Medicine: Laugh and Lie Down

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Every Pickwickian remembers the drowiness of Dickens' Fat Boy, whose master constantly prods him awake, crying: "Joe! —Damn that boy, he's gone to sleep again." Dickens did not know it, but Joe was a victim of a rare nervous disorder known as narcolepsy* (from the Greek narke, stupor, and lepsis, seizure). When narcoleptics experience certain emotions —anger, fear, grief, amusement—they crumple up, fall sound asleep. Less than 100 cases have ever been reported.

Last week, at a clinical session of George Washington University School of Medicine in Washington, D. C., Dr. Paul Fredericq Dickens (no kin to the novelist) told a crowd of colleagues about another narcoleptic, whose name was not revealed. Professor Dickens showed movies of a balding, middle-aged man of average intelligence, average income, who has been catching 40 winks all his life. The doctors thought it great stuff.

The first scene showed the patient in a chair, smoking, vivaciously telling Dr.-Dickens a funny story. Suddenly he chuckled, clapped his hand to his mouth to suppress a laugh, slumped forward in his chair, his face contorted, arms dangling. Dr. Dickens pinched his arm—no result. In a few minutes, the patient came to, rubbed his eyes, went on with his story.

In another shot, the patient started to laugh, pitched forward on his face. When he is only mildly amused, he is perfectly safe. But guffaws and belly" laughs knock him out. His drowsiness never lasts more than a few minutes, but he sleeps ten hours a night.

Doctors have no idea what causes narcolepsy. Dr. Dickens hinted at an evolutionary explanation: "It is found more commonly 'in certain types of animals [possums, some dogs] who inadvertently collapse . . . when terrified."

Dr. Dickens' treatment: thyroid extract, which jolts the patient into action for a short time. But his patient is getting sleepier every year.