Dr Seward, the asylum superintendent in ‘Dracula’, decided to invent a new diagnosis for his pet patient Renfield – ‘zoophagy’ (animal-or life-eating).
However, Renfield wanted to go beyond his usual flies, spiders and birds, and attacked Dr Seward himself, explaining that ‘the blood is the life’ as mentioned in the Bible and in the advertisement shown above. (In fact this Mixture’s chief active ingredient was potassium iodide.)
The real psychiatrist Dr George Savage had in 1888 described a case with similar self-proclaimed motivation:
He visited the city abattoir, obtained and drank blood hot from the slaughtered animals. This was after a few days stopped, but fortunately he was watched, for he was seen to try to decoy children to his rooms, and he owned to me that he wished to have their blood, as blood was his life, and his life was that of a genius.
Dr Savage was considering the psychopathology of Jack the Ripper.
Dr Conolly Norman reviewed the issue of beri-beri in asylums in 1899. He pointed out that following the outbreak in the Richmond Asylum, others had occurred in Suffolk, England, Alabama and Arkansas in the USA, and at St. Gemmes-sur-Loire in France. Norman remained puzzled as to the possible causes: sometimes there seemed to be an association with nutrition but he thought that the Richmond diet was quite as good as in other asylums.
He wondered about a ‘miasmatic poison’ especially in conditions where the ground was damp and marshy, and subject to frequent excavation as was common with asylums. (He is probably thinking here of the frequent building works, probably on top of human waste and, indeed, buried corpses.)
He decided that ‘infective peripheral neuritis’ would be an appropriate term, and that at least asylum doctors needed to be aware of the problem even if the cause and treatment were unknown.
In the early 20th century an outbreak of pellagra was noted by Dr Searcy, the medical superintendent of the Mount Vernon Hospital for the coloured insane in Alabama. He thought the disease was caused by toxic maize, but was not contagious – the nurses did not suffer. Pellagra began to be recognised as widespread amongst poor black women in the Southern USA eating mainly a diet of cornmeal.
For years afterwards any relationship with dietary deficiency was opposed – preferred explanations were genetic susceptibility, infection and poor sewerage.
Hospital admissions for insanity due to pellagra were common in nineteenth century Europe. Observing this, the Italian psychiatrist Cesare Lombroso (1835 – 1909) provided an early description, and considered toxic maize to be the likely cause.
Cesare Lombroso is referred to positively in the novel ‘Dracula’ with respect to his theories of criminality and physiognomy, as an aid to working out the Count’s way of thinking. The British Medical Journal in 1889, stirred by the Jack the Ripper killings, commented sceptically on:
Professor Lombroso’s description of the habitual homicide, with ‘the cold, glassy, immobile look; the eyes somewhat bloodshot; the nose often aquiline or hooked, always full; strong jaws, long ears, large cheek-bones, hair crisp, abundant, and dark, and the canine teeth prominent’.
Bram Stoker had presumably read something very similar when he thought up Count Dracula.
They groaned, they stirred, they all uprose, Nor spake, nor moved their eyes; It had been strange, even in a dream,
To have seen those dead men rise. The helmsman steered, the ship moved on; Yet never a breeze up blew; The mariners all ‘gan work the ropes, Where they were wont to do: They raised their limbs like lifeless tools — We were a ghastly crew.
The undead seamen were presumably scorbutic hallucinations, but as the Ancient Mariner had blessed the water-snakes, he will be saved.