Historical Issues in Sleep MedicineDante’s description of 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.
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)
- et al.
Narcolepsy with cataplexy
Lancet
(2007) - et al.
Hypocretin (orexin) deficiency in human narcolepsy
Lancet
(2000) De la narcolepsie
Gazette des Hôpitaux (Paris)
(1880)Uber narkolepsie
Munch Med Wochenschr
(1927)- et al.
Criteria for the diagnosis of the narcoleptic syndrome
Proc Staff Meet Mayo Clin
(1957)
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Epilepsy in Dante's poetry
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