The dancing mania or choreomania

Paracelsus (born Philippus Aureolus Theophrastus Bombastus von Hohenheim, 1493 –1541) was a Swiss Renaissance physician, botanist, alchemist, astrologer, and general occultist.

Paracelsus pioneered the use of chemicals and minerals in medicine. He used the name "zink" for the element zinc in about 1526, based on the sharp pointed appearance of its crystals after smelting and the old German word "zinke" for pointed.

"Paracelsus", meaning "next (in his status as physician) to Celsus" or "beyond Celsus", refers to the Roman encyclopedist Aulus Cornelius Celsus from the 1st century, known for his tract on medicine.

Paracelsus is credited as providing the first clinical/scientific mention of the unconscious. In his work “Von den Krankeiten” he writes: "Thus, the cause of the disease chorea lasciva(Choreia[1], or chorea, is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias[2]) is a mere opinion and idea, assumed by imagination, affecting those who believe in such a thing. This opinion and idea are the origin of the disease both in children and adults. In children the case is also imagination, based not on thinking but on perceiving, because they have heard or seen something. The reason is this: their sight and hearing are so strong that unconsciously they have fantasies about what they have seen or heard."
[1]Choreia (or chorea) is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias. The term choreia is derived from the Greek word χορεία (=dance), as the quick movements of the feet or hands are vaguely comparable to dancing or piano playing.
[2] Dyskinesia is a movement disorder which consists of effects including diminished voluntary movements and the presence of involuntary movements, similar to tics or choreia. Dyskinesia can be anything from a slight tremor of the hands to uncontrollable movement of, most commonly, the upper body but can also be seen in the lower extremities. Discoordination can also occur internally especially with the respiratory muscles and it often goes unrecognised. Dyskinesia is a symptom of several medical disorders and is distinguished by the underlying cause.

The dancing mania or choreomania was a strange phenomenon of crowd behaviour of epidemic size which appeared in medieval Europe. Crowds of people would suddenly form circles, start dancing and continue for many hours until exhausted. During the compulsive dancing participants often had hallucinations of being immersed in blood which they said made them jump very high, or of seeing the Virgin Mary.

In 1237 at Erfurt around 100 children were seized upon by dancing and jumping along the road to Arnstadt. On arrival many were exhausted and died on the return journey home. Many more were left with a tremor for the rest of their lives. On the 17 June 1278 in Utrecht, 200 people started to dance on the Mosel bridge, which collapsed and many drowned. During severe outbreaks society appeared to be near to collapse as 'peasants left their ploughs.

A large epidemic started on St John's day (24 June) 1374 at Aix-la-Chapelle, the modern day Aachen in West Germany. The epidemic spread throughout Germany and the Netherlands, with several outbreaks in France and Britain. St John's day, 24 June, coincided with the festivities for the summer solstice. Pagan custom held that those who jumped through the fires lit on that day would be cured from disease for a year.

After an outbreak of dancing mania in Strasburg in 1418, however, the role of protector of these dancers was taken over by St Vitus, and St John was relegated to protecting only sufferers of epilepsy. In 1418 wagon-loads of dancers and their hired attendants were ordered by the town's chief magistrate to make their way to the chapel of St Vitus in the remote Alsatian village of Zabern. They danced in the chapel, fell down in worship before an image of St Vitus and were miraculously cured. As word of this 'miracle cure' passed from one village to another, the cult of St Vitus quickly became widespread in Germany, Switzerland and the Netherlands.

Paracelsus (1493-1541) was the first to raise the dancing mania, which he called 'chorea sancti viti', from superstition.
He divided it into three types –
• chorea imaginativa (arising from the imagination),
• chorea lasciva (arising from sensual desire) and
• chorea naturalis (arising from corporal causes).
The third type was a milder form of the disease which was more common in the 16th century. It was accompanied by involuntary laughter without howling or screaming although the victims still had an urge to dance.

The term 'St Vitus dance' flourished after Thomas Sydenham (1624-1689) used it in his description of acute chorea.


However, in 1944, following the publication of the criteria for the diagnosis of acute rheumatic fever, which included chorea as one of the major signs, Dr. T Duckett Jones instilled the ancient St Vitus into the memories of generations of medical students.