The terrific book by Jennifer Wallis called Investigating the Body in the Victorian Asylum, takes us through the story of patients in the insane asylums, who insidiously loose their minds, yet are able to physically survive, move around, and suffer for decades, as they slowly deteriorate. These patients were often assumed by many, to be bad people with many moral failures instead of physically ill people with nonspecific signs of various organ failures. A kind of “Us versus Them” mentality which assumes that we are different and essentially “good” and therefore, will somehow escape their horrible fate.
Any one of us can fall ill and can also become just like “THEM” and this is a scary thought indeed. Anyone can loose their mind at any time in their life and become misunderstood and helpless. Without one’s mind it becomes more and more difficult to direct one’s behaviour or one’s words or one’s thoughts or one’s emotions and no one will understand this unless it happens to them and then SNAP it will be too late! Pretty tragic.
Wallis describes the scientific detective work leading to the eventual scientific understanding of one [and only one] particularly common cause of Insanity, what we now understand to be tertiary syphilis, a microbial bacterial infection. In the late Victorian era , [the late 19th century] there was “an increasing amount of discussion among the psychiatric community about the relationship between the mental disease and the body. There was a sense among many of these researchers that mental disease could be located somewhere, deep within the bodily fabric.“. Jennifer Wallis, Investigating the Body in the Victorian Asylum, Investigating the Body in the Victorian Asylum, second page of the Introduction.
Dr Emile Kraepelin believed in experimental science and the modern tools that were coming into their own in the late 19th century and early 20th. Kraepelin was a polymath who understood that it was not only the ” body fabric” that was important, but also the metabolism helping the body fabric, including the brain, to function appropriately.
In his patients with Manic Depressive Insanity, another syndrome involving loss of mind, he found evidence of disorders of metabolism, pointing to disorders of pH in bodily fluids. He discovered that abnormal breathing rate at rest was involved.; [chronically too slow in depressive insanity and chronically chaotic and/or too fast in manic attacks].
Are some psychiatric diseases, diseases of pH, as Kraepelin hypothesized?
Well, in 2017, Diana Kwon, science writer for Scientific American asks that very same question : “Increased acidity found in the brains of patients and mouse models of schizophrenia and bipolar disorder raises treatment questions” Are Some Psychiatric Disorders a pH Problem? https://www.scientificamerican.com/article/are-some-psychiatric-disorders-a-ph-problem/
Remember that increased acidity lowers pH and that this can cause altered mental status and altered mood [dysphoria/euphoria/irritability/anxiety]. Diana Kwon goes on to say that the researchers studying this comment that… “Even as it becomes clearer that brain acidity may be a key characteristic of schizophrenia and bipolar disorder, whether this could be a cause or effect remains an open question”.
Kraepelin’s findings of abnormal breathing rates at rest during attacks of bipolar illness suggests that the increased brain acidity in the brains of bipolar patients are the cause of their mental and motor disturbances, and that the brain’s acidity is due to respiratory pump failure and hypercapnia .
Science advances our knowledge. Science changes our thinking. Science changes our medical approaches and inventions. Science can revolutionize our treatments.
I would like scientists of all stripes to investigate the role of respiratory pump failure on mind and behaviour [with or without infected lungs]. In John M Barry’s thought provoking book -“The Great Influenza”- I learnt about the research done to understand and fight the 2018 flu pandemic, which resulted to worldwide advances to science and to medicine . We need to push hard in order to advance science and medicine in the fight against neuropsychiatric illness.