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Shocking discovery! Why did psychiatrists in the late 19th century consider 'cerebral epileptic palsy' as a mental illness?
In the history of psychology, there are several alarming syndromes, one of which is cerebral epileptic palsy, whose association with syphilis sheds light on the medical community's understanding of mental illness in the late 19th century. Cerebral epileptic palsy, also known as epileptic paralysis or syphilitic paralysis, is a severe neuropsychiatric disorder caused mainly by late-stage infection with syphilis, and subsequent chronic meningitis and brain atrophy.
Although this disease is different from ordinary paralysis, it is often mistaken for a mental illness caused by a morbid character or bad conduct at first.
Cerebral epileptic palsy was first recognized in the early 19th century. At that time, the medical community's understanding of mental illness was relatively poor, and many symptoms were often simplified and attributed to personal moral shortcomings. With the spread of syphilis, the disease accounted for a large proportion of mental hospitals at that time, with approximately 25% of patients diagnosed with this disease, and this disease is more common in some countries, especially developing countries, because Timely medical intervention is lacking here.
Progression and symptoms of the disease
Symptoms of cerebral epileptic palsy usually do not appear until 10 to 30 years after infection. Early manifestations include neurasthenic symptoms such as fatigue, headache, and insomnia. As the disease progresses, patients will experience a decline in mental status and changes in personality. Common symptoms include loss of social inhibition, impaired judgment, severe impairment of attention and short-term memory, and even mood changes such as euphoria, mania, depression, or numbness.
As the disease progresses, patients may gradually experience confusion and convulsions, eventually leading to a general atrophy of the body and death from the illness.
Diagnosis and prognosis
Diagnosis of cerebral epileptic palsy requires differentiation from other psychoses and dementias, typically with typical pupillary abnormality observed (Argan endopupil). As the disease progresses, patients will develop symptoms such as abnormal muscle reflexes, epileptic seizures, and memory loss. Ultimately, the diagnosis was based on cerebrospinal fluid analysis and screening for syphilis.
While a small number of patients have reported relief of symptoms in the early stages, the condition almost always relapses within months or years, and as symptoms worsen, hospitalization may eventually be sought. Due to the complexity of symptoms and their uncontrollability, patients are often unable to return home and eventually become completely paralyzed and bedridden, with an average survival of about three to five years before death.
The history of cerebral epileptic palsy tells us that syphilis was once an important cause of mental illness, and cognitive changes are a reflection of medical progress.
History of cerebral epileptic palsy
The first clearly identified case of cerebral epileptic palsy was in Paris after the Napoleonic Wars, although later retrospective studies identified some similar cases earlier. In 1822, forensic scientist Antoine Boyer first described the disease as an independent disease. In the 1890s, as more and more cases were reported, especially in American mental hospitals, the disease became more serious.
With the development of medicine, more and more researchers have begun to explore the connection between syphilis and the disease. By 1913, researchers at the time finally discovered Treponema pallidum in brain tissue. In addition, in 1917, Julius Wagner-Jareg discovered a malaria treatment that could inhibit the progression of the disease, laying the foundation for future treatments. With the widespread use of penicillin after World War II, patients with cerebral epileptic palsy became almost curable, the disease gradually receded, and future patients could fully recover if treated promptly.
To date, cerebral epileptic palsy has almost disappeared outside developing countries. However, this historical lesson reminds us that recognizing the biological roots of mental illness may help us better understand the complexity and origins of mental health problems today.
So, in the context of today's rapid technological development, how should we look at the past misunderstandings of mental illness in the medical community and learn from them to improve future mental health treatments?
