Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Cabin Fever

Episode Date: May 8, 2020

Did you know that cabin fever isn't just the cooped-up funk we all find ourselves in? It's a real actual disease called typhus -- or at least, it used to be. It's confusing, we know, but this week we're gonna walk you through all the extremely gross details.Music: "Medicines" by The Taxpayers 

Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, of misguided medicine. for the mouth. Hello everybody and welcome to Saul Bones, a marital tour of misguided medicine.

I'm your co-host Justin McRoy. And I'm Sydney McRoy. You're just looking at me. You look disappointed. Go look disappointed. Yeah. I don't mean to have that. You had a disappointed face.

I was going through very neutral. Oh, I thought that I thought that was intentional. No, I want to be open to whatever you got for me. I don't know what sort of challenging new information about the coronavirus. I'm going to be asked a process today. So I just want to be a blank canvas on which you can pay your masterpiece. No, I thought maybe you saw the first line of my outline, my first order of business before I get into. Oh, yeah. Before we start recording, Sidney said, I said, how do you want to lead into this episode? She said, well, first I have to apologize to Sweden. So Sidney.

And the first line of my outline says, first apologize to Sweden. Just I wasn't going to forget, but I like to. So what do you want to apologize for? I like to have everything in there. First of all, I'm thrilled that we have so many listeners from Sweden. Thank you, all of you, for listening to our show. Every few hours in the Macroi household for the past week, I just hear this refrain from somewhere in the house. It's another email from Sweden. It's another email from Sweden. Either we have a huge listener base in Sweden or our smallest from Sweden is very vocal. Strangely vocal.

Either way, last week on the show, I made the comment that Sweden was not practicing social distancing, which I will clarify was not just based on the ridiculous video that we were talking about. It was based on multiple other American news outlets that I had read while I was researching this episode. However, as our Swedish listeners have informed me, Sweden is not, they are not mandated by their government. They're not enforcing social distancing, but they are indeed practicing social distancing

because the government suggested it and they are doing so. So while in the US, it was a federally mandated and then locally mandated at state level and county level and city level, various levels of government mandated different types of social distancing. In Sweden, it was recommendations and then I think on like private individual, private businesses, their decisions to do these things. But the Swedish people are indeed practicing social distancing as they have made it very clear to me.

And I apologize for insinuating otherwise. I mean, so long. Well, what I would say is that I admire and I am envious of a country where you have so much faith in your leaders that they will recommend that you do something and people will actually do it, whereas I don't know what that's like now. Yeah, must be nice. I did know what that was like at some point in my past, but not now. But I apologize for insinuating that you were not practicing social distancing.

Sweden, I realize you are. It is just not government mandated. And I hope that you will all be well and farewell throughout this difficult time. And my, as is my hope for all of the world. And lay down your arms and stop emailing us. Please don't be mad at me. Some day when it is safe, and we're all vaccinated and no one will give each other any infectious diseases, we will come to Sweden and make amends. I will come bearing gifts of pepperoni rolls. That's our local delicacy,

straight from West Virginia to you. But Sydney, we're not going to talk about Sweden this week. Is that correct? No, I'm not going to talk about Sweden anymore and I'm not going to talk about COVID this week. Cause I need a break. Okay. I think you all need a break too.

What I did wanna talk about was cabin fever. And I know that sounds related because I think we may all be experiencing a little bit of cabin fever. Would you say that's true? Yes, yes. I, yes. In the colloquial sense. Yes, I didn't know there was a non coll of cabin fever. Would you say that's true? Yes, yes. Ah, yes. In the colloquial sense.

Yes, I didn't know that was a non-colloquial sense. I just assumed it was like spring fever, you know what I mean? Or you're just like, woo, getting a little so wild. All right, spring fever is very different from cabin fever. No, I just think it's another fake fever. It's like spring fever is like, oh my gosh, the temperature is changing, my hormones. Bada-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da-da- local bad boy, kind of wild man. No, you say it. I guess I never really thought about that way, but I guess that's true. That's not true. I knew you at 20.

Cabin fever in the sense that we are all experiencing it, or many of us probably are. I will discuss briefly at the end of the show because there's some helpful tips out there that are very serious and not at all jokes that I think could be. I know we're helpful for me to read. But I wanted, as I was researching, because I looked into this, I was like, well, as cabin fever, first of all,

it's not a diagnosis in that sense. It's just kind of like you said, just a thing we call something. I don't like being stuck in the house. I have cabin fever. But cabin fever did use to refer to something else before people started being locked in cabins. And that was typhus. So I wanted to take a diversion from our current infectious disease to talk about an infectious disease that is

largely historical these days, although it still occurs, it is largely a historical disease typhus. Do you know much about typhus? The literally, is it related to typhoid Mary? Nope. Okay, then no, I don't know anything about typhus. Well, actually I do. I know that it was the disease that originally cabin fever was based on. That is what you know now.

It is an adaptation of the novel. Camphee was an adaptation of the novel Typhus by Sapphire. No. Okay. But, you know, it's funny that you say that. I was, that is part of my problem when it comes to Typhus. I start, I always start getting things confused because one is we'll get into there are several different kinds of typhus and two, it sounds like typhoid.

Yeah, confusing. And not only am I confused as a modern day medical professional, but all throughout history, the two would get like kind of overlapped and we're, you know, there are times where we have like historical descriptions of something and the question is was it Typhus or was it Typhoid? Because there are some similarities, although some distinct differences, it's hard to tell throughout history. And they're not related. No. Great. They're not related. That's a bad job for me all. If I may say, if I'm going to be so bold. The the name Typhus the

Antifoy that that term that root is from the Greek for smoke Which I believe was a reference to like the confusion that could occur like the Delirium the Lost in a haze lost in a fog kind of feeling to smoke Mm-hmm. So that is that is where the root of this comes from, but they're very different. There are three types of typhus, and I want to briefly mention each one before I focus on epidemic typhus, because it is the most interesting, I think, from a historical perspective. First of all, there's something called scrub typhus, which I think the most interesting bit about scrub typhus

is that the bacteria that causes it is called orincia tutu gamushi. This is a good name. Which is a good name for a bacteria. It is spread by getting bit by a chigger, which is a larval mite. I just assumed it was spread by hanging out the side of your best friend ride trying to holler at me

Is that what you thought? That we thought about scrub typhus yeah, so it it occurs In many different parts of the world Southeast Asia Indonesia China Japan India Northern Australia But it is not again. It is not the one I want to focus on. I want to mention two muring typhus, or sometimes called endemic typhus. It is a different bacteria called ricketsia typhi. Typhus typhi, always like when it pairs up that way, but don't get confused,

because there are other typhus that aren't typhi. I know, I know. And it is spread from fleas that are on animals to humans. Okay. And I think this is an interesting bit about how does it get from the flea to the human? What would you assume? That you pet the animal and then it jumps on your hand.

But then how does the bacteria get out of the flea and N2U? It bites you. See, that's what people think. It's so much closer than that. Cool, good. And I want to go ahead and explain that with mirroring typhus because this is going to be true about the last typhus that we will focus on. So the flea will bite you, because that's what fleas do. Fleas, you got to flee. But the ricketsia typhy is not going to get from the flea to you through that bite. What's going

to happen is the reason the bite is important is that you've now you've got a little abrasion, a break in the skin, right? You've got a wound, a small wound, but a wound. Over time, that flea is going to poop. And the bacteria is in the poop. Oh, man. And it's going to get into that wound. And that is how you get infected. Are you telling me it's going to alternatively, I guess you could like crush the flee against your arm and smush its body into the wound. That would work too. Are you telling me it's gonna poop and the poop's gonna, it's gonna bite me and then the poop's gonna get in the by hole?

Yes. I can't calm my whole life. I made it 39 glorious years without this information. Can you imagine, we'll get into a little bit of how people found how people think. Can I imagine anything'll get into a little bit of the how people found how people can imagine anything else is the question. Can you imagine the first researcher because you know the way that this worked is somebody said well it's transmitted from the fleece so the flee must bite you and give it to you and then

there is the first guy who is like excuse me actually, it's way nasty. It dookies in the bite hole. So the other thing, the other method, I don't know if this is more appealing, less appealing to you. And this again, this is true. This can be true of a lot of different infectious diseases. We think a lot about like the flea is on you, the poop is on you, rub it in the wound,

there you go, you got it. But imagine like these droppings are very small. And so if you like shake out like a bed sheet that's been infested or something like that, you could just like spray what the CDC likes to, I think very cheekily call flea dirt. Flea dirt. It's a little charming, you can even amism. So you could just kind of like send flea dirt sailing into the air. Don't call it dirt, don't buy into their eyes. And then it lands on your mucus membranes like on your eyes or perhaps your mouth that

is open at that moment. This type of typhus, mirroring typhus, it can occur anywhere, especially places where humans have close contact with animals, so specifically rats. So if there are rats, there are fleas, they could have typhus and they could give it to humans if everybody's kind of smushed in together. So anywhere in the world that can happen. But the one that I want to focus the most on is epidemic typhus. And that is caused by an organism called Riketsia Proud Chechi. And this is, like I said, this is the one that I personally think is really interesting

because we have had big outbreaks of it throughout history and it has, it used to do a lot more damage to the human race than it louse. Did you know that about humans? No, I didn't know that. We have our very own louse, the human louse, the human body louse, ridiculous, humanist, corpus. That's our very own human body louse. We are the one, we are its hosts, it likes us, it's we are its favorite place to live.

You may well, I am not ashamed to admit I have come in contact with its very very very close relative ridiculous humanist capitus. You know the capitus refers to no your head headlice headlice It is very very closely related to headlice. Great. Which... Another cool, just cool thing. I, well again, a lot of us have had. There is no shame. I had it when I was younger.

I am not. I was very lucky that I did not have to cut my hair. I was able to just treat it. The other kids kept their distance from me. I never got it. I was a recluse. Oh yeah. Our whole kindergarten got it.

Bad boy. Well, it was a bad boy. I like to read super fun, by myself in a corner. So I didn't get a lot of the life. Did you find anything in school simultaneously more like soothing and nerve-wracking at the exact same moment than when they did the headlice checks. I'm just realizing I don't think I was checked. I may have just already been through. Did you never have a headlice check?

I don't know. If I did, it didn't make a big impression on me. Maybe I'll stick that day. See, with your, with your penchant for ASMR, I feel like you'd remember it because they would take, at least at my school, they would take this really long thin like stick like dowrod type thing and like part your hair slowly to look through your hair. Super don't remember ever doing that. Really? Never. They would do that at my school. Was your school the dirty one that I heard everybody talk about? That is exactly the kind of connotation that's not fair. You're right. Lice can get anybody.

Lice can get anybody. We're not talking about Lice. We're talking about our own private concierge louse for our species. I mean, oh, okay. Is it just people saying you're wrong? If I'm saying you're wrong the whole time? No, I'm gonna say a single louse or plural lice.

All your kidding, baby. Did you? Hahaha. Wow. How did you know? So you're mocking me now? You're mocking me now? I thought I made that clear. Yes, there's the body, there are body lice and there are head lice and a lot of us have

had head lice. Most of us have not had body lice. Some people have. Okay. Do you want to talk about body lice? Do you want to talk about some things that you don't know about that I do that I can maybe scoff at you about? I just, okay, sorry.

I apologize. Do you apologize? I do. Okay. So I am not going to talk about ridiculous humanist capitals, which is headlice. I'm going to talk about ridiculous humanist corporus, which is bodylice, and the bacteria

that they can transmit, Riketsiaparalchekki, which causes epidemic typhus. Did I make that clear? Yes. It's a lot, right? There's a lot of words and a lot of different levels of this. So the exposure root is the same as with the fleas

that we talked about that was so gross. The louse has the bacteria in it, and then it bites you and either poops and you get the poop in you or you smush it. A lot of times, like people will scratch and just kind of smash its body into the wound inadvertently. I mean, you're not trying to do that, but you do that and then you get it. You can also. You can also inhale it the same way, or like we've talked about it can land inside your nose or your mouth or your eyes. Another tour. Yeah, by all means, let's take another trip, not memory lane.

Well, imagine like, if it likes clothes, it likes layers of clothes, so like you take your jacket off and shake it or something, anyway, you can see where it could get in. What's interesting, I think, is that in a lot of these, like, bug-borne diseases, they don't kill the bug, Typhus does kill the mouse.. Like it's not just a carrier, it's gonna get rid of the louse, just like it's gonna hurt the human.

Just wants to bring down one of us with it. But what it'll do is it lives in the gut and eventually it'll cause the gut to rupture of the louse. They're gutter, are gut. They're gut. And just like in humans, it's bad if you're gut ruptures. It's bad if it allows us gut ruptures. That very pretty much any gut rupturing

across the animal kingdom is a bad time. It's a bad thing. And when that happens, the lousy will, like the blood will seep out of the lining of the gut and everything and just kind of fill the louse. If you look, if you're interested, you can Google picture of a louse. It's very small and kind of transparenty looking. And so you can see where if it filled with blood, it would turn red. Most of, I mean, like humans don't, but a lice, some, a louse does. Lice

do. So anyway, it will turn red. And so the other name of this disease was occasionally red louse. Oh, because they're awful with delicious blood. So anyway, it will turn red and so the other name of this disease was occasionally red louse. Oh, because they're all full of delicious blood. Yes, because of the typhus. The symptoms of all of these typhuses, typhy, typh... Typhy? Typhy.

Typhoid. No, not typhoid. Not something else. The symptoms are pretty similar, but we focus a lot on epidemic typhus because it tends to be the worst. It tends to be the one with the most severe complications. The others can, but this tends to be the bad one. And this is because one, you can have widespread outbreaks of this in crowded conditions and

to the complications can be really severe. So the symptoms that all tend to have in common are fever and chills and headache, body aches. There's a rash, like a red bumpy, we call macular, popular rash, that you can get from this, which helped denote this from other things throughout history. This is one of the ways we can look back and say, hey, they probably had typhus because of the rash. And then you can get nausea vomiting, you can get altered mental status, meaning like confusion. And severe cases, this can progress to seizures, jaundice, inflammation of your blood vessels

of vasculitis. You can go into a coma. You can die of epidemic typhus. And it has, it has unfortunately killed many Humans in some of these crowded situations throughout history You can't get it again Good But it can

Like recur in some people we found that some people will have it and survive it and then months or years later Have like a recurrence of it. Oh wow,. And that's called brills insur disease. And that's usually not as severe that second time around. Although it can spur another outbreak because you're contagious when you have the brills insur disease. So there have been times where that has been the reason there's been an outbreak somewhere. This is all interesting, but I don't understand the connection between cabin fuser and this. I'm going to talk about that.

I did want to reassure you we can treat this now. Oh, okay. Yes, but we don't see it much these days and we can treat it with doxycycline. Okay. So that's good to know. Well, that's good. And I'm going to talk about the connection between all this and crowded conditions. But first, let's go to the billing department.

Let's go. The medicines, the medicines that I skilled at my cards for the mouth. Okay, so I understand epidemic typhus as well as somewhat of my sort of base level intelligence can, but I don't understand the connection between that and Kevin Feaver. Well, so as I kind of alluded to, the type is itself is going to be spread the best when body lice can get around easily, right, from human to human. Body lice can't, they can't move very far very quickly. They're very small. They can get from human to human

and they will try to do that, especially if like you're really hot, not like in an attractiveness sense. Like you have a fever. They don't like that when you have the fever and they'll try to find someone who's cooler. But if you're sexy and have a fever, forget about their way out. But they are, and they also like clothing. They like to hide within layers of clothing, within folds of clothing. So you can see where, if you have just one person alone somewhere, that's a really hard way, like where is the allow us going to go. But, and this is, it's kind of interesting. This is a, kind of, a 180s to the louse gonna go? But, and this is kind of interesting. This is kind of a 180s to the way we think of cabin fever now, right?

Because a lot of cabin fever colloquially responds to it. It's about isolation. Yeah. Whereas this is really about, it's a fever that occurs because a bunch of people are stuck in a cabin together. It was also known sometimes as like jailhouse fever. That makes that's maybe clarifies it a bit better. Exactly. Anywhere, anywhere where people were crowded together for long periods of time, then you can get an outbreak of typhus because if people

are close together, you can see where the the lights can move from person to person much easier. Also, if it's a cold place where people would be wearing a lot of layers of clothing, and then you have to add in there like the inability to wash that clothing regularly, because if you're washing your body and your clothes regularly, you're not going to give the lifetime to do their thing. But if you are in a situation where hygiene is going to be an issue, people are stuck together a long periods of time, they're cold, they're dirty. This is where you're going to get the lice. And then you get an outbreak of typhus. Now, any time throughout history that that has happened, you may have had an outbreak of typhus. And like I said,

it's difficult to tell when we look into historical accounts of diseases. We've talked about on saw bones a lot. So many things are just called a fever. Right. And there are lots of things that cause a fever. It's debatable. Some people suggested was typhus, the plague of Athens, probably not. It doesn't really fit that description, but it could have been around since those days,

certainly. There's some debate, there's an account of a disease in 1083 in Spain that was thought, is that an outbreak of typhus, but it doesn't quite fit. There's some other things that might fit better. For sure we know that in the 1500s, Fracastoro, who was a doctor from Florence, described typhus. So we know that by then... It was... Another thing? Yes, it was a doctor from Florence described typhus. So we know that by then, it was a thing. Yes, it was a thing.

There were outbreaks of typhus. And a lot of it has to do with like that fever with the rash kind of thing. And then you combine that with like people living close together. Because you know, we're thinking about like jails or like wartime situations, which certainly are risks, but also just places where people live really close on top of each other and

where poverty is an issue. Because then you have that added layer of people who have to wear the same clothes a lot because they can't afford a lot of clothes and they don't have the ability to go wash their clothes easily. Right. So poverty definitely contributes to it as well. I feel like with all these diseases, there's always the debate,

like did it come from the old world to the new world or vice versa who brought it where? I mean, anything, we have accounts from the 1500s throughout Europe, so I feel bad. Probably, probably our bad or Europe's bad. But it's always that those things are always disputed, I feel like. But it wasn't until the 1800s that you really start

to see like typhus and typhoid really well distinguished, which I think is interesting because if you read the symptom, certainly like fever is there, but like with typhoid, you tend to have diarrhea and with typhus, you usually don't. And so I feel like that would have been a pretty obvious. Yeah, but I mean, it's hard, you know, we were so dumb. They can both have rashes, but they tend to be different rashes. I don't know, in retrospect, it's always easy, right? Of course, right.

In hindsight, what would mean to look at COVID right now? The spectrum of symptoms of that is all over the map and we still are having trouble here in incredible 2020, trying to pin that down. That's true. I think in the future, we'll probably be able to have a pretty defined case definition of what it looks like and what the less common presentations are. But yeah, it was hard for us to figure out. It wasn't until 1836 William Gerhard while studying an together in poverty. And if you look to like early American history,

a lot of these outbreaks actually occurred among immigrant populations because they would, like in New York or Philadelphia, they would move into a new area of the city and like because of poverty would be stuck kind of a lot of people living in a small space altogether. And then there was also thought that like perhaps it was coming with one person because it wasn't as frequent in that, you know, like was where we bringing it into the city that way. But the outbreak seemed to be kind of just focused on that one community, which again speaks

to like the poverty and the crowded conditions and all that kind of stuff. People who were living outside of it weren't exposed to that because of that. Anyway, so he was studying one of these outbreaks and he noticed that in typhoid fever, which is different, that's the thing we're not talking about. There is a very specific inflammation and ulceration of a part of the intestine called the pyres patches, which is just some lymphatic tissue that's in the elium. It doesn't matter. The point is this is very typical of typhoid, and all these patients that he was seeing did not have that on autopsy. We're all thought to have had typhoid, but they didn't have that.

And so it was typhus. And that was one of the ways. That's not a very helpful way if you think about it, since it's like a post mortem. You can't poke ground up there and just be like, let me check your pyres patches real quick. But it's always helpful to say like, now we know these are two distinct entities. And this is something else, and this is what it looks like.

And then you can start trying to pin down what might cause it. And by 1909, Charles Nicole at the Pasture Institute showed that the human body louse is the way that this is transmitted. We're able to this this typist thing, that is different than typhoid, it lives in this body louse and that's how people are getting it. And then you can start to make the connection between crowded living conditions and all that kind of thing. The Howard Ricketts, who we've, I haven't talked about Howard Ricketts. I don't recall if so.

I don't, yeah, I don't think we have a famous researcher did a lot, especially for injecting himself with things while he was studying them. But very, very smart found a lot of things out about epidemic typhus as well as Rocky Mountain Spotted Fever. He was studying the causative agent trying to figure that out about Typhus and actually died of Typhus while working with it and trying to figure this all out in 1910. But I mentioned him because he helped further that research and his name Ricketts, the organism, his name, Rickettsia Pralal Cheki, you probably see where I'm going with us. It wasn't until Enrique de Roca Lima described the actual organism and that would have been

in 1916 that we knew exactly what was causing typhus. So we knew it was the Laos and then this is the guy who figured out exactly what it was in the Laos that was spreading the the disease that was responsible for the disease. And the reason he named it, as you notice, his name is not in there anywhere. First of all, we already covered bacterial just Howard Ricketts, who helped further the study of it and tragically died of typephus, well investigating it. The Roca Lima worked with a guy named Stanislas von Proucheck, who helped him do his research into this. In 1914, they were both transferred to study a Typhus epidemic in Constantinople.

And the two were appointed because of World War One to fight typhus in a Russian prison camp. And while they were doing so, they both got sick. And Proudcheck died in 1915. So Rokalima got better and he continued to research Typhus because of all this. And he named it honor of the two men that died of Typhus. So that is why it's called Riketsiya Proud Cheki, which I think is a really nice, interesting history of the name of the disease. He didn't name it for himself, which I think is.

I never would. I don't understand these people that discover something terrible and they're like, it's Doug. And for the rest of the time, people have to be like, friggin' Doug, you got us again. I hate Doug. I wish there was a cure for Doug. Doug is incurable and fatal. To be fair, I think that you're a little bit shielded

because of scientific names, because outside of the science community, how many people call Typhus, Riketsia Prouchekki, as opposed to Typhus. Right, that's fair. That's, yes, okay, I guess. And so the only people who really know the name also would kind of think it was cool

to have a disease named after them. It's like people who think the Bobo Rylea is called Teenage teenage wasteland. It's the Venn diagram of people who want a disease named after them and who also know all the scientific names of the bacteria and whatnot that cause the diseases. It's a perfect circle. Got it. So we're fine. Anyway, so they've named it. that's good. I think that I wanted to make a brief mention of this research that was done to find this organism. I think it's a fascinating way to do the research. So they knew the body louse was transmitting it or they thought so. But in order to prove that, what they did

is they took some small flat boxes. They were described as like about the size of a pack of cigarettes. And you would put lice in the box and then cover one side of the box with just gauze. OK. OK. And so what that would allow is that the lice could like feed through the, through the

gauze. It was, it had enough holes in it that it could, they could eat through the gauze, but they couldn't get out. And so then what you would do is put the lice box on somebody with typhus. Okay. To make sure that you could infect the Lice with typhus. Okay. Okay.

And once you were sure that the Lice, you know, that they'd fed on the typhus patient for a while, and so you knew that they were probably infected with typhus, then you would have the Lice infect some guinea pigs, and then you could cut the guinea pigs open and look for typhus, then you would have the license infect some guinea pigs. And then you could cut the guinea pigs open and look for typhus. Great. Right all around. Great for everybody involved.

This gets even wilder when in 1920, there was a researcher, S. Bert Wolbach, who was studying a typhus outbreak in Poland. And they wanted a way to continue to expand the work on Typhus that had just been done by the scientists we mentioned and he knew about that method of you know the box and the gauze and the Typhus and all that and so what he thought was if I'm gonna do this experiment I need to make sure that I have some healthy lice because if you don't know if the lice are

already infected you can't prove things anyway so he had to get some healthy lice because if you don't know if the lice are already infected, you can't prove things anyway. So he had to get some healthy lice. So what he did was he got some some lice that he knew were healthy in North America before he traveled. I actually got him, I think he got him in Montreal and he put them in the box and put the gauze on them and strap them to his own leg and traveled with these lice on this transatlantic voyage. Oh my God. With these lice strapped his leg because that would keep them alive and he didn't have typhus so then they

weren't gonna get infected. So that's the that's how you keep them alive. So we kept them alive on himself. Do they know on him? Do they eat him? I mean, yeah, they bit him. Yeah. God, Sydney. Like long plane trips are bad enough, but you can't like watch Dumb O and drink enough ginger ale enough times to like forget that there's lice eating you. What about the VT's? You supposed to get up and walk around the plane with lice eating you? Do you want cookies or pretzels? It couldn't matter less. It was 1920. Yeah, it would be worse. They had to watch their original dumbbell.

So I just I think that that's fascinating. Never way to keep them alive. And you wouldn't get sick because they were healthy lights So you would just have some lights on you. I had a professor in college who used to keep Tony Alfungus all the time he wouldn't treat his toenail fungus so that he could show us his toenail fungus in class Stop it Stop what you're doing Finish your podcast Sydney. I'm so disappointed in you doing finish your podcast, Sydney. I'm so disappointed in you.

So there continue to be outbreaks as I kind of talk about, talked about, especially in as we look at like World War One and any kind of prison camps, refugee camps, that kind of thing, you would find outbreaks of it. It's interesting kind of just from a historical perspective to see like there were times where it what it should have been a big problem but it wasn't. I actually read a whole paper kind of studying like why this wasn't a huge scourge during the Civil, the American Civil War. Why? It should have been. Everybody was stuck together. There were crowded prison camps. People were you know dirty and you know definitely like living in close quarters and wearing the same clothes every day. It should have been a big problem,

but outside of a couple specific possible instances, it really wasn't a big problem, which is weird. Similarly in World War One, even though it was a huge problem on the Eastern Front, it wasn't a problem at all on the Western Front. Why? I don't know. It's a really interesting question as you look at the history of typhus and humans, because

all these people had lice. It wasn't a difference in whether or not they had lice. We look back and we know people were covered in body lice in all these cases. Everybody was very licy, but they didn't get typhus. I read some interesting theories. Could it be a fabric preference? Oh. Like wool over cotton or something.

There's never been proven or really looked into. And there's a lot of evidence that, I don't know, maybe not. There was an interesting thought that in that study that I talked about with a woolback when he carried the lice on his leg from Montreal. He wasn't really successful in once he got those lice into the lab and infected them with typhus and then tried to you know pass the typhus along and whatnot. He wasn't his experiments were not nearly as successful as the ones that Derokalima had done. And so there was a question like, I wonder why was there something with the methodology?

Because he followed the same methodology. He really tried to do the same thing they did. And part of the thought was, is there a difference between the laughs in different parts of the world? Are we not? Because we haven't looked, I mean like researchers don't think so, but have we really looked to see, are there slight differences in the North American body louse and the European body louse and one is better at transmitting the Rakesh. Yeah, I don't know. Anyway, there's all these interesting questions, but

one way or another, it seems to have fallen out as a huge problem for most of us these days. It is always a possibility anywhere where you are going to have humans living in crowded conditions, or being kept temporarily in a crowded, dirty place where they are not able to access regular hygiene or wash their clothes or change their clothes. Certainly, they're going to be at risk. Especially if people are already in those crowded conditions, so they're going to be at risk. And especially if people are already in those credit conditions, so they're suffering from other diseases

of like malnutrition or other communicable diseases, they're in like a weakened state too. So that could, that could also spread it. But anything like that, it's possible the body allows lives with us. It is our, we are its host. It is our, we are its host, it is our, you know. It's our friend, it's our constant companion. It is our companion. There was an isolated case of

this in West Virginia in 2002. All right. From it is thought a flying squirrel. That's so man. It can be transmitted by flying squirrels. Oh. and while the man didn't come in contact with a flying squirrel, he had just cleaned out his cabin, which was full of squirrel poop. And so perhaps when he was, as I said, like sweeping the floor, squirrel poop debris, as if as if flying squirrels weren't distressing enough. Yeah, so I could, I could catch typhus from a flying squirrel, and the fact that I saw a flying squirrel would still be the most distressing thing

that happened to me that day. Gear, like, absolutely. I'd rather catch typhus than see a flying squirrel. You still don't want typhus. Typhus's... Actually, their rat bodies just soaring at you with incredible grace and speed. Ugh.

Ugh. So worst. So typhus is still obviously bad, and we would rather not get it. The prevention is stuff you can imagine. Like there's not a vaccine, but they're- Destroy all flying squirrels. You can prevent Typhus by ensuring that humans

don't have to live in these inhumane conditions, or keeping them in inhumane camps, or settlements, or prisons, or things like that. Yeah. Allowing people to have access to their own living space, clean clothes, regular bathing and hygiene. If you can do those things, you can prevent the spread of typhus. And if somebody gets typhus, now we have doxycycline, you can treat it that way. And another great point about that to build on that is that the sky is the domain of the birds

and the squirrels presence there as an abomination is just to build on kind of what you were saying. Right, that has everything to do with what I was saying. Probably great. The cabin fever that, woof, the cabin fever we have, you have I have maybe, is really like I said, the colloquial term probably started with like the settlers on the Great Plains who would like build a cabin

and then have to set out the winter alone or just like the two of them or whatever. Yeah. I mean, there was no TV. There were no podcasts. What did they do? Not a single injury. And, you know, you're probably having a lot of these symptoms. You're feeling restless, you're feeling sad or depressed,

lethargic, you have trouble concentrating, no patience. White, hurry it up. Food cravings. Oh yeah. No motivation, difficulty getting up or napping all the time. Sleep disturbances, you're starting to feel hopeless. Your weight might be changing in either direction and you're having trouble coping with stress. Wow, 100%.

So I think a lot of us are feeling that right now and that's hard and that can certainly in some people who already have maybe a mental health diagnosis that can be even more difficult, even more stressful. Some strategies which you probably, if you were suffering from many of these things, you may have already sought these out, but just in case you haven't, some things that are friendly neighborhood therapists or psychologists might recommend. One is to have a routine which seems obvious, but it's important. Right now it can feel like a weird vacation, not a vacation, but like there are aspects of it that seem vacation-y.

Because of that you'll have a tendency to just free-form it, and that's not as good for our brains. If you can have a tendency to just free form it. And that's not as good for our brains. So if you can have a routine that's better. Structure. Move about your space as much as you can. I saw that much maligned article about how you should just move into your guest room right now, and then it'll feel like you're at a hotel or whatever.

Everybody's got one of those. Right, that's not great advice for a lot of people. Don't have guest rooms. Or, you know, that's all somebody to say. I'll just sleep in the guest quarters for the East Wing or whatever. Anyway, so move about your space as much you can or like change things up.

It might be a good time to rearrange a room, redecorate a wall, move the pictures around, anything like that can at least, you know, give your brain something different, can help like that. As much as you can stay active is good. So physical activity is important. I've been doing these kid workout videos

and yoga videos with the girls that Justin actually found on YouTube. And they're just fun little workout videos that you don't have to have a lot of space to do. And if you have any way to watch a YouTube video, you can watch them they're just fun little workout videos that you don't have to have a lot of space to do and if you have Anyway to watch a YouTube video you can watch them. They're free and those can be fun things to do mentally active Listen to music readable podcasts listen to a podcast Whatever something to keep your brain active do a crossword puzzle do a puzzle my mom's all about puzzles these days do a puzzle

Connect with people, of course. I think we've all heard that a lot. Connect with people via phone, FaceTime, Zoom, whatever, whatever your chosen mode of communication is. Connect with others as much as you can. And the last point I saw somebody mention and I thought was really helpful is embrace discomfort. Right now, you're not going to feel, I think, or at least for me, I would say, as completely

fulfilled by certain activities as I did previously when I was able to go out into the world and travel and like in my job, like see patients in person and actually examine them and all those things. And that's normal. We're all feeling that. And if you, I think that cognitive dissonance between trying to achieve that same level of satisfaction as you had previously and what you're able to do right now can be very distressing. And if you just accept that right now, it's a little uncomfortable, or a lot uncomfortable. That can provide some relief. And then if it doesn't, seek help.

Seek help, ask others for help, reach out, talk to people, don't be quiet about it. Just some things that you can do to help mitigate the symptoms of cabin fever. But that embraced discomfort really spoke to me. Yeah. We, hopefully, we've helped you just forget about this comfort for 45 minutes or so, except for what I would say.

The parts where my wife tried to actively create more discomfort in your existence. So I am sorry for that. I just wanted you to be thankful that you don't have typhus. That we know of. You probably don't. I did want to address really quickly because we got the other than all the emails from our Swedish listeners, just thank you and I'm sorry. We also got a lot of emails, a lot, a lot of emails, requesting that we talk about plannedemic, that conspiracy theory, ridiculous movie thing

that I think has already been pulled from YouTube, because it's spreading a bunch of lies and it's dangerous public health. I haven't, I just couldn't this week. I will, I'm aware, I know it's out there. I know I know that it is important right now to combat misinformation and the spread thereof, but I did at least want to address that. You don't need to email it to us.

Well, no, not that, but that I was aware that it was a problem and that it is out there and that yes, I fully support that this is a complete load of bull crap and not something that should inform your opinion about current events or how you should move forward in the world of science and medicine. Folks, thank you so much for listening to our podcast. We hope you enjoyed yourself.

Thanks to the taxpayers for these Thurson Medicines as the intro and outro of our program. Thanks to the maximum fun network for having us as a part of their podcasting family. And thanks to you for listening. We really appreciate it. We will be with you again next week until then my name is Justin McRoy. I'm Sydney McRoy. And as always, don't drill a hole in your head. Alright!

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