Saturday, March 13, 2010

He's mad I tell you! Mad!




Since Alice in Wonderland is in the news right now, I'm putting up 2 history posts in one day.

The Mad Hatter is well known in English literature. He was created by Lewis Carroll (real name Charles Lutwidge Dodgson) for the story Alice's Adventures in Wonderland. An interesting side note is that the character was most likely based on a furniture dealer, and not a hatter.

The phrase "mad as a hatter" actually predated the story, and has an interesting neurological history.

Mercury is a metal with multiple human toxicities. It can affect many organ systems, and in sufficient amounts can cause brain damage. When this occurs common symptoms are memory loss, confusion, and behavioral changes.

Mercury poisoning is uncommon in modern medicine, but before it had been identified as a toxin it was commonly used in the cloth industry, in the manufacture of felt.

A hatter, obviously, is someone who makes hats. And in 18th & 19th century England, felt was commonly used in hats. So hatters had a fairly high level of exposure to mercury, and after several years of plying their trade they sometimes developed brain damage, and went "mad". And that's where the phrase came from.




Alice in Wonderland has other neurological trivia. As many of my migraine patients will tell you, their headaches can be preceded by all kinds of visual changes. Typically these are flashing or sparking lights, dark spots, colors, or squiggly or zigzag lines. But some patients will see visual distortions, where things suddenly seem to grow or shrink in front of them. This perception change is now called Alice in Wonderland Syndrome.

It's known from his personal diaries that Lewis Carroll suffered from migraines with visual changes. It's unknown if he had the perception changes of things growing and shrinking, but who knows? Maybe one of the most famous books ever written was partially inspired by a migraine.

It's something to think about.


29 comments:

Anonymous said...

I think it's something in the tea.

Cthulhu Sashimi said...

Or it could just be a marketing scheme, like Crazy Eddie. "My hats are so cheap, I must be INSANE!!!!"

Anonymous said...

The part about the "mad hatter" is fascinating...

Helen said...

That's fascinating! Thanks for posting about it.

I've loved Lewis Carroll for a long time - there's something wonderful about the way he embraced and celebrated oddness, wherever it came from. I'm looking forward to seeing the movie.

J-Quell'n said...

Awesome post! I've heard about Alice in Wonderland Syndrome before...and the mad hatter thing I remember from high school physiology. I've actually never seen the cartoon (or the new movie), but I have read the book...a good story.

As a side note, I have also never seen The Wizard of Oz (just random parts of it).

Jo said...

What was the name of the king who slept on a floating mattress in a fountain full of mercury? Damned if I can remember right now, but I do recall that the story gave me the heebie jeebies.

Anonymous said...

Too cool! I've had migraines since I was really young (like 3) and I have had that weird sensation of growing/shrinking. I thought that it happened to everyone. I've never associated it with the headache though. Interesting, I'll have to pay more attention now!

Anonymous said...

Also, maybe Lewis Caroll was being treated with laudanum (opium) for his migraines and that added to his visions.

Just like Samuel Colridge Taylor, who wrote "Kubla Khan," "Rhyme of the Ancient Marnier.' and others under the influence of laudanum.

Lo said...

Ah, Dr, G, I love it when you make me think as well as laugh.
More of both, please.

Kim Wombles said...

Your line that mercury poisoning in modern medicine is rare had me chortling, not because you're wrong on that, but because of how I spend much of my blogging time, countering the portion of the autism community who firmly believes that there is indeed a lot of mercury poisoning going on; indeed they believe an entire generation is being poisoned. Sigh.

Charles Nelson Reilly said...

How's that for a topper?

Anonymous said...

Before I got smart and became a cop, I was an environmental tox prof, and mercury was my "thing". I did research on a mercury-polluted river in VA. The Hg levels were still so sky-high 30 years after the polluting industry closed, there was absolutely nothing living in the sediment over a mile-long stretch downstream of the original input site. I always wondered about what all that fish the locals caught there, and ate, was doing to them.

Anonymous said...

the phrase mad as a hatter is also used in a ryhm to describe toxicity from anticholinergics :) ...I think it is
"red as a beet, dry as a bone, blind as a bat, mad as a hatter, and hot as a hare." From a Pharmacy Friend

Sara said...

Very interesting. Thanks for sharing!

NikkiK said...

I've read about the Alice in Wonderland syndrome - I have migraines now and had symptoms like those when I was a kid, before my migraines started. Having read the Alice books, I could completely believe that 'Lewis Carroll' suffered from migraines.

student dr. blaze said...

that's *really* interesting!

Kim Wombles said...

Dr Grumpy,

It's not just some of the parents, though, referencing my earlier comment, it's doctors of "functional medicine," too:

http://www.huffingtonpost.com/dr-mark-hyman/autism-mercury-toxicity_b_497047.html

Anonymous said...

thanks for the story but with a bit more research you could have come up with some orginal alice pictures rather than the disney ones.

pharmacy chick said...

I collect pharmacy drug antiques and have a large collection in my house. One of the drugs I have is called Chamberlains Pills, for many ailments....active ingredient?
MERCURY.

Anonymous said...

One time I took a Maxalt MLT for my migraine and I swear I went down the rabbit hole. I think I got a bad batch.

terri c said...

Cool! Dr. Oliver Sacks, in one of his books, speculated that the mystic Hildegard of Bingen also suffered from migraine.

Unknown said...

We were discussing this after the Alice in Wonderland movie (which was amazing by the way). So I googled it. Another take on the mad as a hatter phrase is that it was actually originally mad as a adder (angry as a snake).

@anon 11:20pm. Nah, that's just the way Maxalt makes some people feel. The rain cooling sensation is particularly weird in my opinion.

Lipstick said...

I had Alice in Wonderland syndrome (until Topamax...Ahhh!)so I knew about that term, etc but I did not know about the Mad Hatter. Thank you for sharing!

The Mother said...

I love this stuff. History is great, and the history of art/literature is absolutely fascinating.

We studied Alice in college logic. I was shocked to hear that the Johnny Depp version actually has a PLOT. Sad.

RSDS said...

I already knew about both the mercury and migraine connections.

What I have wondered, though, is what the caterpilar is smoking in his hookah. Opium, perhaps?

lapharmacienne said...

I learned in a pathophysiology class that Van Gogh suffered from migraines with aura too and that "Stary Night" is a depiction of those flashing lights.

Rothase said...

@Pharmacy Chick- Mercury was also the primary "treatment" for syphilis for a couple hundred years. YIKES. If the disease didn't kill you, the treatment would!

Grumpy, M.D. said...

"A night with Venus, a year with Mercury."

Steve said...

I know a former director of a drug rehab clinic in LA. He would give all his employees a copy of the book so they will be educated on the symptoms of opiate use/abuse.

 
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