Neurology through history: Lewis Carroll's writings as neurologic phenomena

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Lewis Carroll’s Alice's Adventures in Wonderland and Through the Looking-Glass are rich with fantastical elements and peculiar characters, some of which have been linked metaphorically or symbolically to various neurologic, psychiatric, or medical disorders as well as conditions like poisoning. For example:

• Alice's size changes (micropsia and macropsia). In the story, Alice experiences dramatic changes in size, growing very tall or shrinking very small. This has been likened to micropsia and macropsia, conditions where objects appear smaller or larger than they are, respectively. These phenomena can occur in migraines, epilepsy, and certain drug intoxications.
• The Mad Hatter (mercury poisoning). The Mad Hatter's erratic behavior and the phrase "mad as a hatter" are often associated with mercury poisoning. In the 19th century, mercury was used in the manufacture of felt hats, leading to neurologic damage in hatters, characterized by tremors, mood swings, and confused speech.
• The Cheshire Cat's disappearing grin (visual hallucinations). The Cheshire Cat's grin that remains after the cat has disappeared could be compared to visual hallucinations. Such hallucinations can occur with several conditions, including migraine auras, schizophrenia, and psychedelic drug use.
• The White Rabbit's anxiety (general anxiety disorder). The White Rabbit's constant worry about being late may be likened to symptoms of general anxiety disorder, characterized by excessive, uncontrollable worry about everyday things.
• Tweedledum and Tweedledee's aggression (intermittent explosive disorder). The twins' sudden and disproportionate aggression might reflect intermittent explosive disorder, a condition characterized by sudden episodes of unwarranted anger.
• The Caterpillar's use of a hookah (drug use). The Caterpillar's smoking and altered state of consciousness could metaphorically represent the effects of drug use, particularly hallucinogens.
• The Queen of Hearts' impulsivity (borderline personality disorder). The Queen of Hearts' impulsive behavior, extreme mood swings, and black-and-white thinking can be likened to borderline personality disorder.
• The sleepy Dormouse (narcolepsy). The Dormouse's constant state of sleepiness resembles narcolepsy, a condition characterized by excessive sleepiness and sleep attacks.
• Alice's frequent confusion and forgetfulness (amnesia or dissociative disorders). Alice often forgets who she is and experiences a disjointed sense of reality. This can be metaphorically linked to dissociative disorders or transient global amnesia.
• The Dodo's race (circulatory exercise for migraine relief). The Dodo suggests a race to dry off, which Carroll might have included as a metaphor for circulatory exercise, a common recommendation for migraine relief.

It is important to note that these associations are largely speculative and metaphorical. Although they provide an interesting lens through which to view Carroll's work, there is no concrete evidence that he intentionally embedded these conditions into his characters. Carroll's own experiences, particularly with migraines, may have unconsciously influenced some of his fantastical descriptions. The enduring fascination with his work partly lies in these rich and varied interpretations.

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