The mysterious dancing mania and mass psychogenic illness

Try to imagine yourself walking along the streets of a city (maybe the one you live in, or one you’ve visited, or one you simply make up in your head—as long as you can picture it clearly it doesn’t matter much). Think of the shops and businesses you might pass as you stroll down the sidewalk, the smells of food emanating from nearby restaurants, and the noises you’d hear—intermittent car horns, snippets of conversation, the discordant sounds of construction equipment. Now, imagine you approach a street corner, and as you do you begin to hear some rhythmic music playing from just out of view—on what sounds like bagpipes (to really set the mood, click play on the video below for some appropriate background music). As you turn the corner, curious to find the source of the music, you see a large city park. It charmingly interrupts the asphalt and concrete of the city with expansive green grasses, dense leafy trees, and a bubbling decorative fountain. But despite its beauty, the park is also the backdrop to one of the strangest spectacles you’ve ever witnessed.

The park is filled with people—perhaps a hundred, maybe more. Many of them are naked. Others are wearing clothes that are dirty, ripped, and often hanging loosely from their undernourished bodies. A large group of them have formed a circle by holding hands, and many others are contained within the circle. Someone you can’t see is playing the aforementioned upbeat (almost eerily so, now that you can see the whole picture) tune on the bagpipes, and nearly everyone is dancing—but not in a choreographed manner you might see from a flash mob today. Instead, this dancing is convulsive and jerky, and almost out of control—like there is a maniacal puppet master manipulating their movements from above.

As you cautiously take a few steps closer to this bizarre scene, you see that many of the dancers are staring blankly up at the sky, as if in a trance. Occasionally, they yell—shriek might be the more appropriate word—unintelligibly into the air. Some of these shrieks become agonized screams, and you can clearly make out the word “help!” shouted at least once or twice. You notice that, in the middle of the circle, several couples are on the ground having sex with one another. The whole thing looks like a drug-fueled ritual/orgy, but it’s taking place right out in the open, for everyone to see.

One of the dancers suddenly falls to the ground and starts convulsing. He’s clearly having some sort of seizure, his body thrashing about wildly and uncontrollably—but everyone just ignores him. After what must be about 30 seconds, he recovers, slowly gets up, and begins dancing again.

Think of the shock and horror you would feel when you encountered this scene. Now consider that if you lived in certain parts of Europe between the fourteenth and seventeenth centuries, this spectacle may not even have been cause for alarm. These types of dancing displays were not unheard of, and it’s very possible you would have seen one before.

In those days, the people who participated in the dancing rituals were thought to be afflicted by some malady (often assumed to be demonic possession) that led to compulsive dancing. The ailment was deemed contagious, and it was believed onlookers could be overcome and compelled to join the dancing at any moment. The condition was often called the dancing mania or St. Vitus’ dance, the latter name coming into use because the afflicted would often dance near the churches or shrines of St. Vitus, the patron saint of dancers. Priests from these churches frequently tried to intercede, frantically attempting to exorcise the demons from those who were affected before they were able to pass the sickness on to members of the clergy.

A depiction of dancing mania by Pieter Brueghel the Younger.

One such event occurred in 1374 and spread across a large area of Europe that included western Germany, Belgium, the Netherlands, Luxembourg, and northeastern France. Dozens of independent chroniclers of the events agree that thousands of people were affected, and the dancing went on for weeks. Another incident in Strasbourg in 1518 involved around 400 people, a number of whom were reported to have died while dancing in oppressively high summer temperatures. There were many other smaller occurrences of dancing mania, and sporadic reports of it persisted up until the mid-1600s.

While it’s possible some of the details of these events have been embellished, the number of independent verifications of them suggest they did occur in some form. So what could have caused this strange behavior? To this day, scientists are stumped. Some have suggested the culprit might have been widespread ergot poisoning. Ergot is a fungus that grows on rye; it has strong psychoactive effects when it’s ingested, and it can cause hallucinations, tremors, and convulsions (a constituent of ergot, lysergic acid, can be used to synthesize LSD). Is it possible, then, that widespread consumption of tainted rye could have led to these “epidemics?”

It doesn’t seem very likely. Ergot poisoning is characterized by spasms and convulsions, but also by symptoms like nausea and diarrhea, making it improbable sufferers could have danced for days on end. Additionally, ergot poisoning often involves the appearance of gangrene (i.e. tissue dying due to a lack of blood flow—it causes gruesome blackened skin that’s difficult to overlook) on the toes and fingers, but reports of dancing manias don’t include such descriptions. Finally, outbreaks of dancing mania also sometimes occurred in regions where rye wasn’t a common crop.

Of course it’s possible there was some other environmental exposure we haven’t identified that had a widespread influence on behavior, but such things are difficult to ascertain so long after-the-fact. And due to the lack of viable alternative explanations, many scientists have begun to believe the dancing mania was a manifestation of something called mass psychogenic illness, or MPI.

MPI involves the appearance of symptoms that spread throughout a population, but don’t have a clear physical origin. In other words, in MPI the brain is causing the patient to think they are afflicted by some ailment—even though the brain itself is the creator and orchestrator of the illness. This doesn’t mean that the symptoms aren’t real; there can be legitimate physical manifestations of MPI. But there’s no evidence the symptoms are produced by something (like a poison or a germ) other than the nervous system.

MPI is surprisingly common throughout history. Before dancing mania, there was a condition known as tarantism that occurred during the Middle Ages in Southern Italy. Victims of tarantism suffered from a number of symptoms ranging from headache to difficulty breathing, which, according to the victims, began immediately after the bite of a tarantula. (In those days, tarantula referred to a wolf spider, not the spiders we typically think of as tarantulas. Regardless, whether a spider bite was really involved was usually difficult to verify; it’s suspected that in many cases, the spider—like the resultant condition—was a phantom of the mind.) Once the malady took hold, however, the victims didn’t seek out antidotes to spider venom. Instead, they immediately began to take part in the only recognized cure: dancing. Patients would dance on and off for hours, days, or even weeks to upbeat melodies now known as tarantellas (this is what you heard in the video clip above).

Since these dancing disorders of the Middle Ages and early modern times, there have been hundreds of other potential instances of MPI as well. But, you might be thinking, perhaps MPI occurred in the distant past because people were more superstitious and easily-duped than they are today. Surely, we must have advanced past this era of gullibility, right?

Wrong. There is a long list of examples of possible MPI in modern times. For instance, in 2011, twenty classmates at a high school outside Buffalo, NY suddenly began to experience tics, verbal outbursts, and other symptoms that resembled those of Tourette syndrome. Despite investigations by doctors and state health department officials, no environmental cause of the condition was identified, and most doctors eventually agreed that the students’ conditions were brought on by psychological factors. Some doctors even suggested that social and mainstream media contributed to the “spread” of the affliction. Those who were more inclined to post frequently about their ailment on sites like Facebook and those that gave frequent interviews to the press were thought to have the most aggravated conditions. The students who avoided these practices tended to improve more quickly.

Havana syndrome is potentially an even more recent example. Havana syndrome began in late 2016 in Cuba, when American and Canadian diplomatic personnel started reporting a number of symptoms—like headaches, nausea, dizziness, memory problems, hearing loss, and even “mild brain trauma”— which typically appeared after hearing a prolonged harsh, high-pitched noise. Strangely, other people nearby usually didn’t report hearing anything. By 2018, up to 40 cases of Havana syndrome had been documented among American and Canadian diplomatic personnel in Cuba. And in early 2018, similar claims began to be made by U.S. diplomats in China.

At first, many thought this was a case of international espionage at its finest—perhaps Moscow testing a secret acoustical weapon. But evidence to support that theory is lacking, and a number of scientists have now decided it’s more likely the diplomats were experiencing MPI. (Some have even suggested the high-pitched noise the diplomats heard was actually the sound of a particularly noisy type of cricket.)

There are many more examples of MPI in both modern times and the distant past. So, what is actually going on here? Well, first it’s important to point out that it’s almost impossible to completely eliminate other potential causes in these cases. There’s always the chance the unexplained symptoms linked to occurrences of putative MPI could be better explained by a toxin in the environment, a pathogen, or something else altogether that we just haven’t been able to identify. Perhaps, for example, Havana syndrome really was caused by some new weapon being surreptitiously tested by the Russians. We don’t know for sure.

But it’s also likely that at least some of these cases of potential MPI are due mainly to psychological factors. And if so, we’re at a loss to explain how, exactly, that might occur.

Some have suggested that extreme stress, pushing the brain to its cognitive breaking-point, might be a risk factor. Dancing mania, for instance, often affected areas that had recently been ravaged by harsh societal blights like food shortages, devastating diseases, etc. Others have argued that MPI preys primarily on the most suggestible people in the population. According to this hypothesis, there are some who are simply more inclined to believe a mysterious illness is taking hold of them, especially after they’ve heard about or seen someone else affected by that “illness.” (These might also be the same people who are most likely to be susceptible to the influence of something like hypnosis.) And still others are unconvinced that MPI is a viable diagnosis in many cases, since it implies a certainty we can’t possess (that there is no other cause of the condition) and assumes we have the ability to explain behavior that might have been prompted by any number of factors ranging from actual physical illness to cultural elements we may not completely understand.

Thus, at this point, MPI is controversial. We can’t explain why it might happen, and we also can’t say for sure how often it really does. But, there are many scientists who believe this type of mass hysteria is a legitimate phenomenon that has the potential to affect anyone, given the right circumstances. That’s a sobering thought, although it’s still unclear if it’s grounded in reality or if it, like the condition in question, is merely an example of the inherent fallibility of the brain.

References (in addition to linked text above):

Bartholomew RE. Tarantism, dancing mania and demonopathy: the anthro-political aspects of 'mass psychogenic illness'. Psychol Med. 1994 May;24(2):281-306.

Waller J. A forgotten plague: making sense of dancing mania. Lancet. 2009 Feb 21;373(9664):624-5.

Optograms: images from the eyes of the dead

On a cloudy fall morning in 1880, Willy Kuhne, a distinguished professor of physiology at the University of Heidelberg, waited impatiently for 31-year-old Erhard Reif to die. Reif had been found guilty of the reprehensible act of drowning his own children in the Rhine, and condemned to die by guillotine. Kuhne’s eagerness for Reif’s death, however, had nothing to do with his desire to see justice served. Instead, his impatience was mostly selfish—he had been promised the dead man’s eyes, and he planned to use them to quell a bit of scientific curiosity that had been needling him for years.

For the several years prior, Kuhne had been obsessed with eyes, and especially with the mechanism underlying the eye’s ability to create an image of the outside world. As part of this obsession, Kuhne wanted to determine once and for all the veracity of a popular belief that the human eye stores away an image of the last scene it observed before death—and that this image could then be retrieved from the retina of the deceased. Kuhne had given these images a name: optograms. He had seen evidence of them in frogs and rabbits, but had yet to verify their existence in people.

Optograms had become something of an urban legend by the time Kuhne started experimenting with them. Like most urban legends, it’s difficult to determine where this one began, but one of the earliest accounts of it can be found in an anonymous article published in London in 1857. The article claimed that an oculist in Chicago had successfully retrieved an image from the eye of a murdered man. According to the story, although the image had deteriorated in the process of separating the eye from the brain, one could still make out in it the figure of a man wearing a light coat. The reader was left to wonder whether or not the man depicted was, in fact, the murderer—and whether further refinements to the procedure could lead to a foolproof method of identifying killers by examining the eyes of their victims.

Optograms remained an intrigue in the latter half of the 19th century, but they became especially interesting to Kuhne when physiologist Franz Boll discovered a biochemical mechanism that made them plausible. Boll identified a pigmented molecule (later named rhodopsin by Kuhne) in the rod cells of the retina that was transformed from a reddish-purple color to pale and colorless upon exposure to light. At the time, much of the biology underlying visual perception was still a mystery, but we now know that the absorption of light by rhodopsin is the first step in the visual process in rod cells. It also results in something known as “bleaching,” where a change in the configuration of rhodopsin causes it to stop absorbing light until more of the original rhodopsin molecule can be produced.

In studying this effect, Boll found that the bleaching of rhodopsin could produce crude images of the environment on the retina itself. He demonstrated as much with a frog. He put the animal into a dark room, cracked the windows’ shutters just enough to allow a sliver of light in, and let the frog’s eyes focus on this thin stream of light for about ten minutes. Afterwards, Boll found an analogous streak of bleached rhodopsin running along the frog’s retina.

An optogram Kuhne retrieved from the retina of a rabbit, showing light entering the room through a seven-paned window.

Kuhne was intrigued by Boll’s research, and soon after reading about it he started his own studies on the retina. He too was able to observe optograms in the eyes of frogs, and he saw an even more detailed optogram in the eye of a rabbit. It preserved an image of light coming into the room from a seven-paned window (see picture to the right).

Kuhne worked diligently to refine his technique for obtaining optograms, but eventually decided that—despite the folklore—the procedure didn’t have any forensic potential (or even much practical use) at all. He found that the preservation of an optogram required intensive work and a great deal of luck. First, the eye had to be fixated on something and prevented from looking away from it (even after death), or else the original image would rapidly be intermingled with others and become indecipherable. Then, after death the eye had to be quickly removed from the skull and the retina chemically treated with hardening and fixing agents. This all had to be done in a race against the clock, for if the rhodopsin was able to regenerate (which could even happen soon after death) then the image would be erased and the whole effort for naught. Even if everything went exactly as planned and an optogram was successfully retrieved, it’s unclear if the level of detail within it could be enhanced enough to make the resultant image anything more than a coarse outline—and only a very rough approximation of the outside world.

Regardless, Kuhne couldn’t overlook the opportunity to examine Reif’s eyes. After all, he never did have the opportunity to see if optograms might persist in a human eye after death and—who knew—perhaps optograms in the human eye would be qualitatively different from those made in the eyes of frogs and rabbits. Maybe human optograms would be more accessible and finely detailed than he expected. Perhaps they might even be scientifically valuable.

Reif was beheaded in the town of Bruschal, a few towns over from Kuhne’s laboratory. After Reif’s death, Kuhne quickly took the decapitated head into a dimly-lit room and extracted the left eye. He prepared it using the process he had refined himself, and within 10 minutes he was looking at what he had set out to see: a human optogram.

Kuhne’s drawing of The image he saw when he examined Erhard Reif’s retina.

So was this the revolutionary discovery that would change ophthalmic and forensic science forever? Clearly not, or murder investigations would look much different today. Kuhne made a simple sketch of what he saw on Reif’s retina (reprinted to the right in the middle of the text from one of Kuhne’s papers). As you can see, it’s a bit underwhelming—certainly not the type of image that would solve any murder mysteries. It confirmed that the level of detail in a human optogram didn’t really make it worth the trouble of retrieval. Kuhne didn’t provide any explanation as to what the image might be. Of course any attempt to characterize it would amount to pure speculation, and perhaps the esteemed Heidelberg physiologist was not comfortable adding this sort of conjecture to a scientific paper.

This experience was enough to deter Kuhne from continuing to pursue the recovery of human optograms, and it seems like it would be a logical end to the fascination with optograms in general. The idea of using them to solve murders, however, reappeared periodically well into the 1900s. In the 1920s, for instance, an editorial in the New York Times critiqued a medical examiner who had neglected to take photographs of a high-profile murder victim’s eyes, suggesting that an important opportunity to retrieve an image of the murderer had been lost.

But as the 20th century wore on and our understanding of the biochemistry of visual perception became clearer, interest in optograms finally dwindled. Those who studied the eye were not convinced of their utility, and that opinion eventually persuaded the public of the same. It’s intriguing to think, though, how different our world would have been if optograms really had lived up to the hype. It certainly would have simplified some episodes of CSI.

Lanska DJ. Optograms and criminology: science, news reporting, and fanciful novels. Prog Brain Res. 2013;205:55-84. doi: 10.1016/B978-0-444-63273-9.00004-6.