Wellcome Film of the Month: Acute Encephalitis Lethargica (1925)

This is a short filmed case study of a female patient with encephalitis lethargica; an epidemic illness that appeared between 1915 and 1926 affecting the nervous system. We still understand little about its origin today. One theory suggests that it is an auto-immune illness connected to the Spanish Flu influenza pandemic. Recently, the writer Laurie Winn Carlson has suggested that the symptoms of bewitchment investigated in the Salem Witch trials (1692-93) were in fact due to an outbreak of encephalitis lethargica (see her book A Fever in Salem: A New Interpretation of the New England Witch Trials).

Also known as ‘sleepy sickness’ or ‘sleeping sickness’ (in the non-tropical medicine sense), Encephalitis lethargica was popularised by the neurologist Oliver Sacks in his 1973 book Awakenings. Many of his patients had been hospitalised for 50 years. Sacks famously treated these patients (as well as others with Parkinson’s disease) with L-DOPA and, as the title of the book suggests, watched in amazement as they woke from their deep sleep. The story was fictionalised in 1990 and made into a film starring Robert De Niro and Robin Williams.

Our Wellcome film is a unique case study of a female patient showing the outset of her illness and then a short while after. At the beginning, she is shown to have ‘anaesthesia’ of one side and is visibly barely conscious, needing to be held up. She has ataxia (lack of control over her bodily movements) and a tendency to fall over; she duly falls to the right when the doctor releases her. According to an intertitle, in the eighth week, she began to grow somnolent (a state of drowsiness which is close to sleep), although she was completely ‘orientated’ and ‘rational’ (the exact nature of this condition experienced by patients is expressed in Oliver Sack’s book). Later, she touches her nose with her left hand, but falls asleep performing this important finger-to-nose test ( one of a battery of tests used by neurologists to evaluate coordination, which can indicate temporary or permanent malfunction of the brain)..

The early 20th Century was an exciting time in neurology and neurologists were early adopters of the medium of film. They captured the observable manifestations of certain conditions caused by disturbances in the nervous system; typically the gait and eye movements. The clinician behind this film was a German neurologist, Fredriech Henrich Lewy (1885-1950), who was based in Berlin at the time the film was made.

As a medical student, Lewy worked in Alois Alzheimer‘s laboratory at Emil Kraepelin‘s psychiatric university hospital in Munich. Alzheimer of course gave his name to a degenerative condition of the brain. Lewy emigrated to the US and was latterly known as “Lewey”. He gave his name to ‘Lewy bodies’, the subject of his final dissertation and an indicator of Parkinson’s disease or dementia with Lewy bodies. The connection between these diseases is still the subject of medical research.

Angela Saward

You can learn about the Wellcome Film project here. If you would like to make use of this archive footage in your own projects, please visit the Wellcome Library catalogue to download the original files, which are distributed under a Creative Commons Attribution-Non-Commercial 2.0 UK: England & Wales licence.

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