British Journal of Psychiatry(1995), 166, 701—702 Dreadlocks and Mental Disease Editorial An old argument and an early epidemiological study (1843) H. FORSTL and H. ELLIGER Enigmatic disease concepts are notoriously difficult to refute. The history of ‘¿trichomillau'strates the spectacular rise and silent vanishing of an obscure ailment once thought to be responsible for a large proportion of mental disturbances. Dreadlocks (convolutio et contricatio capillorum firmissima) formed the diagnostic sign of a disease called trichoma, plica polonica (Latin), kottun (Polish)and Weichsel-or Hexenzopf (‘witch plait'G;erman).Thisillneshsad been prevalenitn Poland during the late middle ages and Renaissance (Cromerius, 1558). Staringeius (1599), rector of the University of Zamosc, was the first Polish physician who wrote about this disease. Schlegel (1806) reviewed the literature of the following 200 years and listed 136papers, dissertations and monographs from different authors. The number of publications increased steadily until in 1843 Beschorner, director of the first asylum in Poland, published a large population-based study and could not substantiate the disease concept. This led to an immediate cessation of publications on the matter. Publicationsbefore 1843 The symptoms and signs of trichoma were described as protean, a ‘¿chameleown'ith hardly two cases resembling one another (Matuszynski, 1832). The premonitory stage was believed to develop over a period of from six hours to several months with headaches, increased sensitivity to light, sound and touch, vertigo, tinnitus, pain in the eyes, ears, bones and joints, disturbances of sleep and appetite (pica), constipation or diarrhoea, etc. If the trichoma was cut off during this first phase, the unhealthy substances or ‘¿miasmaws'ere feared to attack other organs, causing melancholic, hypochondriacal, hysterical and epileptic states or encephalitis and meningitis. Fevers heralded the second stage of illness with a fully developed trichoma, which could then fall off spontaneously or be removed without a major risk for life or mental sanity (Wolfram, 1804; Schlegel, 1806). Different types of immature and mature, real or false, dry and humid trichoma were distinguished and it was accepted that similar phenomena could occur in dogs, oxen, sheep, wolves and foxes (Chromy, 1813). Even though the existence of this disease was not questioned, its nature was a subject of controversy. A hereditary transmission was proposed, because the real trichoma allegedly affected Polish and Jewish men after the age of six, but not women or foreigners (Schlegel, 1806). Other authors favouredthe contagious, infectious paradigm and thought that trichoma was a modified form of lepra, or syphilis or of another venereal ‘¿miasma' (Frank, 1788;Wolfram, 1804).A lack of cleanliness, and the obstruction of fine tubules in the hair due either to the constant use of fur hats or to shaving of the head, were discussed as modifying influences (Schlegel, 1806; Chromy, 1813). Matuszynski (1832) suggested that trichoma was the local and endemic crisis of a variety of acute or chronic diseases. Schlegel (1806) wrote that trichoma had a lethality of 5%, leaving45% of the affected crippledand with 50% making a full recovery. He felt that trichoma was the true cause of up to 32 000 of 55000 deaths per year. The estimated prevalencewas 1:10 to 1:30 (de la Fontaine, 1792; Schlegel, 1806). Beschorner'sepidemiologicalstudy Beschorner was the director of the first asylum in Poland and thought that a thorough scientific study of this matter was urgently needed, because —¿ according to public and medical opinion - there was a close causal relationship between trichoma and mental illness (‘Irresein').He used data which had been solicited by Minutoli, the governor and police president of Posen in 1842. 5327 cases of trichoma were identified, yielding a prevalence of 1:231 in a total population of 1 233 850 in the county of Posen. Beschorner admitted that cases may have been missed and that the true prevalence was probably slightly higher, though ten times as great seemed most unlikely. 2460 patientsweremale and 2687 werefemale, and therefore the male preponderance and the trans mission pattern suggested earlier could not be supported (de la Fontaine, 1792; Schlegel, 1806). Seventeen per cent of the reported cases were five years old or younger. This was considered as an argument against the venereal nature of trichoma and the opinion that trichoma would only develop after 701 702 FORSTL&ELLIGER the age of six was refuted. Eleven per cent of the cases were over 60 years old, corresponding to 26@@o of individualsin this age group. Only9% of the cases were children and adolescents between 10 and 20 years. Beschorner hypothesised that a greater clean liness in this age group might contributeto this effect. Trichoma was more frequent in Catholics (1:170) than in Jews (1:264) or Protestants (1:849). Beschorner found that this was related to the ethnic background, with the Slavic [Catholici population being more frequently affected (1: 171) than the Jewish (1:264) or German [Lutherani people (1:730), and to the social status, with 90% of all reported cases coming from the lowest socio economic class. Beschornerquestionetdhediagnostiscignificance of trichoma, because in 20°loof all individuals with this sign, no other signs or symptoms of illness were found. He questioned the idea of heredity or familiarity, because80% of the cases were sporadic. If more than one case per family was found, therewas often excess morbidity from other illnesses and the majority of family members would still be unaffected. Beschorner used 12 physically healthy chronic psychiatric in-patients to prove that trichoma was simply caused by the appropriate external conditions. The patients were not allowed to comb or brushtheir hair and had to wear tight caps. All of five women and two of seven men developed trichoma. He went one step beyond and inoculated specimens from trichoma patients into the scalp of other patients and could not observe a faster development of trichoma in the inoculated patients (an early example of the abuseof psychiatricin-patientsfor researchpurposes). He concluded that trichoma was not a disease sui generis and that it did not exert a significant effect on other illnesses. His results were immediately accepted by the scientific public (e.g. Rohnert, 1844). Comment Trichoma is one example of folk mythology intruding into medical science. In spite of its obscure nature, its presumedimportanceseemedto grow with an increasing number of publications about this topic. Most of the literature on trichoma is highly repetitive. A large number of dissertations simply combined previous publications without introducing any original thought and data. The concepts became more complex and confused. Trichoma was not only the external sign, but also the disease itself and also its remedy. Mental illness was its cause and its consequence. Empirical data were necessary to clarify the most fundamental issues regarding trichoma. With the introduction of the simple statistical methods of his time, Beschorner put an end to useless academic debates. Beschornerdemonstrated the insignificance of the presumed relationship between an individual symptom â€t”h¿e dreadlock - and its surmised causes and accompanying features, devaluating ratherthan falsifying the trichoma concept. The availability of novel methods or insights into medical science may lead to similarrevolutions, with concepts sinking into oblivion rather than clashing with new paradigms (Kuhn, 1962). Acknowledgement The preparation of the manuscript was supported by an H. & L. Schilling professorship to H.F. References BESCHORNER, F. (1843) Der Weichselzopf. Nach statistischen und physiologtschenBeziehungendargestellt.Breslau:F. Hirt. CHROMY,T. E. (1813) Neueste Ansichten des Weichselzopfes in seinerGrundursache.Freyberg:Craz & Gerlach. CROMERIUS, M. (1558) Polonia s. de Origine et Rebus Gestis Polonorum.Libr. XXX. Basle. @ Fo@ir@itmS,. (1792)Chirurgssch-medicinischAebhandlungen Polenbetreffend.Breslau. Fw@x, P. J. (1788) System einer vol!standigen medicinischen Polizey.IV. Vienna:Trattner. KUHN, T. S. (1962) The structure of scientific revolutions. Foundations of the Unity of Science,2, (2). MAruszYNsKl, J. (1832) Uber die Natur und Behandlung des WeichselzopfesU.niv. Tubingen(Diss.):Osiander. ROHNERT, C. F. A. (1844) De plica Polonica. Gryphia: F. 0. Kunike. SCHLEGEL, J. F. A. (1806) Uber die Ursachen des Weichselzopfes der Menschenund Thiere.Jena:J. C. 0. Gopferdt. STARINGEUULS. ,(1599)Epistolaad AcademiaPaduanamdePlica. WoLFR*i@i,J. G. (1804) Versuch überdie höchstwahrscheinlichen Ursachenund Entstehungdes Weichselzopfesnebst einer sicherenHeilungdesselben. Breslau:W. 0. Korn. H. Förstl,MD, Hanna Elliger, Central Institute of Mental Health, Mannheim Correspondence: Dr H. Förstl,Central Institute of Mental Health, J5, 68159 Mannheim, Germany (First received 3 October 1994, final revision 2 November 1994, accepted 8 December 1994)
I've just read it all and it still doesn't make too much sense.. From what I gather it's saying there were mental patients who had to wear caps all the time and not brush their hair.. this was the cause of some disease called Trichoma or something which made them ill with headaches and stuff, and some really bad stuff and 50% of people made a full recovery with the rest dying or being left disabled.. But really they now think it was all some myth. I'm confused.
basicly it says that anything they didnt undewrstand 200 years ago was labled a disease they saw some ppl had dreads and decided it must be a mental, illness thewy threw abunch of statisticsa out to pretend they knew what they were talking ablut then over years realized these staTISTICS MADE NO SENCE AT ALL AND THE DISEASE ITSELF PROBLY NEVER EXISTED TO BEGIN WITH MEANWHILE THEY LOCKS EM ALL UP IN ASSYLUMS TO STUDY THEM WHICH CAUSED 5% TO DIE EITHER FROM SUICIDES OR THE DEPLORABLE CONDITIONS OF THE ASSYLUMS BACK THEN (REMEMBER THIS WAS A TIME WHERE DRILLING HOLES IN YOUR SKULL TO RELEASE DEMONS WAS COMMON PRACTICE AND THE MENTALY ILL WERE TURTURED TO DEATH IN ATTEMJOTS TO CURE THEM..AND IF U ACCIDENTLY ATE THE WRONG MUSHROOM ..OR WERE SCARED OF THE DARK YOU COULD END UP IN AN ASSYLUM HAVING HOLES DRILLED IN YOUR HEAD (OR WORSE YET BEING BURNED AT THE STAKE FOR BEING WITCHES JUST CAUSE U KNEW WHICH HERB WOULD STOP BLEEDING) damn caps so as i was saying, this is a menrtal health study from the dark ages of mental health studies someone just got all excited cause it mentioned dreadlocks i guess
I did this to be provocative not insulting, I just thought it was interesting also im sorry for the poor translation, I got it form the PsychINFO ebsco database from the UMass Dartmouth library
hah, it's a friday. I thought I was done with reading informative texts for the week... interesting? so... people with tight caps grew dreads and therefore had headaches? It was probably just the tight caps. ya know, I wore a large rubber band around my head for a few hours once, and it gave me a terrible headache. trichoma, perhaps?
i took the liberty of cleaning your post up and making it a little easier to read. i hope you dont mind. i think others will find it much easier on the eyes,i know i did.. its still not perfect but that thing was a fucking mess lol and at least now its somewhat readable. interesting stuff..
Still takes up more space than it deserves Certainly a bit prettier though Seems more interesting now it's less of an eye-sore
soaring eagle was right, this is the dark ages of psych, I just reviewed the sources and the earliest one is from 1599, and nothing past 1962, this seems like a very long collaboration of psychologist to basically say nothing interesting lol
Maybe look a little closer before copying and pasting anything Google threw up with the word dreadlocks in it
no no this isnt google, this is from the ebsco data base from UMass, a scholarly journal collection used for existing research and for aiding in new research in any one field concerning mental health. But hey, it got people talking!
Lol sorry And despite all of the scientific and social progress that's been made since then, there is still enormous ignorance about dreads...like in that other thread about cutting off dreads for court. Seems so weird measured against all the efforts to abolish discrimination over race or which gender we choose to shag, and puts them into a rather odd perspective when some people still can't get over some tangled hair
Actually i find it very interesting.. People were classified as "mental", "not right", "feeble minded" etc in very peculiar ways. I have read quite a bit on eugenics in the last several months and right up into the last century someones dreads would have most likely had them classified as feeble minded and then tossed into an institution and sterilized. People who traveled too much were considered wayward in the 1920s and sterilized because of studies such as these. I am sure back in the day this document was a leading edge study and anyone that read it followed it as a new age science. It really is amazing to read back in time and learn how they pieced the medical world together and came up with conclusions. Hell even now sometimes the whole psychiatric world has some very wacked out ideas that most of us would find backwards or from the dark ages...
remember they used to treat a fear of rats with a cage full of rsats bolted onto your head locking someone in a metal cage barely big enough to squat in then spinning the cage for days afyer days was a treatment for depression hpomosecuality was either caused by demons (religios view) or brain dammage (scientific view) one was treatted with excorsism (the lucky ones) yhe ptheres were locked away and tortued ..or steralized.. well technicaly not steralozed..unicized i guess..chopped off forced to be sexless