Saturday, January 27, 2007

Tantra medieval, mantra modern

Parkinson’s disease, recently in the news with the isolation of a gene related to the disease, was originally known as St Vitus dance.

KALPISH RATNA


Have you noticed how often a chance word makes the connection? It's uncanny, almost as if the brain prioritises what it sees.

Last night I was reading a 1523 bestseller, Courtship, which isn't very different from the latest issue of Cosmopolitan. The author Desiderius Erasmus (1466-1536), the European humanist, made a pile off racy tracts like Courtship by making them into textbooks, on the pretext of teaching Latin.

This morning, the first word that hits my eye is the name Erasmus. It eyeballs me from a slurry of fine print. There it is: Erasmus. But the page has to do with neurology. What's he doing here?

It turns out he's lent his name to the University of Rotterdam, no more, but his shrewd eye for news hasn't dimmed one whit. Researchers from his university have just isolated one more gene implicated in Parkinson's Disease (PD), taking the count up to 3. PD's protean profile continues to bewilder and misinform both patient and clinician.

New gene
This newest gene, discovered by Vincenzio Bonifat and his colleagues, named DJ-1, mutates in a familial form of early onset PD. Like the earlier genes implicated, parkin and Eo-synuclein, mutations in DJ-1 too might explain rare familial forms of the disease. Even more likely, these genes are just a few more pixels in the larger picture, one more step towards the truth that prompts all discovery, small or great: we simply don't know.

That maxim ought to apply also to the old name for PD, St. Vitus' Dance. More often, it is applied to another illness with abnormal movements, Sydenham's Chorea, but neither label is historically correct. The tag dates back to the time of Erasmus, and was probably prevalent in his neighbourhood of Gouda where St Vitus had rock star status.

St Vitus' feast was a 16th century Woodstock, and the frenzied dancing of the celebrants provoked the cruel comparison with the uncontrolled jerks and tremors of neurological disease.

Paracelsus
The man who made that comparison was the Great Panjandrum of medieval hocus pocus, now gaining rapid fame as a poster boy for alternative medicine. Auroleus Phillipus Theophrastus Bombastus von Hohenheim (1491-1541) is better remembered by his arrogant nom de plume, Paracelsus.

Chorea sancti viti was the term he used in opprobrium, seeing a prurient element in the dance. But he wasn't just describing a ritual feast. The 16th century dance commemorated an epidemic that swept Europe in the 14th and 15th century.

Whole cities succumbed to the "dancing malady"--people holding hands and dancing till they dropped. Reading the description today, one wonders what triggered off that mass hysteria. When the disease hit Strasbourg in 1418, St Vitus was called on to help.

A hundred years later, Paracelsus, observing the feast, commented shrewdly on the disease it commemorated. He described three sorts of chorea. Chorea imaginativa, an imaginary malady, the hypochondria of a later age; sexually induced chorea — that Freud would have recognised immediately; and chorea naturalis the result of an "internal prurience" in the brain.

The British physician, Thomas Sydenham (1624-1689), in Schedula Monitoria de Novae Febris Ingressa (1686) pinched the credit. He used the term St Vitus' Dance in his poetic and dramatic description of a disease with twitchy and uncontrolled convulsive movements.

The label, in fact, enjoyed a brief notoriety as a catchall for all "shaking palsies." It was unfortunate, to say the least, that Sydenham should have given the name chorea to an affection which had nothing whatever to do with the Chorea Sancti Viti, but custom has now sanctioned the use; another instance in medicine in which we know a disease by a name the original significance of which has long been lost.

Cloning recipe
Paracelsus will probably share the stage with Severino Antinori and Ian Wilmut when the first human clone is announced. He was the first one to describe how to do it. And — are you listening, empowered sisterhood? — entirely without female contribution.

With our insatiable greed for newer reproductive technologies at the devastating cost of maternal morbidity and child mortality, Paracelsus' recipe for a homunculus ought to be a sensational hit. For those seriously considering it as a cottage industry, here's the procedure: Let the semen of a man putrefy by itself in a sealed chamber with the heat of venter equinus (a 'horse's womb') for forty days, or until it begins at last to live, move, and be agitated, which can easily be seen.

After this time it will be in some degree like a human being, but, nevertheless transparent and without body. If now, after this, it be every day nourished and fed cautiously and prudently with the arcanum of human blood, and kept for forty weeks in the perpetual and equal heat of venter equinus, it becomes thenceforth a true and living infant, having all the members of a child that is born from a woman, but much smaller...

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