{"id":3468,"date":"2011-10-27T17:34:13","date_gmt":"2011-10-27T21:34:13","guid":{"rendered":"http:\/\/blogs.bu.edu\/ombs\/?p=3468"},"modified":"2011-10-27T17:34:13","modified_gmt":"2011-10-27T21:34:13","slug":"le-horla","status":"publish","type":"post","link":"https:\/\/sites.bu.edu\/ombs\/2011\/10\/27\/le-horla\/","title":{"rendered":"Le Horla"},"content":{"rendered":"<p><span class=\"st_twitter_large\"><\/span><span class=\"st_facebook_large\"><\/span><span class=\"st_ybuzz_large\"><\/span><span class=\"st_gbuzz_large\"><\/span><span class=\"st_email_large\"><\/span><span class=\"st_sharethis_large\"><\/span><br \/>\n<script type=\"text\/javascript\" src=\"http:\/\/w.sharethis.com\/button\/buttons.js\"><\/script><script type=\"text\/javascript\">stLight.options({publisher:'0b9142ea-42f7-4b62-947d-dd7654ef4f2d'});<\/script><\/p>\n<p>This semester I decided it was a good idea to take up French again. So I signed up for \u201cLF 303,\u201d which is now where I sit for fifty minutes every Monday, Wednesday and Friday trying to convince my professor (and myself) that I am a halfway-competent French speaker. Which, it turns out, I could be. I have a feeling it won\u2019t be long before I start dreaming in French again, at which point I\u2019m sure I will have something neuroscience-related to say about that. <img loading=\"lazy\" class=\"alignleft\" src=\"http:\/\/cdn.7static.com\/static\/img\/sleeveart\/00\/006\/739\/0000673909_350.jpg\" alt=\"\" width=\"280\" height=\"280\" \/><\/p>\n<p>That hasn\u2019t happened yet, but French class has actually had some direct mind and brain content. Last month we read a short story called \u201cLe Horla\u201d by Guy de Maupassant. The story is written from the perspective of Dr. Marrande, a psychiatrist who comes across an interesting case and calls on some of his colleagues for their opinions. Dr. Marrande introduces his coworkers to the patient (referred to as such &#8211; \u201cle malade\u201d), and he lets the patient tell his own story. <!--more--><\/p>\n<p>\u201cLe malade\u201d explains that his problems started with insomnia and anxiety, for which he was prescribed potassium bromide (a widely used sedative and anticonvulsant in the late 19th century when this story was published). He was also instructed to take showers. This treatment worked for a little while, and then he began experiencing frightening hallucinations. Upon waking up one morning, he found that a glass of water that he had set out the previous night was now empty.<\/p>\n<p>As an experiment, \u201cle malade\u201d set out water, wine, and chocolate, all of which he enjoyed, and milk, which he did not. In the morning, he found the water and milk gone, at which point he became suspicious of the true nature of his problems. Was someone coming into his bedroom at night? The hallucinations continued: \u201cle malade\u201d describes an instance where he saw a rose floating in mid-air and being unable to see his own reflection in the mirror before having it come back bit-by-bit in an eclipse-like fashion. The rose incident left him with the feeling that he had been haunted before and was being haunted again, and he thought perhaps \u201cle Horla\u201d was the cause of the mirror incident. By the end of the story, he is explaining a theory to the doctors and scientists that includes \u201cle Horla\u201d as a member of a new race out to take over humanity.<\/p>\n<p>Is \u201cle malade\u201d insane? In our class discussion, I said yes (or, rather, \u201coui\u201d). When you assume that the cause of your problems is a new, vampire-like race coming in on ships from Brazil to bring down humanity, yes, you\u2019re probably a little nuts. However, one detail of the story left some of my classmates and I wondering. See, in his very lucid description of his plight, \u201cle malade\u201d mentions other people &#8211; a neighbor and two employees &#8211; who had problems similar to his own during the course of his illness.<\/p>\n<p>Could he have been suffering from a contagious illness and lacking a better explanation assumed he was going crazy and needed psychiatric treatment? After some investigation, the only thing I found that seems to occasionally cause insomnia are yeast infections, and \u201cle malade\u201d never mentioned any symptoms of infectious illness. Perhaps it\u2019s more likely that these characters were all affected by anxiety or insomnia (fairly common complaints) for which they all took potassium bromide.<\/p>\n<p>Bromide intoxication creates a variation in the serum anion gap: the difference between sodium concentration and the concentration of chloride and bicarbonate in the liquid component of blood. A low serum anion gap is seen in bromide poisoning &#8211; which was still being reported on <a href=\"http:\/\/www.bmj.com\/content\/2\/3958\/957.full.pdf\">here<\/a> in 1936, when alternative sedatives had become available in the form of barbiturates. I did some research regarding acetylcholine receptors, bromide, and hallucinations that quickly became too convoluted to bring me to a truly arguable conclusion. However, it seems to me that this anion gap imbalance could potentially have anticholinergic effects that cause bizarre neurological symptoms.<\/p>\n<p>So was \u201cle malade\u201d actually losing his mind? Was Dr. Marrande doing his patient a disservice by prescribing potassium bromide, or is my theory a stretch? It\u2019s still a mystery to me, which in my opinion, keeps the intrigue in the story.<\/p>\n<p><a href=\"http:\/\/books.google.com\/books?hl=en&amp;lr=&amp;id=W7cNAAAAYAAJ&amp;oi=fnd&amp;pg=PA7&amp;dq=potassium+bromide+anxiety&amp;ots=PloIPWjxwW&amp;sig=tmlheXf3Xasnwt3TjW8Dywqn9_o#v=onepage&amp;q=potassium%20bromide%20anxiety&amp;f=false\">The physiological and therapeutic action and value of the bromide of potassium and some of its kindred salts<\/a> &#8211; Edward H. Clarke, M.D.<\/p>\n<p><a href=\"http:\/\/cjasn.asnjournals.org\/content\/2\/1\/162.full\">Serum Anion Gap: Its Uses and Limitations in Clinical Medicine<\/a> &#8211; Clinical Journal of the American Society of Nephrology<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This semester I decided it was a good idea to take up French again. So I signed up for \u201cLF 303,\u201d which is now where I sit for fifty minutes every Monday, Wednesday and Friday trying to convince my professor (and myself) that I am a halfway-competent French speaker. Which, it turns out, I could [&hellip;]<\/p>\n","protected":false},"author":6448,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[588],"tags":[],"_links":{"self":[{"href":"https:\/\/sites.bu.edu\/ombs\/wp-json\/wp\/v2\/posts\/3468"}],"collection":[{"href":"https:\/\/sites.bu.edu\/ombs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sites.bu.edu\/ombs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sites.bu.edu\/ombs\/wp-json\/wp\/v2\/users\/6448"}],"replies":[{"embeddable":true,"href":"https:\/\/sites.bu.edu\/ombs\/wp-json\/wp\/v2\/comments?post=3468"}],"version-history":[{"count":0,"href":"https:\/\/sites.bu.edu\/ombs\/wp-json\/wp\/v2\/posts\/3468\/revisions"}],"wp:attachment":[{"href":"https:\/\/sites.bu.edu\/ombs\/wp-json\/wp\/v2\/media?parent=3468"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sites.bu.edu\/ombs\/wp-json\/wp\/v2\/categories?post=3468"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sites.bu.edu\/ombs\/wp-json\/wp\/v2\/tags?post=3468"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}