An Epidemic in the Works

Abstract

On the morning of May 21, 1979, in an elementary school in Norwood, Mass., a sixth-grade boy became ill and fainted. The entire student body had gathered for the final general assembly of the year, and within a few minutes the illness spread to a few other children in the vicinity of the sick boy. Within a short time one-third of the students in the school became ill, and it became apparent to school officials that they were dealing with an epidemic: in the end, 34 severely ill children were hospitalized, and another 40 to 50 were treated on the school grounds. Despite the rapid and general spread of the illness, the symptoms disappeared fairly quickly, and in the end everyone recovered fully. Public health officials began their routine investigation, looking for sources of contagion in the water supply, the food, the ventilation system. As they did, two psychiatrists began an investigation of their own, looking for the source of contagion in the minds of the stricken children. While the health officials came up empty handed, psychiatrists Gary W Small and Armand M. Nicholi Jr. of Harvard University Medical School were intrigued by certain features of the epidemic. Most of the victims were girls. The predominant symptoms were dizziness and hyperventilation, accompanied in many cases by headaches, chills, nausea and stomach pain. And the epidemic was completely benign. In short, the incident had all the characteristics of epidemic hysteria. Epidemic or mass hysteria is a medical anomaly. According to the scant medical literature, the victims of mass hysteriamostly females suffer from no known organic illness, yet they show the physical symptoms of illness. The symptoms, presumably psychological in origin, spread in epidemic fashion throughout the social group usually accompanied by highly charged emotions. Although the symptoms generally pass quickly, relapses are common. Although epidemics of hysteria seem to be rare, they have an ancient history. The word hysteria derives from the Greek for uterus, reflecting the once popular medical notion that emotional disturbances were caused by a wandering womb. According to Small (now at the University of California at Los Angeles), the earliest known occurrences of epidemic hysteria were in medieval Italy, where outbreaks of tarantism or dancing mania were fairly common. Particularly in the summer, people would flock into the streets, dancing maniacally until, exhausted, they collapsed. Dancing manias were reported in other European cities as well, and it has been suggested that such hysterical outbreaks were related to apprehension about the plague, which at the time was threatening all of Europe. The diagnosis of individual hysteria was quite common during the 19th century, and although the latest diagnostic manual has renamed it conversion disorder, the meaning remains fundamentally the same: the expression of psychological conflict or need through physical symptoms hysterical blindness, paralysis or pregnancy, for example. Mass hysteria, though clearly akin to individual hysteria, is something more than a concatenation of individual pathologies, experts say; it is instead a social phenomenon involving functioning and otherwise psychologically normal people. If the concept is resisted by many in the medical and psychiatric fields, it is at least in part because of its extreme cases, which have all the trappings of demonic possession.