to 1923.

Kroker’s article on encephalitis lethargica and American neurology also included material from Dana’s medical file and the development of the Matheson Commission. Dana’s quote about encephalitis lethargica being exceedingly rare came from Kroker’s article.

Chapter 19: Josephine B. Neal

Though discrimination against women in early medical schooling is widely covered, I relied on two sources: Regina Morantz-Sanchez’s
Sympathy and Science
(1985) and John Duffy’s
From Humors
to
Medical Science
(1993).

Sullivan’s book
Our Times
(1937) describes the transition from farming to city homes and its effect on women, including the details about washing day, ironing day, cleaning day, etc., pages 424—28.

The French social psychologist who compared an intelligent woman to a monstrosity, specifically a two-headed gorilla, was Gustave Le Bon, and he was a student of Paul Broca, the famed craniologist. His statements were taken from Stephen Jay Gould’s well-known and popular book
The Mismeasure of Man
(1981). Gould, an anatomist and anthropologist, criticized early brain study as rooted in racism and sexism.

The American writer who said that a woman’s name should appear in print but twice was Arthur Wallace Calhoun in his book
A Social History of the American FamilyfromColonial Times to the Present
(1918), page 326. Unfortunately, he is sometimes accused of making the remark, when in reality, he was quoting a southern gentleman. Calhoun’s book highlighted the lack of progress in women’s education and social standing.

Morantz-Sanchez wrote about the number of women in law, Ph.D., and medical programs, page 314. Morantz-Sanchez was also the historian who remarked upon Vassar, Bryn Mawr, and Smith sending women to Johns Hopkins for over two decades, page 250. Duffy, too, on pages 294—95, described the statistics: in 1915, 2.6 percent of medical students were women; in 1927, that number had climbed only to 5.4 percent and then dropped again. In fact, according to Duffy, page 288, Harvard Medical School did not admit a female student until 1945.

Duffy, pages 294—95, refers to the unofficial quota systems that prevented minorities from entering medical schools in large numbers, but Duffy also suggests that the attitudes professors held about women students played an even larger part in discrimination.

Marie Curie’s two Nobel Prize wins can be found on “Multiple Nobel Laureates,”
www.nobelprize.org
.

The two issues women lobbied for in public health were the United States Children’s Bureau, established in 1912, and the Sheppard-Towner Maternity and Infancy Protection Act of 1921 (Morantz-Sanchez, page 296). In fact, one of the pioneers of public health, a nurse named Lillian Wald, had started the movement for home health care as early as 1893—actually going into the tenements and slums to care for ill people and help teach them about child care and sanitation.

The high number of deaths during delivery and births in a hospital vs. a midwife came from Morantz-Sanchez, page 298, as well as Duffy, pages 286—87. Public health as “the woman’s branch” was taken from Morantz-Sanchez’s book, page 301.

The definitions of meningitis and encephalitis came from a medical dictionary.

Jonas Salk announced his vaccine on April 12, 1955. However, Neal’s work with a polio vaccine at the bacteriology lab of New York’s health department was reported in the
New York Times
(July 7, 1934). Discussion of testing the polio vaccine can also be found in Lawrence Altman’s
Who Goes First?
(1987), pages 126—28.

Descriptions of New York streets came from historic photos, including one that depicts piles of refuse on street corners.

Details about the New York Academy of Medicine came from personal observations during many visits there.

The quote about encephalitis lethargica as one of the “most imperative problems the science of medicine has to solve,” appeared in
a New York
Times article, “Light on Encephalitis Gained by New Survey” (November 17, 1929).

Chapter 20: Vaccine Trials

The history of the CDC can be found on its website,
www.cdc.gov
. Originally called the Communicable Disease Center, the name was later changed to the Centers for Disease Control and Prevention. The center was founded in 1946 as an organization primarily for entomologists and engineers studying mosquito-borne diseases. Some of the more famous investigations include Legionnaires’ disease (1976), Marburg virus (1967), Ebola (1976), and HIV (1983-84).

Information about the Matheson Commission and its vaccine work came almost entirely from the Matheson Files held at the Augustus C. Long Health Sciences Library at Columbia University and the three reports published by the Matheson Commission:
Epidemic Encephalitis: Etiology, Epidemiology, Treatment
(1929, 1932, 1939). All three reports are available at the New York Academy of Medicine and Columbia’s Health Sciences Library. Neal also published a book entitled
Encephalitis
(Grune and Stratton, 1942) that provided a number of statistics about the 1920s epidemic of encephalitis, particularly in New York.

I also consulted E. D. Louis’s article “Vaccines to Treat Encephalitis Lethargica: Human Experiments at the Neurological Institute of New York, 1929-1940,” in
Archives of Neurology
59, no. 9 (September 2002).

Information about Rosenow’s work came from Kroker’s article in the
Bulletin of the History of Medicine,
as well as an article published by Neal, “The Present Status of the Etiology of Epidemic Encephalitis,”
Journal of the American Medical Association
91 (1928). Kroker’s article went on to explain the fact that Neal’s position as a woman made her somewhat of an outsider.

Material about William Park’s lab and bacteriologist Anna Williams came from Morantz-Sanchez’s book, page 160. Additional biographical information about Williams was taken from Rosner’s book,
Hives of Sickness,
page 171. In fact, Williams was the bacteriologist who isolated the diphtheria bacillus—the research surrounding diphtheria and its antitoxin helped put the bacteriology labs of the New York health department on the map of great medical research centers.

The quote about Park’s “harem” came from Rosner’s book, page 171, and originally appeared in Anna Williams’s autobiography.

Details about Matheson’s heart attack aboard his yacht came from his
New York Times
obituary.

Constantin von Economo’s three Nobel Prize nominations can be found on
www.nobelprize.org
.

Early information about neurosurgery came from Lawrence Pool’s book about the Neurological Institute. Pool, who was among the first generation of neurosurgeons, told the colorful stories about early surgery at Bellevue, the patient who smoked a cigarette during surgery, and the “initiation” nurses had for new surgeons.

Chapter 21: Sylvia

Though her name has been changed to protect her privacy, I found “Sylvia’s” case history in the Melvin D. Yahr Personal Papers and Manuscripts at Columbia’s Augustus C. Long Health Sciences Library. Yahr turned over a number of the Matheson Commission case files.

The letter dated September 24, 1942, came directly from her file. In fact, one of the reasons I chose her case study was because of the ongoing correspondence between Sylvia and her doctors.

Estimates about the number of women who served in the military during WWI—as many as forty-nine thousand served in uniform—came from Brian P. Mitchell’s
Women in the Military
(1998), page 3. And descriptions of the conditions came from the firsthand accounts in various World War I histories like Horne’s book
The Price of Glory.

Rarely is there a consensus when it comes to diagnosing—retroactively—an illness of the past, especially when it involves someone as important as a U.S. president. Not surprisingly, Woodrow Wilson’s illness at the close of the war has been debated among historians. Edwin Weinstein’s
Woodrow Wilson
(1981), pages 336-40, suggested that a series of strokes earlier in Wilson’s life, as well as a bout with influenza, followed by an encephalitis virus (as many physicians considered encephalitis lethargica to be) led to neurological complications and an altered disposition during the Paris peace negotiations. Alexander George’s
Presidential Personality and Performance
(1998), pages 69-80, on the other hand, disputed those findings, finding little evidence of previous strokes and believing instead that Wilson was behaving as he always did—stubbornly. John M. Barry, in his book
The Great Influenza
(2004), expanding upon the theory of Alfred Crosby, believed Wilson acted as anyone might while suffering from a terrible case of the flu. The quotes I used about aides reporting the “queer changes” in Wilson’s personality after the sickness came from Barry’s book, pages 385—88. What is certain is that Wilson suffered a severe case of the flu, and whatever the cause of his mindset, his policies changed. As Barry wrote, “Historians with virtual unanimity agree that the harshness toward Germany of the Paris peace treaty helped create the economic hardship, nationalistic reaction, and political chaos that fostered the rise of Adolf Hitler.”

Details about the film footage Tilney took of patients came from Lisa Cartwright’s book
Screening the Body.
Tilney referred to it as “bradykinetic,” or a “slow movement analysis.”

Information about encephalitis lethargica as a possible inspiration for the zombie films of the 1920s and ’30s came from Gary Don Rhodes’s
White Zombie: Anatomy of a Horror Film
(1997). On page 44 of his book, Rhodes mentions encephalitis lethargica, as well as catatonia, as inspirations for zombie films. Many films from that era, like
The Cabinet of Dr. Caligari,
also described sleeping sicknesses and sleepwalking.

The quote from one of Neal’s patients who said, “I am become mentally subnormal,” was published in Neal’s book
Encephalitis
(1942), page 344.

All details came from her file and the correspondence between Sylvia and her doctors, as well as correspondence between the doctors and Sylvia’s family, including the final letter dated March 20, 1945.

Chapter 22: I Have Seen the Future

Information about Mayor Jimmy Walker in the 1930s came from Edward Robb Ellis’s book
The Epic of New York City
(2004), page 526. Further information about Walker was taken from Burns and Sanders’s book, pages 416—18. Details about La Guardia’s election came from Burns and Sanders’s book, pages 420—23; Silver’s book, pages 258-59; and Ellis’s book, pages 551-52. The quote about the condition of New York when La Guardia took office came from Ellis’s book, page 551.

Paul Starr’s
The Social Transformation of American Medicine
(1982), pages 270—71, pointed out that all the civic improvements in New York during this time ultimately hurt public health, which received much less funding.

Ellis’s book, page 553, also described the building of the Rockefeller Center and the fact that John D. Rockefeller, Jr., was able to employ thousands of people during the Depression.

White’s well-known quote about New York reaching the highest point in the sky at the lowest point of the Depression appears on page 30 in the reprint of his book.

Details about how Central Park changed in the 1930s came from Rosenzweig and Blackmar’s
The Park and the People,
pages 441—54, and Silver’s book, pages 59 and 244. Descriptions of “Hooverville” came from Silver’s book, page 258.