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Let's Dance: the Strasbourg Dancing Delirium

No, we're not talking about the David Bowie song here (though the song is now stuck in my head.... "Put on your red shoes and dance the blues...")

We're talking about the mysterious Dancing Delirium that affected and infected Strasbourg, France in 1518.

First a little context about what was happening in 1518.

King Henry VIII was king of England and Catherine of Aragon was struggling with providing an heir after multiple stillborn babies. Francis I was on France’s throne where Anne Boleyn was maid of honor to his first wife, Queen Claude. He was prodigious patron of the French Renaissance by working with great Italian artists such as Leonardo da Vinci and acquiring Mona Lisa. In Germany, where Anna of Cleves (later to marry King Henry in 1540) was still just a toddler, Charles V, nephew of Catherine of Aragon, reigned. It was an age of kings and queens and dynasties, a time of great exploration and when human knowledge, philosophy, and art reached its height in the Renaissance.

It was a also a time of mass psychosis from July to September in 1518 in the quaint town of Strasbourg on the border of France and Germany when a dancing mania broke out among the citizens. It’s the very thing that would strike fear into the hearts of the adults in Elmore City in the movie Footloose.

Apparently, the mania began with Mrs. Troffea when she began slowly Dancing in the Street—except she didn’t stop. Within the week over thirty more people joined her. The priests and religious community were consulted to see if this were a matter of spiritual concern.

The officials and nobles were relieved to hear that the dance mania was likely not the result of supernatural influence. Nevertheless, they wanted a solution. So, they turned to reputable physicians who concurred that the common treatment of bloodletting would likely not cure the dancing disease. In fact, they recommended more dancing since the dancing obsession was attributed to the hot blood of the dancers instead of an imbalance of humors.

In medieval society, the medical community believed four humors existed in each human body: phlegmatic, sanguine, choleric (yellow bile), melancholic (black bile) which corresponded to four temperaments, elements (air, fire, water, earth), seasons, phases of life, air quality (hot, cold, dry, humid), and the astrological signs.

Since bloodletting only served to rebalance one’s humors, the doctors believed the dancers' “hot blood” could be cured by exhausting the unbalanced humor. In order to speed along the process of fatiguing the dancers, a stage was constructed and professional musicians were brought in.

By August 1518, the number of dancers, made up primarily of women, grew to over four hundred. Supposedly, up to fifteen victims per day died from exhaustion, heart attack, stroke, and other deadly causes resulting from the constant physical exertion. Though there’s no official count of the death toll, legend has it that about four hundred people died of dance.

However, controversy exists over whether people danced to their deaths. Some sources claim that the plague killed around fifteen people per day, but the sources from the city of Strasbourg during the event don’t mention the number of deaths, or even if there were fatalities. So far, historians haven’t found any contemporaneous sources that note any fatalities.

John Waller, who has written several journal articles on the subject, and the book A Time to Dance, a Time to Die: The Extraordinary Story of the Dancing Plague of 1518 says that sources citing dancing to death come from later accounts of the events. Therefore, it’s likely that exaggeration and mistaken memory over the years played a part in forming the legend. There is also uncertainty around the identity of the initial dancer and the number of dancers involved (somewhere between 50 and 400). Of the six chronicled accounts, four support Mrs. Troffea as the first dancer.

Regardless of how it began or how many were involved, the outbreak began to subside by early September.

But what caused the Dancing Delirium of 1518?

The exact cause isn’t known, but it’s believed that ergotism (one of the suspected culprits behind the Salem Witch hunt) is the most likely cause. Ergotism is caused by the consumption of rye infected with the ergot fungus. Unbeknownst to the citizens of Strasbourg, infected rye was harvested, ground into flour, then baked into bread. When people consumed the infected bread, they become ill. Alkaloids in the ergot fungus contain lysergic acid, similar to that found in LSD.

The main strands of the disease are what’s known as St. Anthony’s Fire which causes gangrene or St. Vitus’ Dance / St. John’s Dance, which causes convulsions and hallucinations.

It should be noted that St. Vitus’ Dance is now more often associated with Sydenham chorea, which causes uncontrollable movements of the hands, arms, shoulders, face, legs, and trunk. They look like twitches and disappear during sleep; whereas, St. John’s Dance is now usually considered a a form of a nervous system disorder, called apraxia, which causes confusion in using limbs appropriately or in recalling how to perform other motor skills like blowing out a match, using tools or instruments, or the order of processes.

Convulsive ergotism initially manifests as heaviness in the limbs and head associated with diarrhea. As the illness progresses, symptoms include the pins and needles feeling of limbs falling asleep. As the disease worsens, the victim could experience opisthotonus, which is a spasm of the muscles causing backward arching of the head, neck, and spine, or status epilepticus, which is a seizure lasting longer than five minutes.

The convulsive form of the ergotism known as St. Vitus’ Dance or St. John’s Dance became associated with the illness because St. Vitus of Sicily (c.290-303) is the patron saint of dancers and actors. He is known for having converted to Christianity at an early age and successfully exorcising Emperor Diocletian’s son of an evil spirit. When Vitus refused to sacrifice to the pagan gods, his cure of the emperor’s son was attributed to sorcery and he, along with his tutor and the tutor’s wife, were subjected to various tortures, including a cauldron of molten lead, from which they emerged unscathed. They were also thrown into the den of a hungry lion where the beast merely licked Vitus affectionately.

In the Middle Ages, 10% to 20% of patients died from severe convulsive ergotism. If patients recovered they were often left with dementia or delirium. A relatively recent account of convulsive ergotism comes from Pont Saint Esprit, France, in 1951. One in 20 of the small village inhabitants experienced hallucinations, convulsions, and burning sensations in their limbs. The illness left many of the villagers running mad in the streets. The cause of the villagers’ “madness” was diagnosed as ergotism caused by bread made with fungus-contaminated rye. (This sounds interesting enough to write about in another blog post!)

Historically, gangrenous ergotism, a.k.a. St. Anthony’s Fire, began with mild limb pain followed by burning pain shooting through the affected limbs. As the disease progressed, the limbs became numb. In time, the tissues darkened until they turned black, resembling charcoal and appearing as if they had been burned by fire. Often the limbs would all off completely without pain or bleeding.

The connection between ergotism and St. Anthony began in the late 11th century. The Hospital Brothers of St. Anthony, or Antonines, were a Roman Catholic order founded for the purpose of treating St. Anthony’s Fire. The hospital was found by nobleman Gaston of Valloire after his son’s miraculous cure from St. Anthony’s Fire by praying to the relics of Saint Anthony the Great.

St. Anthony was a 3rd Century Egyptian ascetic (c. 251-356) who lived by the Red Sea and was known for long fasting in which he confronted terrible visions and temptations sent from the Devil. Anthony was a popular subject for art in the Middle Ages and his symbol is a large blue "T" sewn onto the shoulder of the order's monks, symbolizing the crutch used by the ill and injured. Though many patients died at the hospital, the survivors experienced “miracle cures” in spite of losing limbs.

Interestingly, St. Anthony’s Fire, the ergotism that causes gangrene, was usually found west of the Rhine River whereas St. Vitus’ Dance more commonly appeared east of the Rhine River.

Events similar to this are said to have occurred throughout the medieval age including 11th century in Kölbigk Saxony, where it was believed to be the cause of demonic possession or divine judgment. In 15th century Apulia Italy, a woman was bitten by a tarantula, the venom caused her to dance convulsively. The only way to cure the bite was to ‘shimmy’ and to have the right sort of music available.

However, John Waller argues that the ergot poisoning is not likely, since those poisoned by ergot couldn’t have danced for days at a time. Nor would so many people have reacted to its psychotropic chemicals in the same way. Waller believes the ergotism theory also fails to explain why virtually every outbreak occurred somewhere along the Rhine and Moselle rivers, which are areas linked by water but with different climates and crops.

Another theory is that the dancing delirium was a psychogenic movement disorder occurring in a mass hysteria or mass psychogenic illness, which involves many individuals suddenly exhibiting the same bizarre behavior. The behavior spreads rapidly and broadly in an epidemic pattern. Such behavior could’ve been caused by heightened psychological stress, caused by the ruthless years the people of Alsace were suffering. Let’s face it, being a peasant in the Middle Ages was no cake walk. Peasants were oppressed by authoritarian monarchs, heavy taxes and poverty, failing crops, starvation, six days of exhausting manual labor, improper nutrition, high mortality, rampant disease caused by unsanitary living conditions, a lack of understanding about how disease spread, and lack of medical and scientific advances.

Seven other cases of dancing plague were reported in the same region during the medieval era. Similar manias took place in Switzerland, Germany and Holland, though few were as large as the one triggered in 1518.

Throughout the centuries there were other mass psychosis that spread through various populations. Here are some of the more interesting ones. I will likely write about a few of these in future blog posts because the concept of mass psychosis is strange and fascinating:

  • A nun who lived in a German convent in the 1400s began to bite her companions, the behavior soon spread through other convents in Germany, Holland, and Italy.

  • Obviously, the witch trials in the early modern period from 1450 to 1750 and especially from 1580 to 1630.

  • J. F. Hecker cites in his 1844 book, The Epidemics of the Middle Ages, an unnamed medical textbook, a nun who lived in a French convent during an unspecified time in the Middle Ages inexplicably began to meow like a cat, shortly leading the other nuns in the convent to meow as well. Eventually, all of the nuns in the convent would meow together for a certain period, leaving the surrounding community astonished. This did not stop until the police threatened to whip the nuns.

  • Irish Fright (1688): In England and parts of Wales in December 1688 during the Glorious Revolution, false reports that Irish soldiers were burning and massacring English towns prompted a mass panic in at least 19 counties, with thousands of people arming themselves and preparing to resist non-existent groups of marauding Irishmen.

  • Würzburg, Germany (1749): an outbreak of screaming, squirming, and trance in a nunnery led to the execution of a suspected witch.

  • Great Fear (1789): a general panic that took place between July 17 and August 3 at the start of the French Revolution.

When I read these accounts, I’m reminded of the stories emerging in the past few years of people (mostly young girls) who become convinced they’re cats or some other animal and behave and dress as such. It would seem we might be repeating history, proving the adage that there is nothing new under the sun.



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