Magic or Medicine?

Placebo (comes from Latin for ‘I will please’) is a simulated medical treatment with no therapeutic value, its purpose is to deceive the recipient and can merely affect the patients psychologically, however Placebo can often produce an actual improvement in their conditions. Is this magic or medicine?
  • In a recent study 50 percent of Parkinson's patients showed improved motor function after receiving a Placebo.
  • Psychiatric illness has among the highest rates of Placebo response - anywhere from 30 to 50 percent of the people in a depression medication study will respond to Placebo.
  • Placebo can keep heart failure patients alive. In a worldwide study with thousands of patients, those taking a Placebo regularly experienced similar reduced mortality as those taking a heart failure pill.
  • Placebo won't shrink a tumour or reduce a fever but they do affect pain, insomnia, anxiety, asthma, depression, irritable bowels and stomach ulcers (subjective symptoms).
  • You can even Placebo yourself into inebriation.   
     
     Sugar pills are one of the most common types of Placebo which are made completely identical to the real drug but contains basic ingredients such as sugar which will not physically help the patient in any ways. Other types of Placebo may contain some active ingredients however aren’t proven to work on the patient's particular condition. They would produce the same side effect as the real drug to the patient. Placebo treatments do not only come in the form of pills, they can be injections, creams, surgeries, drinks and other types of medical therapies. 97% of doctors in the UK has prescribed Placebo at least once in their career.

     New drugs are always tested against Placebo preparations as the control group in clinical trials in order to assess the efficiency of drug before it is marketed. When neither the patient nor the doctor is aware of which preparation an individual has been given this is called a ‘double blind trial’. A more realistic and accurate set of results can be obtained in this way.

The Placebo effect itself remains mysterious. Doctors still don’t fully understand how it operates and why its effect can be varied from large, small or non-existent for a given treatment or patient. It seems the power of Placebo increases when the size of the pill is bigger or there’s larger number of them. If someone believes the Placebo would have a negative effect, they can experience that negative effect. This is called a Nocebo.

Our minds tell us to believe a brand named drug works better than a generic drug; an expensive drug with good packing is better than a discount drug- even though the active ingredients are exactly the same and manufacturer is the only difference. A placebo injection has bigger effect than a placebo tablet- the appearance of drugs had almost as big an impact on health as whether the pills had any drug in them.


The scientists are faced with a paradox when it comes to the use of a Placebo. It is beneficial when it eases your pain from a migraine and helps you recover from depression or anxiety. It also has the advantage of producing fewer side effects.  However the biggest concern for the doctors is the act of having to deceive their patients. Patients should have the right to be honestly and fully informed about the treatments or medicines that they are taking. It is genuinely unethical for doctor to prescribe placebo to patients who are in a life or death situation as it cannot cure the illness, which effectively means the patients are sacrificing their safety for the investigation of new treatments.

Your brain has the power to generate effects in response to whatever it believes to be true. So the next time when you feel under weather, be positive and make the magic happen.











First Aid Fridays: Hyperventilation

Welcome to a new series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article each week explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that further training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.

This week's post is fairly short and basic however it features a condition which many of us are likely to come across - Hyperventilation. This condition often accompanies a panic attack and is likely to occur in vulnerable individuals who have recently experienced an emotional upset or have a history of panic attacks. Hyperventilation results in a dramatic reduction of carbon dioxide in the blood, causing the chemical composition of the blood to alter. You may have seen in films and programmes that some people use a brown paper bag to reverse the effects of hyperventilation however the DK First Aid manual does not promote this as these bags are not necessarily readily available.


Recognition Signs:

- Unnatural, fast breathing.
- Fast pulse rate.
- Apprehension.
- Attention Seeking behaviour.
- Dizziness and faintness.
- Tingling and cramps in the hands, feet and around the mouth.
- Trembling, sweating and a dry mouth.


Procedure:

  1. Encourage the casualty to sit down and relax. It is advised to move them to a quieter area if this is available - you should speak to the casualty calmly but forcefully.
  2. Explain to the casualty that they must regain control of their breathing in order to relieve the pain.
  3. Once the breathing has returned to normal, advise the casualty to seek medical attention for assistance in preventing and controlling future panic attacks.
Helping a casualty to control their breathing.
For more information, see page 99 in the DK First Aid manual.


Seeing Your GP Online

Doctors can now complete
video call consultations.
In some areas of the UK, you are now able to have an appointment with your GP over an online video call rather than having to visit the local medical centre. Using this technology has allowed the NHS to reduce costs as each GP can have more appointments per day, however this new scheme hasn't been plain sailing – the article below includes the controversial debate over this new scheme.

Initially, this new technological plan appears to be extremely beneficial as it will not only reduce costs to the NHS but it will also allow for more appointments per General Practitioner to be made. From my previous work experience at a local medical centre, I found that this was a critical aspect as it appeared to be a common occurrence across practices that there were not enough appointments for every patient to be seen (this is why the “Open Surgery” appointment style was introduced).

Not only this, but this scheme is also suitable for those patients who would normally struggle to get to a medical centre for an appointment – whether this be for mobility issues or whether they are bed stricken; using the video calls would allow GPs to speak to the patient without the need of transporting the patient. It could be argued that a visiting doctor could be sent to go and see the patient however this is not always practical and does cost the NHS a lot of money (whilst also losing a resource from the local medical centre).

Adding to the previous points, it can also be argued that this online video phone call is a much better substitute to the previously used voice phone calls; this is because using a video camera, the GP is now able to see an image of an injury/condition meaning that a more accurate diagnosis can be made. Making the correct diagnosis is essential otherwise patients can be given incorrect treatment.

Skype is the video call software many
GPs are opting for (it is a free software for all).
Opposing these views is another argument which features issues relating to patient and GP satisfaction. Firstly, it is argued that using this new system may be damaging to the NHS as the patient-doctor relationship could be weakened as the video call scheme is less personal. It is essential for patients to have a good relationship with their doctors in order for them to feel more comfortable and have a better patient experience with the NHS; without this strong relationship, patients may not be entirely honest with the doctor or could be less likely to visit the GP for advice.

Furthermore, this new scheme is reliant on patients having the required equipment (a computer, an internet connection and video camera) in order for them to do this; this is not entirely practical and could cause some patients to feel left out or discriminated – this is definitely not something that the NHS wants to promote as it is a service which provides equal treatment to all.

Finally, an aspect which I noticed whilst on my work placement is that health care staff can generally spot conditions/developing illnesses other than the ones which the patient has come in to see them about. For example, on my placement we had a patient who came in for an annual blood pressure check however whilst speaking to the patient, we soon realised that the patient had become hard-of-hearing. As a result of noticing this, an eye inspection was made and it was found that the patient was in a desperate need of an ear syringe due to a large build up of ear wax. The patient had not noticed this issue as it was a gradual effect however once it was syringed, they realised the significant impact that the wax had on their hearing. This is just one example of how an appointment for one condition can lead to a series of other illnesses – this is not necessarily noticeable over video calls as so many other factors are taking place. This is a serious point to analyse as spotting any developing conditions early can prevent further treatment being needed; as we all know, prevention is much better than treatment.


In conclusion, it is obvious that this is a highly controversial argument with multiple for and against arguments. Overall, I personally believe that this new scheme is ideal as it will reduce NHS costs however it must be refined in order for patient satisfaction to be maintained high; if this scheme is likely in ruin the experience for the patient, I would be strongly inclined to stop the scheme as this experience is essential. Furthermore, if this scheme were to operate, I would want to limit the number of video call appointments that could be made before a medical centre appointment were to be made; for example, I would limit 3 video call appointments per every medical centre appointment – this would be an attempt for developing conditions to not be missed by GPs.

What do you think about this scheme? Feel free to discuss ideas and opinions in the comments section.

Why Are Gay Men Banned From Donating Blood?

If you were to go on the NHS Choices website and go on to the 'Blood Donation - Who Can Donate?'
page, you will find a long list of reasons why a person may not be able to donate blood. These include:
  • People who have had acupuncture in the last four months.
  • People who have a sore throat 
  • People who have had sex with someone who has injected drugs in the last 12 months
  • Men who have had sex with other men in the last 12 months. (Men who have had sex with men are referred to as MSM in this article and in many official documents) 
All of these seem to be sensible restrictions as they increase the risk of someone catching an infection from a blood transfusion, but the last reason is certainly the most questionable. In 2011 a lifetime ban on MSM was lifted in favor of excluding only men who had had gay sex in the last 12 months. But requiring someone to be celibate for an entire year to give blood is a big ask.

The main reason for these regulations is that MSM have a much higher chance of catching HIV, AIDS and HBV (Hepatitis B Virus) among others - with gay news source 'pink news' reporting that HIV rates are as high as 1 in 20 in the UK.

But surely even if someone with an STD does donate blood this would still be detected as blood is so extensively screened for such diseases as HIV, Hepatitis B, Hepatitis C, Syphilis and HTLV (Human T-Lymphotropic Virus). Well, not always: there is a delay between someone acquiring a disease and the disease being detectable in blood tests, this is known as 'the window period.'

Does 'the window period' justify the harsh restrictions on men who have had sex with men? MSM are banned from donating up to 12 months after having sex, however the window period for HIV is approximately nine days long.

However despite many advances in blood testing, the tests are still fallible which is why the NHS has taken the decision to ban the donation of blood by men that have had sex with men in the past 12 months as well as banning other high risk groups: "Any transmission is one too many."

But is the NHS missing out on a potentially large source of blood by implementing this policy? The latest survey results say that 1.5% of men in the UK are homosexual, and 0.3% are bisexual, however results are expected to be much higher as 4.7% of people refused to answer the 2012 ONS survey. If this survey is accurate then at least 1,138,000 men in the UK are gay or bisexual; many of these people will be unable to donate blood due to possibly unnecessary restrictions.

For further reading on the subject:
http://www.blood.co.uk/resources/leaflets/men-who-have-sex-with-men/

For heavy reading on the subject:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/264413/SaBTO_Report_Tissues__cells_MSM_v3.pdf

What do you think about the policy? Feel free to discuss ideas and opinions in the comments section.

Testing Possible Ebola Treatments on Patients: Is This OK?

The Ebola Virus
Due to the severity of the recently discovered disease called Ebola, the World Health Organisation (WHO) has now permitted the use of experimental drugs on patients with the illness. Ebola Virus Disease is a human disease which is caused by an ebolavirus; the condition features a fever, headaches and muscle pains along with vomiting and diarrhoea. Following this fever, sufferers may also have reduced liver and kidney features - during this time period, the sufferer may also develop internal and external bleeding. So far, it has been reported that there are 2,473 suspected cases of Ebola with a death toll of 1,350.

Normally with new medications, the World Health Organisation states that the drugs should be tested on humans in multiple stages, beginning with a small number of healthy volunteers - this is to ensure that the drug is safe for human use. The following human tests then increase in sample size and finally are then tested on sufferers of the targeted condition; these multiple steps are in order to check the effectiveness of the drug as well as ensuring that it is safe to use, this is complying with the medical principle of 'do no harm'.

Internal and external bleeding as a
result of Ebola
As new drugs have to be extensively tested before they can be used, this can mean that medication can take many months to be tested. Due to the severity of Ebola and it's rate of spread, the World Health Organisation have allowed for the testing stages to be skipped and for the experimental drug to be given to the sufferers. This permission by the WHO has sparked a large ethical debate as conflicting views around the topic have been raised. Below we will be evaluating a few of these ideas.

Promoting the change of testing procedures for this drug are those who argue that without this, thousands of other people are left vulnerable to the virus and could add to the current death toll figures. This is believed to be true as the normal procedures for drug testing would result in the earliest medication being released during 2015 or possibly even 2016 - taking this long could allow for an epidemic to develop. Surely attempting to stop the spread of this virus is worth the gamble? Adding to this, some argue that the patients taking these medications would rather run the risk of having side effects from the experimental drugs if there is a possibility that the drugs will save their lives - this is entirely understandable however before this argument can be used, it should be checked whether this was a genuinely belief by the patient.

Quarantine has been set up in
locations where Ebola has broken out
Opposing this are those who believe that there are these guidelines set for a reason, they strongly believe that giving this experimental medication will not only endanger the patients, but it will also endanger the structure of testing future drugs before being released to the public domain - what if other manufacturers claim that their new drugs are for essential illnesses just like this? Shouldn't they be given the same treatment? Furthermore, people argue that it must be ensured that the patients are voluntarily accepting the experimental drugs and are not being forced to take them - this is a highly ethical section as the patient has a right to refuse treatment. If the patients are not volunteers, giving this treatment could be infringing their human rights.

Not only this, but it has also been shown that there are only a set number of experimental drugs made; the final batch of this drug has now been shipped away meaning that no further medication is currently available - this could appear to be a flaw with the system as it now means that some countries are not receiving the required medication, this could lead to the spread of infection growing vastly meaning that even more of the drugs will be required; this appears to be highly inefficient and is putting the populations at risk. Is it fair that some populations have been given the medication whilst others have been left without any?

Overall, making an ethical decision, I believe that the choice made by the World Health Organisation was a correct one to make as it is promoting the prevention of further spread of the disease - I agree with those who state that without this action, we could be at risk of an epidemic. However if I were part of the WHO, I would ensure that all patients formally agree to the medication before being given it - I would provide them with a document to sign declaring that they understand and accept that there may be side effects and that the drug may play no role in over coming the virus. Along with the signing of this document, I would ensure that a mental capacity test is conducted to make sure that the patient is able to make an informed decision; only once this has been completed would I allow the experimental drug to be prescribed to the patient. Following prescription of the medication, I would also conduct an on-going report of the patient's condition and general health; this would be in order to establish whether the drug has actually had an effect and whether we should continue to give other patients the drug - if no effect is found with multiple patients, I would be inclined to not want to continue prescribing this drug.



Sources:

- Ebola Virus description: http://en.wikipedia.org/wiki/Ebola_virus_disease#Treatment
- Ebola symptoms: http://mobile.nation.co.ke/news/WHO-permits-Ebola-patients-treated-/-/1950946/2418388/-/format/xhtml/-/mvnju3z/-/index.html
- Images: Search "Ebola" on Google Images.

The Significance of ALS and The 'Ice Bucket Challenge'

Even celebrities have joined in
on the challenge!
Recently, the 'Ice Bucket Challenge' has stormed social media sites in order to raise awareness of a disease known as ALS. The activity is pretty self explanatory: it is one which requires a nominee being given 24 hours to dump a bucket of iced water over their head whilst being videoed; and/or donating a sum of money to ALS Research charity. Although the task is entertaining for both the participant and audience involved, I believe that there is not enough explanation about the condition and its self which is acting as a motive behind these videos - therefore the majority of the public don't truly understand why raising awareness of the condition and donating money to this charity is so critical.

ALS can lead to paralysis.
ALS, short for Amyotrophic Lateral Sclerosis is also often known as 'Lou Gehrig's Disease'. It is a genetic degenerative disorder of the nervous system, similar to motor neurons disease, which inflicts irreversible damage to the motor neuron nerve cells and the spinal chord. The body contains millions of these nerve cells which connect the spinal chord to muscle fibres (also known as effectors) and they are responsible for transferring electrical impulses from the brain which travel down the spinal chord and into muscles all over the body in order to allow them to contract thus causing movement of limbs. ALS causes areas of muscle fibres and motor neurons to degenerate which inflict scarring of that region and is known as sclerosis. When this happens, the motor neurons are no longer able to transfer impulses to muscles fibres and movement can therefore no take place. Muscles in the arms and legs become noticeably more weak; speaking and swallowing require a considerably larger amount of effort during the early stages of ALS. As a result, muscle wastage known as 'atrophy' begins to set in, causing the patient's limbs to look thinner as the muscles are broken down. As the patient's condition worsens, they are left unable to walk, talk, eat or breathe on their own.

An MRI of a patient with ALS.
As previously mentioned, ALS is degenerative meaning that the sufferer gradually gets worse over time and it is impossible for them to get better. ALS results in total paralysis and eventually leads to the loss of the function of intercostal muscles between the ribs as well as the diaphragm - these combined will lead to suffocation and death. Patients survive on average three years once they have been diagnosed with the disease.

Why is the 'Ice Bucket Challenge' so significant? Currently there is no cure for ALS and only 30,000 people in the United States of America have the condition; this figure is even lower in Great Britain. As the condition is so rare, many people are completely unaware that ALS even exists and the US Government do not have a great enough incentive to invest millions of dollars into carrying out research with pharmaceutical companies in order to develop a drug which could potentially slow the degenerative process or even finding a cure for the patients who's symptoms are recognised early enough. Those who experience the agony of watching their loved ones' health deteriorating so rapidly or even suffering with the disease first hand believe that they are being denied the right to find a cure. By inventing an eye-catching and exciting challenge, the ALS Research Charity hopes that they can spread awareness of the disease and increase donations being given in order to have enough money to begin investing in extensive research into finally find a cure. They have already managed to raise $31 million with the 'Ice Bucket Challenge' alone and this is allowing them to become one step closer to achieving this dream and making it reality.


First Aid Fridays - Seizures In Adults

Welcome to a new series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article each week explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that further training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.

A seizure can also be known as a convulsion or a fit - the condition consists of involuntary contractions of many muscles in the body; this is as a result of a disturbance within the electrical activity of the brain. The most common cause of this disturbance is epilepsy however other causes can include head injuries, some brain damaging diseases, a shortage of oxygen to the brain or a lack of glucose to the brain. Some poisons, alcohol and drugs can also result in seizures.

Whatever the cause of the seizure, the main priorities are to maintain airways and monitor the casualty's vital signs. Adding to this, you should aim to protect the casualty from harm during their seizure - you can do this by clearing the surrounding area. Do not attempt to restrain the casualty as this can cause further injuries.


Recognition Signs:

- Sudden unconsciousness.
- A rigid stance with an arched back.
- Convulsive motions.

The following sequence is common for sufferers of an epileptic fit:
- Casualty suddenly loses consciousness.
- They become rigid and has an arched back.
- Breathing can become difficult (this can cause the casualty's neck become red and puffy).
- Convulsive movements (the jaw may be locked and breathing can be noisy).
- Saliva may appear around the mouth - it may be blood stained if the casualty has bitten their lip or tongue.
- Possible loss of bladder control.
- Muscles relax and the casualty regains consciousness (usually after a few minutes). The casualty may feel dazed and confused.
- After a seizure, the casualty may feel tired and fall into a deep sleep.


Procedure:

  1. Make space around the casualty and ask bystanders to step back. Remove any potentially dangerous items. Note the time of the first seizure (this may be required by the hospital and emergency medical services). Call for emergency medical assistance (by calling 999).
  2. Protect the casualties head from objects - you can place soft padding around the neck if possible. Loosen tight clothing around their neck.
  3. When the casualty's seizure has stopped, open their airways. If the casualty is breathing, place them in the recovery position.
  4. Monitor and record vital signs until medical assistance arrives.
Placing a casualty into the recovery position following a seizure.
For more information, read page 168 of the DK First Aid manual.


Video:
A British Red Cross video showing the procedure listed above.


First Aid Fridays: Splinters

Welcome to a new series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article each week explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that further training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.

A splinter can occur when a foreign material (such as wood, metal or glass) enters the skin. These materials can carry a risk of infection as they are often unclean and can carry bacteria on their surfaces. If the splinter is near the surface, it can often be removed however if it deeply embedded or is over a joint, you should leave it in place and seek medical assistance. For shallow splinters, the procedure below may be followed - the main area of concern regarding splinters is the risk of infection so all equipment used should be sterile.

Recognition Signs:

- A foreign object embedded into the skin.

Procedure:
  1. Clean around the area of the splinter using soap and water - do not apply pressure otherwise this could cause pain.
  2. Using sterile tweezers, grasp the splinter as close to the skin as possible. Holding the tweezers near the end will provide a better grip and control.
  3. Pull the splinter out in a straight line - completing the motion in this direction should prevent any further injury. Ensure that the splinter does not break.
  4. Gently squeeze the wound to encourage blood to flow - this should cause any remaining dirt to be flushed out.
  5. Clean and then dry the wound. Then apply a suitable dressing (such as a plaster).


A shallow splinter to the finger.

For more information, see page 202 in the DK First Aid manual.

First Aid Fridays: Asthma

Welcome to a new series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article each week explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that further training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.


An asthma attack can be triggered by a variety of irritants and can even begin suddenly. During an asthma attack, the muscles surrounding the bronchioles contract causing the airways to become narrowed. This makes breathing difficult and will result in the casualty increasing their breathing rate; to oppose this, many sufferers from asthma have their own inhalers - a reliever inhaler should be used in the case of an asthma attack; preventer inhalers should not be used during an asthma attack.

Recognition Signs:

- Difficulty with breathing
- Wheezing
- Difficulty with speaking due to a shortage of breathe
- Coughing
- Distressed and anxiety
- Grey-blue colour to the lips (cyanosis)
- Exhaustion in a severe attack as the increased breathing rate uses more energy as muscles have to contract more.

Procedure:
  1. Keep calm and reassure the casualty constantly. If they carry a reliever inhaler, encourage them to take a puff of it. If a spacer is available, use this as it will increase the amount of medication which is likely to enter the lungs.
  2. Encourage the casualty to breathe slowly and deeply.
  3. Sit the casualty down in a position that they find most comfortable - do not let them lie down. One of the most favoured positions to sit in is leaning gently forwards as this increased the volume for the lungs.
  4. A mild attack should ease within a few minutes. If the attack persists, encourage the casualty to take another puff on their inhaler.
  5. If the attack is severe and if: the inhaler has no effect, the casualty is getting worse, breathlessness makes talking difficult or the casualty is exhausted; then emergency medical assistance should be called using 999.
  6. Until help arrives, continue to assist the casualty in taking their inhaler and monitor their vital signs.
A man assisting a boy in taking his reliever inhaler.

For more information, see page 100 of the DK First Aid Manual.

Video:

A British Red Cross video which shows the procedure, listed above, in a real life scenario.

Dance Fever

Strange Disease Short: Dance Fever

Dance Fever, also known as Dancing Mania and Dancing Plague amongst others, is a truly bizarre phenomenon in which large groups of people would, seemingly uncontrollably, break into erratic dance. Dance Fever is not common in the modern age, it came to prevalence in the middle-ages between the 1400s and 1700s.

Dance Fever is not caused by bacterium or any other type of pathogen: it is believed to be a psychological disorder, more specifically a mass psychogenic illness. Mass psychogenic illnesses are usually caused by a trigger, for example one person will accidentally consume a poison, others in the social group may start to believe they are afflicted by the symptoms of the poison despite never having consumed the poison.

Could those afflicted have been dancing out of choice? Possibly, religious fervour is a plausible explanation, however many of the afflicted danced until they passed out and it was not uncommon for those dancing to die of a heart attack, exhaustion or even stroke.


Strasbourg, July 1518: The most prominent case of Dance Fever occurred, peaking at around 400 dancers, lasting over a month, started by a woman named Frau Troffea. Fortunately a lot of historical sources, such as news chronicles and physicians notes, exist to give us an insight into what happened. To provide some context on the event: the region had been suffering from a terrible famine and there had been many outbreaks of diseases such as smallpox, people in the region would have been extremely stressed, making them more susceptible to a mass psychogenic illness. But what was the trigger? A Christian legend about the martyred Saint Vitus states that if his wrath is provoked he would send down plagues of compulsive dancing. (Saint Vitus is the patron saint of dancers, actors and epileptics which may be why this myth is attributed to him.) This is a very plausible trigger, as a highly stressed and anxious populous would believe that they were suffering the wrath of Saint Vitus and would believe that they had no choice but to dance, even to the death.