Salem Encephalitis?

BBC has an interesting article up today discussing the possibility that an autoimmune illness, anti-NMDAR encephalitis, may have been responsible for some of the symptoms of "witchcraft" that fueled the Salem Witch Trials. Since the 1970's, the hypothesis that the witch craze in Salem might have been fueled by ergot poisoning - which can cause vivid hallucinations - has been reported in a number of places. However, as the article points out, no other symptoms of ergot poisoning were reported during the Salem trials.

Capital-S Skeptics like to run to their favorite explanation for the symptoms seen in Salem, "mass hysteria." As I've mentioned here before, this is basically the Skeptic version of "paranormal powers." We don't understand how it works, we can't predict situations in which it will happen, and we don't understand what triggers it. When a Skeptic describes something as "mass hysteria" he or she really means "I can't explain any of it, but what I do know is that anybody who calls it paranormal is deluded." In fact, whatever this phenomenon is, it is rare enough that it might as well be considered paranormal just like psychic abilities.

While I do understand that the witch trials and other events like them have a psychological component, I also know that they usually start with something, not nothing, and that something is usually inexplicable. That's why the ergotism hypothesis seems so appealing. It's fairly obvious that religious fundamentalists like the Puritans would interpret hallucinations as some sort of spiritual force, and interpret them as evil if they were threatening and scary - as hallucinations out of the blue often are.

But with no other symptoms consistent with ergotism the contention remains weak. That's why, according to an article published in the Journal of Neurology by Michael Zandi and Johnny Tam from University College in London, anti-NMDAR encephalitis could be a better candidate, especially in the case of the two cousins who started the whole thing up.

Here’s the story of a typical patient. She initially develops a flu-like illness. Within weeks, she becomes obsessed by god or the devil, consumed by paranoia and racked with insomnia. Now, she repeats the same words, then is struck mute. Next: seizures, writhing and contorted limbs, odd repetitive movements of the mouth and tongue. Her pulse races or slows, her blood pressure rises and falls. She sweats, drools, grunts and grimaces. She becomes catatonic and then comatose.


For so long, these patients were often diagnosed as hysterics and maligned as neurotics, sent to asylums to become madder still, or to die. But now we know the condition is caused by a neurological disorder following ground-breaking research in 2007, which has shown that an offending antibody reacts against NMDA receptors – hence the term anti-NMDAR encephalitis (the ‘R’ stands for receptors).

...

So could this condition be linked to Salem? Zandi and Tam analysed descriptions of Betty and Abigail and they think it’s a distinct possibility for the following reasons:

 •Anxiety and persecutory delusions feature in anti-NMDAR encephalitis and seem to have been present in the Salem girls.
 •Seizures occur in encephalitis. The girls had “several sore fits’’.
 •The dyskinesias (involuntary limb movements) of anti-NMDAR encephalitis might match the following description: ‘‘Their limbs wracked and, tormented so ... their arms, necks, and backs turned this way and that way, and returned back again”.
 •There are parallels between the loss of inhibition and altered mental status of encephalitis and this account: ‘‘She was at first hurryed with violence to and fro in the room ... and begun to throw fire brands, about the house...’’
 •The suggestion that the girls were hallucinating: “Sometimes making as if she would fly, stretching up her arms as high as she could, and crying Whish, Whish, Whish!...’’
 •The fact that the girls were occasionally “taken dumb”, perhaps suggestive of catatonia.
 •Brain swelling can impair speech. The girls’ “mouths stopped, their throats choked...’’

“Their illnesses seem uncannily similar to a disease we’ve only got a handle on in the 21st Century,” says Zandi. “And why would anti-NMDAR encephalitis not have been present then?” It sounds compelling, but some questions remain unanswered. Why would the cousins have simultaneously developed a condition that isn’t infectious?

Zandi points to the heritability of other autoimmune conditions, so it is possible that both suffered from the same condition, but he recognises that “yes, it’s more likely that only one had it than both".

It seems to me that if this illness was really the inciting incident, only one of the girls would have had to have it. From there, the social and economic factors that mainstream historians consider the source of the witch panic could have taken over. The girls could have found themselves enjoying the power they gained when they accused other Salem residents of witchcraft, neighbors could have made accusations against each other on the basis of personal squabbles, and so forth. It's not inconceivable to me that one of the cousins could be copying the behavior of the other, only that behaviors so consistent with a real illness could have been arrived at randomly through play-acting.

The advantage we have in studying the Salem trials is that they were recognized not long after as a black mark on our nation's history and were widely reported on and studied. They remain a black mark on popular culture today, in that every single paranormal television program or movie that mentions "witches from Salem" ignores that there was no evidence that any of the people executed - murdered, really - during the course of the trials practiced any sort of witchcraft or occultism. Tituba seems to have engaged in some simple Afro-Caribbean folk practices that her Puritan masters blew out of proportion, but that's as far as it went. And, she was imprisoned for a time but survived.

If further evidence emerges supporting this hypothesis of the Salem witch craze, it may also be the explanation for other witch scares in Europe and elsewhere. Ergotism probably also played a role, as the witch trials of the 1600's in Europe do seem to follow a pattern where more accusations were made in years with weather conditions more favorable for the growth of ergot. But the interactions of multiple factors could be why the pattern is not as strong as it might otherwise be. We may never be able to tell for sure, sine the European trials were not anywhere near as massively documented as the ones in Salem were.