Morbid - The Sleeping Sickness Epidemic (1919-1930)

Episode Date: January 12, 2026

In late 1916, while treating a group of patients at his psychiatric clinic at the University of Vienna, Dr. Constantin von Economo began noticing the appearance of strange symptoms that he could not account for. At the same time, in France, Rene Cruchet began noticing similarly strange and unexpected symptoms in his patients. Though the two men had never met and knew nothing of one another’s patients, they would come to learn they were both witnessing the emergence of a new mysterious disease that would soon affect millions of people around the world.The illnesses documented by von Economo and Cruchet would eventually come to be know as encephalitis lethargica, or sleeping sickness, a strange condition that caused profound lethargy, hypersomnia, and a wide range of other frightening symptoms. Between 1919 and the early 1930s, millions of people all around the world contracted the illness, with nearly half of all cases resulting in death, and many more suffering long-term effects; yet a cause of the illness has never been established and the terrifying epidemic appears to have faded from memory not long after the disease itself ostensibly disappeared. ReferencesBrook, Harry Ellington. 1921. "Care of the body." Los Angeles Times, March 6: 18.Crosby, Molly Caldwell. 2011. Asleep: The Forgotten Epidemic that Remains One of Medicine's Greatest Mysteries. New York, NY: Penguin Publishing Group.Hassler, Dr. William. 1919. "No sleeping sickness in S.F." San Francisco Examiner, March 10: 1.Hoffman, Leslie A., and Joel A. Vilensky. 2017. "Encephalitis lethargica: 100 years after the epidemic." Brain: A Journal of Neurology 2246-2251.Montreal Star. 1920. "Sleeping sickness puzzling doctors." Montreal Star, January 15: 3.New York Times. 1936. "Awakens from sleep continuing 440 days." New York Times, June 14: 13.R.R. Dourmashkin, MD. 1997. "What caused the 1918-30 epidemic of encephalitis lethargica?" Journal of the Royal Society of Medicine 515-520.Sacks, Oliver. 1973. Awakenings. New York, NY: Vintage.San Francisco Examiner. 1919. "New sleeping sickness hits S.F. residents." San Francisco Examiner, March 14: 1.—. 1921. "Ten succumb to sleeping sickness." San Francisco Examiner, August 18: 13.Western Morning News. 1919. "Notices." Western Morning News, January 1: 1.Williams, David Bruce. 2020. "Encephalitis Lethargica: The Challenge of Structure and Function in Neuropsychiatry." Archives of Medicine and Health Sciences 255-262.Wright, Oliver. 2002. "His life passed in a trance but his death may solve medical."  The Times, December 14. Cowritten by Alaina Urquhart, Ash Kelley & Dave White (Since 10/2022)Produced & Edited by Mikie Sirois (Since 2023)Research by Dave White (Since 10/2022), Alaina Urquhart & Ash KelleyListener Correspondence & Collaboration by Debra LallyListener Tale Video Edited by Aidan McElman (Since 6/2025) Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Hey, weirdos, I'm Ash. And I'm Elena. And this is Morbin. This is Morbin. Yeah. What are you correcting me? Yeah. What are you correcting me?

Yeah. It's Morinian. It's Morbin. He said, no, it's just fucking Morbin. I'm like overtired today a little bit. I know. Your little off feels. No, I'm like, I'm happy.

I'm just, I did so many social things this weekend. And I'm usually not like that. social of a gal. Yeah. And I socialed so hard Friday night, Saturday night, Sunday. And then- socialed too close to the sun. Yeah, I didn't feel well when I woke up this morning because my body said, what the fuck were you doing this weekend? It's like, calm down. The body said, lie down. And I said, I have to go to work. I must recall. I have to. Yeah, I didn't, I didn't do a crazy amount of socializing. No. We did your birthday dinner. And a birthday dinner, surprise birthday dinner. John was planning that for like weeks and I worked with you that whole day and I literally as I was leaving almost went all right see you tonight and then I could have ruined the whole thing but I didn't because I had no idea because I got sick on my birthday so it was apparently scheduled for that weekend but had to be push it was the day that I forced you to go to urgent care yeah and I was like guess we're not going to dinner tonight because you're going to urgent care exactly you will be at urgent

care probably for a while. But yeah, so that was great. It was really sweet. John had like this whole menu put together. And he wrote witches never aged. Yeah, he's such a sweetie. And Elena thought I did that. I said, I didn't even do that. And then John was like, no, I did. I said, I just texted a few people and said, can you make it? Can you make it? Can you come? Since we've had to change it a hundred times. Yeah. No, it was great. It was wonderful. It was exactly what I wanted. I'm glad. My favorite restaurant. With your favorite people. With my favorite people. Most of them. Yeah, with some of my favorite people. Yeah. I will say. Yeah. But yeah. So, you know, I think I'm 2026. I'm liking it. In fact, it feels like a time. I'm loving it so far. I'm loving it.

I'm loving it. Oh, I have a hack for all of you. Tell me. Have you said this to me yet? I have not. So I wanted, this is a hack for everybody in the room and listening. Because I've tried it. I wanted to try it a few times to see if it actually made a difference. So I've been trying to slowly wake up earlier because, you know, you fall out of it during the holidays and all that shit. Everything gets all fucked out of it. So I've been trying to wake up even earlier because I like to wake up before the house wakes up so I can have my quiet time. Get some shit done. And now when I wake up, I got myself, I got it on Amazon. It's just like a Bluetooth speaker that looks like an old-timey radio. and I play slow Gatsby-esque jazz in the morning.

While I make my coffee, while I open the shades. Listen to you. While I get stuff ready for breakfast. I play slow Gatsby-esque jazz. I made a playlist. I don't do that in the morning. I do that at night when I cook dinner. See, I recommend it for a lot of time.

Yeah, I love it for dinner because it's like your day is slowing down. You're unwinding. It kind of like romanticizes your dinner making. That is exactly what I was going to say. So I started doing that. And what a nice way to wake up. It's nice. Yeah.

Because you're not listening to someone talk at you. I love a podcast. I love it. I do too. But sometimes when I first wake up, I need like a moment before any voices are really like telling me things. Yeah. And so this is like no voices until they. They start singing about some love or something.

There you go. But it's like, I don't, it just like eases you into the day. And it makes it feel a little more like special and romanticized. That's gorgeous. Like when you open the shades and everything, you feel like you're making your coffee. It's a little more of an event. Yeah. And when you, I'm telling you, get an old-timey radio looking Bluetooth speaker.

Then you're really in it. And that shit will change your life because you put it in the kitchen. Yeah. So when you turn it on, it feels like it's coming out of an old-timey radio and you just feel like you're transported. It feels like the 50s, but like you can have a credit card. And also if you're meal planning or you're like cooking dinner, you're getting lunches ready for the kids, put on some slow old-timey jazz. And I'm telling you it'll romanticize the moment. And I even pour like whatever I'm drinking into like a pretty glass. Yes, me too. Because that, especially when I'm cooking dinner. Use the pretty glasses. Use the pretty glasses. Yeah. One thing I'm doing this year that I've been seeing everywhere, and I'll even, I'll post my playlist that I made for a slow time, because I was very serious about the ones that I picked because I didn't want any, like, outliers here. I want it. Strictly the best. Slow old-timey Gatsby S jazz.

Is that, what did you name the playlist? I think I literally might. Let me get it. I'm going to see what I named it. Because I'll put it up on my Instagram for anybody who feels like they. Alina's wreck. It's called Morning Soft Gatsby Jazz. Oh, bitch. Love it.

A little, it hits a little harder. It does, it does. And it's only got a few songs on it, but that's enough. Yeah, just for little things that you're doing. It's just sort of a morning. Yeah. Use the fancy glass. Wear the fancy thing.

Yeah. Because you might, you know, what if you're dead tomorrow? You could. You didn't wear the fancy thing. You could literally die tomorrow. Don't save shit. What are you saving it for? For what?

Don't save it. Every day is a fucking event, all right? You're alive. We live in a hellscape. Let's just every day is a goddamn event that you get excited for. So let's make everything romantic and a big deal. And hot. It really does change things.

Yeah, it changes your attitude. It's starting to think little moments. Yeah. If you can bring yourself to slowly do it, I promise you it'll make a difference. Yeah, it does. And you don't have to do anything crazy. Just little things. Wait, do you know what I've been doing?

I'm a nighttime shower girly. Most of the time. Well, sometimes I do the morning. but lately I've just been doing it at night. And I turn off all the lights lately. And I put in my candle warmer and I play spa music. Yeah. And that is a nice way to enter night.

Honestly, yeah. Because you go from the soft jazz, soft nighttime jazz of dinner with your fancy drink. And then you get into the shower and you're spying. And actually, my aura ring has told me like, whatever the fuck you're doing, keep it up. Really? Yeah. Because it's like my heart rate is better at night or something. Shit.

They're like, did you do something before bed last night to optimize your sleep? Yeah. I'm like, killing it. Yeah. So see, little tips. Yep, that's how you should do your day. Because I think everybody needs little tips right now on how to be happy and fancy-free. Like ease into the new year.

And I'm trying. So I'm going to share whatever works for me. We're out here. But yeah, so that's my thing. Cool. But, you know, speaking of Gatsby's jazz, we're going to be in the early 1900s. There you go. During this.

Perfect. From Gatsby, S. Jazz to an epidemic. Great. So we, this is an interesting one. It's, this is a little different. Okay. It's not true crime, but it's interesting history and like bizarre history.

And it's got a mystery with it. Ooh, I love history. History and history, you know. Listen to you over there, romanticizing your topics. That's right. This, I think. I think this one's really, this one fascinated me because this particular illness were, it was once called the sleeping sickness. It has a lot of wild symptoms that come along with it.

Like I'll mention at some point, one of it is like just a really like legion here. One of the symptoms that would happen is like you would go catatonic and then your face would freeze in a look of horror. Oh my God. And just freeze. And you couldn't. It was like the ring, how they look like, ah. Like your face would just be stuck that way. Or like Harry Potter in the Chamber of Secrets.

Yes. Yeah. Like that was real. Damn. Yeah. So let's get into it. Tell me everything. Let's get into it.

I think this was also called like, and we'll mention it again, it was called different things when it first came up because people didn't know what the fuck this was and still don't really understand what it was. Yeah. Or is. And at one point I think it was called like the grandmother, like the Nona. That's it. Just the grandmother. It was like a sleeping disease. Like it was, it's so crazy.

She's been stricken with the grandmother. With the grandmother. She has the nona. The nona. So let's begin in 1916, shall we? Let's do it. So there was, you know, a war was raging across Europe. And Dr. Constantine von Economo.

Him? Yep, another von. Love a vaughn. Got some vons. Do I love this bond? He had become pretty used to treating men with a variety of maladies at his psychiatric clinic at the University of Vienna. It was a pretty normal thing at this point

because there was a war raging. The war really ushered in a new era of technological advances in weaponry. And these weapons that were now being advancing so far were capable of causing mass destruction and also leaving witnesses to that destruction super psychologically damaged in their wake. There was a whole new host of issues

that people were dealing with. And as a result, Von Economo and medical professionals, professionals like him really came to know and recognize the symptoms of, you know, delirium, shell shock, PTSD. These were all very common in soldiers that they were seeing. Yeah. Several years into the war, Dr. Von Economo had become accustomed to seeing all manner of not just psychological illnesses, but injuries, like physical injuries.

Yeah. You know, they were coming from like the horrific effects of mustard gas, of chlorine gas. Damn. You know, disfiguring damage from artillery shells. It was really bad. Yeah. But the cases that really interested him the most were the epidemic illnesses, like typhus, cholera, influenza. Because there weren't just physical dangers of battle or psychological dangers.

The conditions on the actual battlefield, like the cold, the wet, the dirty. The wet. You know. And the conditions of the soldiers themselves being malnourished, highly stressed, mostly injured, dealing with all this shit, it was ideal for contracting and spreading a lot of infectious diseases. Makes sense. Though these illnesses weren't as obvious, they were definitely not less devastating among the

soldiers, and they spread like wildfire. Because they're in such close quarters. Oh, yeah, and they're just on, yeah, they're on top of each other, and they're all just being, like, switched out all the time. Yeah. And the entire wings of hospitals would be dedicated to their treatment at times. Now, we're talking today about a disease that's called encephalitis lethargica. Okay.

It's kind of unknown where it first appeared. The epidemic of the early 20th century is thought to have started in 1915 Romania, but more recent studies of this disease have thought that, like, maybe something called the English sweats, it was referred to, might have been similar to this, and maybe that was the disease. the first thought of it, like, sight of it or whatever. But it's really hard to pinpoint because, as we'll come to see during this, this has so many varying symptoms and they're so weird. Yeah. Like, they're strange symptoms and they never, it like doesn't hit two people the same way.

Okay. It's very strange. Kind of sounds like COVID. It is. It's really scary. Now, the first documented cases of the disease appeared in 1916 at Von Economos Clinic in Vienna and at the Paris clinic of Dr. Renee Cruchet. At Crochet's clinic, men started arriving from the front lines with just a variety of symptoms that they were easily identifiable, but they didn't really comprise together like a single diagnosis. Okay. By themselves, you could be like, okay, that's that, that's that. But altogether, it was like, what the fuck is this? According to author Molly Caldwell Crosby, quote, some had fever, others did not, most complained of headache and nausea, strangers of all.

was how much these soldiers slept. Now, it makes sense that a person who gets, you know, the flu or a flu-like thing, as these guys were, would probably, you know, want to and need to sleep for longer periods than someone who's healthy. But there was something like very unnerving about these particular patients, not just the amount of time that they were sleeping, but also the way that they looked. Crosby said it would have seemed almost serene at first. their blank expressionless faces, free of terror and pain. But over time, they would fall asleep and stay that way for days or sometimes weeks.

What the fuck? And then sometimes they would never wake up. Oh. Yeah. Now, in Vienna, Dr. Von Economo was seeing like a similar strange combination of symptoms in his own patients that were coming from the front lines, like soldiers. In January 1917, a man arrived at the clinic complaining of exhaustion, confusion, and headaches. And he sat in front of the doctor. And he said that he was like, as he sat in front of him, he was struggling not just to stay upright, but just to stay awake. He like couldn't even stay awake to sit and talk to him. He slumped in his chair. His head was like lolling around from side to side. And he numerous times completely knotted off while he was talking to the doctor. And he said every time the man fell asleep, Von Okonimo could rouse him, but never to full consciousness.

He said he was more like someone who had been woken from a deep sleep and is only vaguely aware that they're no longer sleeping. Oh, that's weird. And by that point, Von Economo had seen this type of exhaustion in, you know, a small number of patients who, again, had come from the front lines of war. But this person was a civilian. Oh. So now he's like, wait. Yeah. So the early cases documented by Von Economo and Cruce were baffling both of them.

this illness seemed to have like similarities to influenza, which was very rampant at the time, but it lacked a lot of the defining characteristics of flu. And more strange was the fact that among the small number of people who did present with encephalitis lethargica, there was, again, just the widest variety of symptoms. The best von Economo could tell was that they appeared to be suffering from encephalitis, which is swelling of the brain tissue. But there was no explanation for that. swelling. Like there was no evidence of head trauma, no other injury that could really account for it.

And also, while some of the symptoms matched a typical case of encephalitis, which is like fever, headaches, confusion, there were others that were not associated with encephalitis at all. Weird. Yeah. So as the weeks go by, Von Economo started noticing new symptoms in his patients, including one epidemic of hiccuping that resulted in one death. Wait, they hiccups themselves to death. An epidemic of hiccuping where one person died. What the fuck? Yeah.

Of, they died of hiccuping. Yeah. Which sounds like the worst kind of death imaginable. Yeah. Think of how awful it is when you start getting the hiccups and you're like, you get one hiccup and you're like, fuck, get it gone. I'm like, give me honey. Someone scare me.

I'm holding my breath. Holy shit. Like, that's awful. Yeah, no, it's the worst. When then other patients started exhibiting even stranger symptoms, like compulsive verbal ticks, uncontrollable blinking, involuntary muscle twitching, uncontrolled salivation, and a small number of people who, quote,

froze still in a catatonic state. It was like the disease was developing new symptoms as it progressed, but with no explanation whatsoever. And while these patients had a lot, lot of symptoms in common. The only symptoms shared by all of them was hypersomnia. Okay. So other than that, it was like they all had hypersomnia, the rest of them. With a whole skew of different things. But then they had a ton of shit that was just outside of that. Really, hilly. Now, in time, von Economone Crochet, who still had not compared notes at this point, because they're in two different places,

they recognized a pattern in the clinical presentation of encephalitis with Argyka. Like the more common form of, you know, encephalitis, the disease affected people. patients in two phases. It was acute and a chronic phase. The acute phase, you know, that had dramatic symptoms like excessive sleep, eye twitching, movement disorders. Those common symptoms, though, were often accompanied by less common symptoms. And these less common symptoms almost felt like they like came and went day to day. Like they kind of appeared one day and went the other. And yeah, for obvious reasons, the chronic phase of the disease took a lot longer to identify and could present months or even years later.

And they would sometimes present in the form of Parkinsonian-like signs. Oh. Yeah. So at their respective clinics, both doctors are just like diving and pouring into medical literature, just trying to find anything that could figure out, because they're also having trouble treating these people too. Right. Just finding anything that resembled what they were seeing.

And, you know, first in soldiers returning from the front lines and then in civilians. But Von Economo recalled hearing stories of a similar plague that had affected parts of Italy in the late 19th century. According to the stories, apparently peasants in a small village in rural Italy started falling into coma-like sleep. And a lot of them never woke up. And those who did wake up were not the same as they were before. These people called the disease, La Nona, the grandmother. La Nona. La Nona.

But I don't think I'll ever ever. over a disease being called the grandmother. That sounds like a horror movie. The grandmother. The grandma. But in the surrounding towns and villages, those who had symptoms were referred to as the living dead. Oh, spooky.

According to Crosby, this was the first time that doctors had considered whether the strange sleeping sickness could be related to the outbreak of influenza that was occurring at the time. Okay. Now, based on those theories, Von Economos started developing his own theory, that these strange symptoms he was seeing in his encephalitis lethargica patients could maybe be a reaction to exposure to influenza. Right.

In April 1917, he gathered all his notes in observation and published a manuscript appropriately titled Encephalitis Lethargica. Coincidentally, and this is total coincidence, just a few days later, René-Crucce published his own paper on the case in Paris. Yeah, like they were both like on the case. Yeah. These two manuscripts were the first to formally identify the disease. But in the decade or so after that, roughly 9,000 papers on the subject would be published in various places,

all theorizing what could be the cause, but absolutely no one being able to figure out the cure, the treatment, or really nailing down the cause. Okay. Yeah. Despite the horrific toll that this is taking on the patient's, the encephalitis lethargica, is taking on a patient's brain and body, it would eventually lead to some pretty ground-baking discoveries about the function of the brain in general.

Because remember, we're in the early 1900s. So though he couldn't examine the brains of his patients directly, at least not while they're alive, von Economo theorized that patients with encephalitis lethargica had been infected with some kind of virus that only affected one part of the brain. As a result, he would eventually establish that the affected region,

hypothalamus was responsible because we didn't know what the parts of the brain were responsible for at this point but he was able to like go backwards and figure out that the hypothalamus is responsible for among other things regulating sleep body temperature thirst and hunger and so on so boom groundbreaking yeah that's big while this is now considered pretty basic information in neurology at least yeah it was a really remarkable discovery in this day and more importantly at least for von Conimo and the other doctors studying this disease, it narrowed down the affected area and helped them to rule out other illnesses and potential causes of mystery illnesses. The problem, though, is that by the end of the decade, encephalitis lethargico was no longer

just affecting soldiers returning from war, but even more alarming was the fact that cases were popping up outside of Paris and Vienna now. The disease was spreading faster than they expected, and they had no way of stopping it or even slowing it down because they didn't know what the fuck it was. Right. So what do you, like what precautions do you even put into place? So as the war raged across Europe, the Middle East, and Northern Africa, troops continued being moved in and out of those regions by the thousands. As men were injured or killed, they would be removed from battle and replaced with healthy soldiers and the war would continue. Now in the context of a battle, that's obviously a necessity.

But it never occurred to anyone in charge that by moving so many people in and out of these places, they were creating the perfect environment for this virus to spread. Now, just as the first patient showed up at the Von Economo and Crochet clinics after being taken off the front lines, other soldiers were cycled off the battlefield and sent to hospitals and clinics in their respective home countries. When the war ended in November, 1918, the vast majority who survived were shipped home,

bringing with them the germs that they picked up while serving. Oh, man, and it was probably just like popping off all over those ships. Now, between 1917 and 1930, nearly one million people contracted encephalitis lethargica. And of those, roughly half died as a result of their symptoms. Jesus. Now, those numbers are small relative to other pandemics and epidemics. But for a remarkably bizarre and mysterious illness, it's pretty surprising that encephalitis lethargica, the epidemic, has never really had like a bit. It's like a footnote in medical history.

Like, it's crazy. And at the same time, it was probably hard to diagnose, too. So who's to, who really knows how many people did die of that? We just didn't know. Exactly. Now, one reason for that status is the fact that among the germs passed around the world following the end of World War I was the Spanish flu. Yeah. A virus that raged for more than two years and killed an estimated 50 million people worldwide. As Molly Caldwell Crosby said, in Europe and elsewhere, few people worried about the little known epidemic of sleep. They were preoccupied with the rapidly spreading, extremely virulent influence of breaking out among troops in Europe and the United States, which makes sense.

Yeah, it does. Now, by 1918, encephalitis lethargica had made its way to England, where it proved just as perplexing and unable to be defined as it had been when it first appeared in France and Italy. Among the first cases reported came from physician Dr. A.J. Hall, who by that time had already heard of this disease. And what struck Hall as unusual was that his patient, who was a young boy, did not seem really exhausted or even sleepy, but he was experiencing a level of muscle weakness that left him unable to lift an arm or leg off the bed. Damn.

Yeah. So his body was tired. Yeah. This was similar to the first civilian to visit von Economo's clinic who was unable to hold himself up in the chair and keep his head up for any period of time. Yeah. Now soon, other cases of encephalitis lethargica started showing up at Hall's clinic, and they arrived with symptoms of the flu, which was rampant at the time. But then a short time later, the symptoms would progress,

and that's when we'd see all the strange encephalitis lethargica symptoms. All suffered from profound lethargy and hypersomnia, which appeared to affect most patients more severely during the day. Interesting. Crosby wrote, it was as if their sleep cycle was turned around. They stayed in the sleepy stupor all day and became delirious at night. And by that time, one or more common symptoms seen in patients in the UK was a tendency to mumble or ramble incoherently like they were talking in their sleep. Ew, that's so spooky.

It's the spookiest illness. I don't like that. As the numbers of infected were growing, more unnerving symptoms started coming out too. Patients would fall asleep with their eyes wide open. Oh, shut the fuck up. wide open, unmoving, staring blankly into the distance. No. Others got facial hypertension, a type of muscle rigidity,

that left their faces twisted and fixed in a mask-like expression of horror. Ew. Yeah. There were other extreme, though much less common symptoms, seem in patients as more cases kept popping up. And in Hall's clinic, many patients who would be in a stupor-like state during the day would come out of that state in the evening and be in a state of euphoria. causing them to talk incessantly or rise around in their beds?

What the fuck? Like what? Makes you think of Nancy at the end of the craft? Yes, that's immediately what I thought of. It gave me the gift. And in one case, a young boy was described as, quote, leaping from all fours into the air like the mechanical toys sold on the London streets called jumping beetles. What?

Yeah. He said, I feel better. Yep. He would just jump at night. That's you. on all fours. That's literally you when you feel like a millisecond better and the doctors are like, no, you still are sick. Lay down. Get it together. It's true. Now for some, the exhaustion rendered them unaware of their more physical symptoms because they were so tired they couldn't really experience any of the other symptoms.

Well, they just weren't with it. Yeah. For others, like the boy leaping from all fours, the symptoms were terrifying, to say the very least. Yeah. Worse than the presentation of the symptoms was the fact that doctors who encountered the disease in their patients, couldn't do really shit for them. Yeah, well, because they just don't know what to treat. Yeah. By the end of 1918, the first year the disease appeared in England, there were more than 500 cases, and in the months that followed, the number doubled. In January 1919, towns and cities across England started posting notices in the papers,

informing residents that one or more cases had been documented in their area, and urging anyone with symptoms to report their case. They said, lay-low motherfuckers. One notice said, in view, View of the serious nature of the disease and the difficulties attending their treatment and presentation, it is highly important that notice be sent to the medical officer of health in every case without delay. Now, in the early months of 1919, as British physicians were just grappling with this mysterious illness, cases of this illness began appearing in the United States.

In New York, several cases appeared in large clusters and among groups with social connections, giving doctors the first clue that whatever was causing this, it appeared to be spread through close contact. In response, they began investigating the commonalities among the affected individuals, including their living conditions, shared food, water sources, and any kinship relations between those showing symptoms. Now, among the first patients documented in that phase

was a 16-year-old girl identified as Ruth. That winter, she was brought to the Manhattan Clinic of Dr. Frederick Tilney, one of the city's most well-known neurologists. When Tilney was first informed of this new patient, all he was told was that she had fallen asleep and wouldn't wake up. Jesus. By that time, Tilney had already read the medical literature

coming for the doctors in Europe and believed he had already seen a few mild cases of sleeping sickness. So when Ruth's parents described her symptoms, he was like, she got encephalitis, lethargica. He says she has the grandma. The grandma. The nona. The nona.

According to Ruth's parents, she had returned. turned home from work one afternoon, about a week after Christmas, and began complaining, and this is the strangest beginning to this, she started complaining of a sharp pain in one of her fingers. Random. That had come on suddenly. What? Within hours, the pain had spread up her arm and into her shoulder, causing numbness that would eventually lead to paralysis. Ew.

By the next day, Ruth had become irrationally fearful and started lashing out violently at her parents. Oh, my God. Like she would gnash her teeth and like thrash wildly. The fuck? She's 16. Yeah. To the point that she had to be sedated and restrained. She was like a wild animal, they said.

Thank God. A short time later, she fell asleep and could not be roused. By the time Dr. Tilney was called, she had been asleep for two months. Why did it take so long to call Dr. Tulney? Because I guess she was at a different hospital. She had a feeding tube and an IV drip to keep her nourished. two months. Two months sleeping. Damn. Back to that finger thing, it's actually, like, that's crazy. That's how I, that's how my COVID started the first, I've only had it once. Your finger hurt? No, it's similar though.

My elbow was like, and it's like joint pain, but my elbow was so sore. And I remember saying to Drew, I was like, oh my God, my elbow is so sore right now. That's so bizarre. And then the rest of my body started hurting and I was like, do I have COVID? But it started in my elbow. Wow. Isn't that one? weird. That is weird. When I looked it up, it was like, yeah, like joint pain. Like it makes sense. But it was one specific elbow. Yeah, it was weird. And Ruth was like, my finger hurts. Yeah, I mean, the finger is like even stranger. That's crazy. Yeah. So among the things that puzzled Tilney the most was the fact that although she appeared to be asleep, this is even weirder. She was able to respond to

simple commands. Well, that's like when we were talking about, um, comas recently. Yeah. Like how we don't have a lot of understanding about that. Yeah. But she was like when we were talking about, like someone in a trance, he said, like her eyes and mouth were closed. Okay. But she was able to respond to simple prompts from the doctor. When Tilney asked Ruth to shift her body from one side of the bed to the other, she did it. So she could still hear it. With difficulty, but she did it.

Okay. By that time, she had developed the additional symptom of hypertension, which caused the muscles in her arms and legs to become rigid and stuck in what was surely uncomfortable positions for hours. I was just going to say that must be so painful. Yeah. And just stuck. Yeah. According to Crosby, when Tilney tried to move her from the bed, she began to tremble. It started with a hand or arm and then spread until her entire body was convulsing in a rabbit-like twitch. Oh, my God. Like so many other doctors around the world, Tilney had come to recognize the symptoms of encephalitis lethargica.

The Nona. The grandma. But was that a loss for how to treat it? That's the worst part of this. Yeah, well, you do. In the end, his recommendations were just basically ways to make Ruth more physically comfortable. Yeah, that makes sense. But he was forced to tell her parents that as of that time, there was no treatment or cure,

and that their daughter was likely to stay in that state. Forever? In fact, a few days later, Ruth's temperature spiked to 107 degrees, and she died. Oh, my God. Yeah. That's awful. What a horrific. After months of living that way too.

I'm just horror. Yeah, that's so sad. So as cases began spreading in the U.S., so did anxiety and fear now about this disease. The Spanish flu epidemic had affected millions of people. people around the U.S. and the world, killing massive numbers of people. But influenza was something people could at least understand. Like they could recognize influenza. You know what the flu is. Yeah. And also the most devastating effects of the flu affecting certain populations, which made it less intimidating to the general public. Right. Encephalitis lethargica, on the other hand,

was something fucking terrifying. Yeah, it seems like anybody could get it. And totally weird and bizarre and scary and horrific. Yeah. Not only were the symptoms varied across patients, but they were psychologically disturbing, physically disabling, and seemingly impossible to treat. And even if one did manage to survive the acute phase of illness, the chronic phase brought with it Parkinson's like symptoms that would be profoundly life-altering at that point. Yeah, which is so scary.

People lived with this forever. Wow. While new cases started popping up around the U.S. with a lot of frequency now, the American and public look to doctors and health care workers to explain this scary disease that it seemed to come out of fucking nowhere. But by that point, the predominant theory was that encephalitis lethargica was somehow related to the flu epidemic that had recently gone crazy. Like almost like a mutated flu? Yeah, like almost just like a pop off of it. You know what I mean? A pop up. You know, quick pop-up store. It's the flu. Pop and off. It's like a pop-up version of the flu.

Yeah. Since so many of the symptoms, particularly the early ones, were seen in cases of the flu, like you would come in with flu-like symptoms. Right. An encephalitis was caused by an infection. It seemed reasonable to presume that the sleeping sickness was an after effect of the Spanish flu. Similarly, just a few years earlier, an epidemic of malaria had spread across the African continent, sharing several of the more prominent symptoms seen in patients with encephalitis lethargica. As a result, some doctors theorized that the newly emerged disease could be related.

I mean, yeah, I could see why they would think about. by early spring administrators in cities across the u.s. were forced to address this growing fear they had to talk to the public they couldn't just let them be like oh because it's like what do you do like what precautions do you take but the worst part is they have no fucking information like they have like very little information there's this episode of sponge bob where he just like is not going to go outside and he sings this song where he's like indoors indoors that's basically what they were doing that would be me they're just door to door stay inside No, in San Francisco, the city's health department released a statement in early March 1919, saying

San Francisco need have no fear of the sleeping sickness. Don't you lie to me like that? As an aftermath of the influenza. It is well established that the sleeping sickness is carried by the Tietzy Fly and occasionally by other insects found in Africa and the South. It has no direct connection with the influenza, which is an entirely different origin. That's a bitch-made statement. That's a very bitch-made statement.

And it would turn out that San Francisco health officials were wrong on literally every point that they put in that. Also, what's a tetezy-fly? It's like a little, I think it's almost like a mosquito kind of thing. A titsy fly. Just four days later, physicians in the city started reporting their first cases of encephalitis lethargica. So they were to, San Francisco health officials were like, nope, don't worry. No titsy flies here. get out of here.

Nope. And then four days later, they were like, so my bad. Does that sound familiar to anyone? No, it sounds totally foreign. I can imagine. It's almost like we were told the same thing. It's almost like that. In one case, a local railroad worker, Chester Jones, came down with symptoms and slept for 10 days

straight. Not Chester. Just Chester. Honestly, he probably loved that 10 days of sleep if that was it because a railroad worker is that's a hard job. Yeah. During that period, Jones's doctor, WB. Coffee, was able to rouse him long enough to eat a small amount of food or drink water. But otherwise, he was out. Damn. And this isn't like a coma. That's the thing. It's like, they are sleeping. Like straight. Because they can wake them up and be like here, have a piece of toast. Right. And then they're like, all right, good night. Like back to sleep. It's crazy. Are they like, I wonder if they were like able to like get up to use the bathroom or. Yeah. Or if they had to like. Yeah. Yeah. Now, Coffee said we have had both hiccups and the sleeping sickness among the various other effects of the influence.

Not the hiccups. So hiccups are back. Ew. This form of sleeping sickness is to be distinguished from that which is carried by the Tietzy fly and is found in the tropics. So he's like, lias. Yeah.

It's not the same. You guys fucked up. Meanwhile, in New York, the first deaths from sleeping sickness were reported, starting with steamship Captain Frank Martin, who'd been diagnosed with encephalitis lethargica just five days earlier. The rising number of deaths inspired way more fear in the public, obviously. But state and local health officials were trying to minimize the danger of it. The New York Health Commissioner told reporters,

The symptoms of the disease are much the same as those of spring fever. Disagree. Lying sacks of shit. Are you all right? Like, that's insane to do. And it's just trying to piss off. And I love this. But just because a man feels languid, he need not jump to the conclusion he has contracted sleeping sickness.

I would jump to that conclusion. If I felt languid, I feel like I have a sleeping sickness, okay? Being languid feels... Feel sleepy. A little more intense than feeling just a little sleepy. Yeah. The fuck. Now, the willingness to disregard the dangers of encephalitis lethargico is not limited to the U.S.

In Montreal, so Canada, you are not immune to this. You are usually on the right side of history. We usually, we're rooting for you. We're all rooting for you. I've never in my life yelled at a girl like this. That's right. But in Montreal, health care workers simply took, they took a very dismissive approach to it. Can't know.

Obviously, it was in an effort to quell public fear. Yeah, they don't need like mass pandemonium. They didn't know enough about like how to properly inform without inciting kind of thing. They didn't know a lot about truth telling back then. It happens. One hospital worker told a reporter, this reluctance to diagnose encephalitis lethargica does not discredit the Montreal physicians in any way. To determine absolutely that a patient was suffering from a new disease is a

extremely difficult. And in every case so far, there's, there has been an element of doubt. Well, that's fair. So they're being, they're being much more like, I would say, like, you know, diplomatic about it. Yes. You know, they're just, they're being like, maybe it's not because we don't want to. It's because it's hard to diagnose a new disease. Which does, yeah, I got that. And you don't want to say something is that and then be completely wrong. Yeah. By 1921, doctors had still not discovered a solution for this or what it was. but they were managing to at least make some headway in like starting to understand it better. Not only were they continuing to narrow down the areas of the brain affected by encephalitis lethargica,

but they were also starting to recognize earlier cases that had been diagnosed as something else. Okay. Because they didn't understand this disease before. In Los Angeles, for example, one doctor described having been referred a patient from, quote, the leading alienist in Los Angeles. I love when they were called alienists. After the young woman had been diagnosed with Catatonia. Okay.

He said, I was called in after three of the physicians, along with their mental specialists, had tried every blood test and every means of diagnosing the condition for a week. In retrospect, the doctor recalled the woman had influenza not long before the new symptoms came. Okay. Which further supported the suspected link between the two. Right. Now, over the course of the 1920s, physicians and specialists kept trying to nail the. shit down. And in 1923, for example, a study out of Europe found that out of a thousand encephalitis lethargicia patients evaluated, only four had a history of influenza within the

previous six months, of which two were doubtful. So that's not it. Yeah. So similarly, in a much larger study conducted at Camp Dix in New Jersey, six thousand cases of influenza were studied and no concurrent cases of encephalitis lethargica were identified. Wow. So it seemed to kind of bashed that link in the head. Definitely. Further complicating matters was the fact that not all patients experience the same symptoms, nor were they affected in the same ways

and for the same lengths of time. There was like no consistency. For instance, a middle-aged man in New York might fall into a coma and die from a fever a week later, which literally happened, while a teenage girl in London would experience delirium and hypersomnia that lasted for a month, then went away miraculously.

And there was hardly ever a clue why. What started it, right? In 1936, Joseph Langen, Jr., a 30-year-old Illinois man, woke from an encephalitis, lethargic a coma after 440 days. Oh, my God. Shocking everyone around. Just a year of your life gone, over a year of your life gone. Just woke up. 440 days.

He said, all right, let's do this. Yeah, he said, I feel rested. Yeah. So let's go. I wonder if he had any after effects. Yeah. That's a thing. Like lingering symptoms.

A lot of them did. And most of the people around him thought he would succumb to what they were calling the sleep of death at this point. Yeah. Now, perhaps one of the most baffling things about encephalitis lethargica epidemic was that after more than a decade of crazy bizarre symptoms and a lot of tragic outcomes, the disease just seemed to disappear. Which is so strange because it's like there weren't a lot of precautions put into place because they didn't know what precautions put into place. Exactly. So like, where did it go? According to Dr. R. R. Dormashkin, by 1927, the acute cases occurring in England were often so mild that the acute phase would pass without much notice.

But the long-term effects could often be quite devastating, leaving a lot of individuals in comas for the rest of their lives. Well, that's awful. While new cases of encephalitis lethargica began slowing as early as the later 1920s, and they were considered exceptionally rare by the 1930s, those who neither died. nor recovered from the illness were left in like a vegetative state for the rest of their... They just didn't really come out of it. Even if they came out of the coma,

they would be like forever changed. Yeah, I mean, of course. And those who did survive were left with what neurologists Oliver Sacks described as extraordinary crises. That could include the quote, simultaneous virtually instantaneous onset of Parkinsonism,

catatonia, tics, obsessions, and 30 or 40 other problems. problems sometimes. Oh my God. Yeah. It's like so that it literally robbed you of your life. It's like it really don't. Yeah.

Like do you? In the aftermath of this epidemic, most doctors were content to accept the theory that it was related to influenza. Or just allowed the disease to be a mystery. They were like, whatever. Who knows? Yeah. But it doesn't happen again.

You know, decades after the epidemic had ended, Sacks's focus was on treating those locked in the comas still by this disease in the first place. Beginning in the late 1960s, Sacks started working with encephalitis lethargica coma or catatonic patients at Beth Abraham Hospital in the Bronx. In his experiments with the amino acid Lodopa, Sacks found that many of the patients suffering with the severe Parkinson's-like symptoms of encephalitis lethargica, including muscle rigidity, spasms, and tremors, could find relief, like incredible relief. Really? Although the success of El Dopa proved limited and temporary at the time,

ongoing research in the years since has resulted into continuing success with treating people who have dealt with these long-term symptoms. Okay. In 2002, the last known survivor of the encephalitis lethargic epidemic, Philip Leather, died in London at the age of 82. Wow. He was once a child prodigy. He had incredible promise, and he contracted the illness in 1931,

while he was still a child. And he spent seven decades in what the press described as a, quote, trans-like state. Seven decades. 70 years. They said he just slowly went into himself over a period of a few years.

That's what his sister, Jean said. Now, after his death, his brain was donated to the Royal London Hospital where a lot of specialists were hoping it was going to just completely unlock all the secrets of the disease. But unfortunately, it didn't really shed any light.

nothing, which is like wild, that there was no like hallmark thing that you could point to to say this is what happened. As of today, cases occasionally pop up from time to time. Shut the fuck up. Don't even tell me that. But they're super rare, like exceedingly rare. They better be. As for the cause of this sleeping sickness, they still don't know.

To this day, 2026, we still have no fucking clue. What the fuck? How? It's no longer widely believed to be related to influenza. Well, just with those studies alone. Yeah, it just doesn't seem to connect anymore. And some neurologists believe it may be like an autoimmune response to a virus. Well, others think that there could be environmental or infectious or viral explanations for it.

But others believe that it could be, there could be like multiple causes for the illness. I wonder if it was like, like, I wonder if the reason it's so rare now is like it was like some kind of illness, obviously. but it was maybe exacerbated by something that we don't intake anymore. Like we don't do anymore. You know what I mean? Yeah. That's what I wonder. I wonder if environmentally there's something that we've shed out of our system

or shed out of our way of life that we're no longer being exposed to. Yeah. I think that would be an interesting thing to go back and look through. Yeah. Try to like work backwards that way. Right. Because it's just, but it's like what would it be? That would affect so many people from so many like, like,

like various age ranges. And give them so many different kinds of symptoms. Yeah. Like the difference in symptoms is wild. And it just makes me think of like the radium girls case. Yeah. How they were like painting their mouths with radium and then all that crazy shit happened. That case will blow my mind for the rest of my life.

No, truly, it really will. But you wonder if it's something like that if it's like this used to be in like our milk or this used to be in a cleaning product. The air. Or, you know, or these people would take for a cold. Yeah, or like these people live near these plants that produced this. Like, I wonder. Like clothing. Yeah.

Hair stuff. Fibers. Yeah. Some of the soap. But it would have to be so vastly used because so many, like, kids were getting this and, like, elderly people were getting this and everybody in between. There was no, like, age range either. It's, like, everybody.

It's interesting. So I feel like it has to be like a, like a, something you'd use on your body. Yeah. You know, that would be, you would use on a kid. Yeah. Or like, or like, you would. said like a cleaning product that somebody might have used in their house. Yeah. I feel like we should really continue looking into this though so that this doesn't happen again. Let's figure this out,

guys. Let's do it. Let's figure it out. I mean, weird things have happened where like the Somertonman case was like solved right after we covered it. So maybe they'll figure it out because we put it into the world. That'd be weird. I'm putting it into the world right now that we're going to figure it out. I would love that. That would be sick. That would be a big fucking claim. That would be. And like I'm never claiming to solve anything, but I'm just saying it's weird timing. Because there's a small contingent of people who get so fucking angry when we will claim that. Stay mad. Which makes we want to claim more. I'm claiming it. But like, I'll claim this one. I would totally claim this one. Imagine if we were right to if they were like, oh my God. It was in a cleaning

product. Based on the mold and podcast. We never thought of it. It was in Clorox. Decades and decades. We never thought of this. Clarox is like, don't. It wasn't me. No, Clorax didn't do it. Clarks is like, fuck y'all. No, it wasn't Clorox. No, it was not Clarks. I used Clorox to disinfect my entire fucking home. Clarks, we love you. Sponser us. Clocks, come on the pod. You're invited.

Oh, man. That's a crazy-ass case. Isn't that crazy? This was just like, every once in a while we like to throw a weird fucking history thing in there, like some weird illness or something, just to like shake it up a little. Anything that falls under the morbid umbrella. Anything that's morbid and bizarre. Yeah.

Every once in a while, we got to throw a curveball. And this one just like really fast. It's fascinating. Dave was fascinated by this. I was fascinated by this. Well, because it's just so crazy that we've never figured it out. That's the thing. Like, we figured out a lot. And then it was like concurrently running when like the Spanish flu was happening. So it got kind of buried under those. What if it was like man made by like some chemist? Maybe. And like got out. Who knows? Who knows? Who knows? Not me. Not me. Not me. But yeah. If you guys ever want us to cover something that like you like something similar to this that like you feel falls under the morbid umbrella, send it in to morbid podcast at gmail.com with like, um, unconventional morbid idea. Yeah. Because you know we don't do these often. Like we try to, you know, we mostly do true crime. But they're really fun to sprinkle in. But every once in a while,

it's fun to like give you guys a little like, huh. Yeah. That was weird and interesting kind of thing. And we could always throw it like, you know, we have that bonus episode to play with it. So we could always throw it over there if it's not everybody's thing. So if you got weird bizarre, history things, science things, medical things that you would just really love to hear a discussion about and a deep dive in. Throw it our way. We'd love to do stuff like that. morbid finds. Yeah, the more the merrier. All right, let's find a weird fact to finish this off. Oh, yeah. I think it's your turn. The word pothole, it's a redundant term because pot comes from the middle English word pit, meaning hole. So a pothole is a whole hole hole. A hole hole. I'm only going to

be calling them hole holes for one on. God damn, well, he's filling that hole hole hole. God damn, and Massachusetts is full of hole holes. So, hole holes everywhere. Holes in your hair. All kinds of holes. I like that. That is a fun fact. A whole hole. with that. We hope you keep listening. And we hope you keep it weird. But that's so weird that you don't keep it real sexy in here. It drives slow over holes and cover your mouth when you got. Avoid them.