Elsevier

Sleep Medicine

Volume 14, Issue 11, November 2013, Pages 1221-1223
Sleep Medicine

Historical Issues in Sleep Medicine
Dante’s description of narcolepsy

https://doi.org/10.1016/j.sleep.2013.07.005Get rights and content

Abstract

Sleep, sleepiness, and dreaming are expressed throughout Dante Alighieri’s (1265–1321) the Divine Comedy from the start of his journey through the afterlife. In the book, Dante complains that he is “full of sleep,” and he experiences sudden wake-dreaming transitions, short and refreshing naps, visions and hallucinations, unconscious behaviors, episodes of muscle weakness, and falls which are always triggered by strong emotions. Taken together these signs are highly reminiscent of narcolepsy, a term coined in 1880 by Gélineau to define a disease consisting of daytime irresistible sleep episodes with remarkable dream mentation, sleep paralysis, hallucinations, and cataplexy (falls triggered by strong emotions). Sleep, sleepiness, and episodes of sudden weakness triggered by emotions are Dante’s literary fingerprints from his earliest works, pointing to a lifelong autobiographic trait.

In the 19th century, Cesare Lombroso speculated that Dante had epilepsy, as he had suffered from frequent spells and hallucinations. However, the multiple emotionally triggered falls Dante experienced in the Divine Comedy contrast with the epileptic seizure he depicted in one of the damned individuals. It is possible that Dante may have intuitively grasped the main features of narcolepsy, but it also is plausible that Dante’s sleep, dreams, hallucinations, and falls are clues to a lifelong pathologic trait and that Dante may have known of or had narcolepsy.

Introduction

In 1880 the French neurologist Jean Baptiste Edouard Gélineau [1] astutely coined the term narcolepsy from the Greek word νάρκη (narkē), or numbness, and λῆψις (lepsis), or attack, to define a disease consisting of daytime irresistible and refreshing sleep attacks and episodes of abrupt motor arrest and falls to the ground, elicited by laughing which he called “astasia.” These episodes of muscle weakness were triggered by strong emotions and were better described by Löwenfeld [2] using the term cataplexy from the Greek word κατά (kata), or downwards, and πληξις (plēxis), or paralysis. Yoss and Daly [3] defined daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucinations as the “clinical tetrad” of narcolepsy with cataplexy (NC). Automatic and complex behaviors related to sleepiness also are common [4], though many patients do not present all of the symptoms. Biologic markers of NC are the occurrence of rapid eye movement (REM) sleep at the onset of sleep, [5] often associated with dream mentation and the reduction or complete deficiency of orexin-A in the cerebrospinal fluid [6].

Herein, I suggest that six centuries before the first scientific report, Dante Alighieri (Florence 1265–Ravenna 1321, Italy), “the father of the Italian language,” depicted NC in his literary works as an autobiographic trait (see Fig. 1, Fig. 2).

Despite almost seven centuries of research, the lack of direct sources and autographic material mean that little is known about Dante Alighieri’s life and personal traits. However, his writings represent a main biographic source of the poet’s life, as Dante himself is the main character in his literary works. Several of the characteristics Dante depicts can easily be ascribed to NC symptoms. Although some features may represent literary devices, it is difficult to argue that this descriptive accuracy is accidental.

Section snippets

Dante’s sleep, sleepiness, hallucinations, and cataplexy

The Divine Comedy, Dante’s masterpiece, is an imaginative and allegoric vision of the afterlife composed by the poet between 1307 and his death. A remarkable feature of Dante’s poem is the vividness of the narration; it is a work of fiction brought to life by the realistic details. According to the oneiric dimension of the medieval narrative model, Dante’s journey in the afterlife from Hell to Heaven is allegorically depicted as a vision occurring during sleep (visio in somno). Dante indeed

Discussion

Dante’s sleep and dreaming have been interpreted by the classics as a literary device. However, other scholars have speculated that Dante’s brilliant creativity could be attributed to a trait, an illness, or a conduct disorder. Since the second half of the 19th century, the multifaceted relationship between creative work and illness has been studied in many well-known artists, writers, and musicians. Information on the nature of the affliction and its manifestations has served to analyze how

Financial disclosures

Dr. Plazzi had consulted for participation in advisory boards from UCB Pharma and Jazz pharmaceuticals.

Conflict of interest

The ICMJE Uniform Disclosure Form for Potential Conflicts of Interest associated with this article can be viewed by clicking on the following link: http://dx.doi.org/10.1016/j.sleep.2013.07.005.

. ICMJE Form for Disclosure of Potential Conflicts of Interest form.

Acknowledgment

I am indebted to Professors Emilio Pasquini, Mirko Tavoni, Giuseppe Ledda, and Keir Douglas Elam for their valuable guidance, stimulating ideas, great advice and encouragement, and to Claudia Giuliani, Ennio Dirani, Alfio Longo, and Beppe Gardella for their help in biographic and iconographic research.

References (11)

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