Autism: an
Historical Perspective

Autism is not unique to the twentieth century. As early as the fifth century b.c., Hippocrates classified it as a "divine disease," implying that it was not even of physical origin. The Roman physicians considered it a type of insanity, and recommended sewing wet goat skins around the child to calm his rage. In Medieval Europe, autistic individuals were presumed to be demon-possessed. Treatment consisted of chaining and beating the child "for his own good and for the salvation of his soul. (1) Sigmund Freud believed that autism was an emotional disturbance caused by a lack of sexual gratification.

The first breakthrough in its diagnosis and treatment came in 1943 when Dr. Leo Kanner of John Hopkins University studied the files of eleven patients with whom he'd worked over the years. Each one seemed to live in his own world, acting as if other people were not there. The children were initially brought to the clinic on the presumption that they were deaf or mentally deficient, or both. At first glance, this appeared to be so, but when he analyzed his test results, he found discrepancies. All eleven patients had normal to excellent hearing and significant intellectual potential; therefore, this disorder, whatever it was, was somehow masking both hearing and intellect. (2)

The strange disorder, defying all explanation, continued to bother him. Later that year, in a report on these eleven, Kanner described their condition as "infantile autism," meaning that the condition, so characterized by a lack of interest in interacting with others, began at or before birth. In that paper, he listed some thirteen characteristics common among the group: an inability in relating to other people, an inability to assume proper posture for being picked up, an inability to use speech to convey thoughts, excellent rote memory, confusion over personal pronouns, an echoing of words and phrases, eating difficulties, extreme fear of sudden or loud noises, monotonously repetitive behavior, a fascination with objects, good intellectual potential, is physically normal otherwise, and has highly intelligent parents. (3)

Kanner also noted that since schizophrenia could also involve a withdrawal from society, then infantile autism must be an early childhood version of that disorder, albeit an atypical type. Since schizophrenia was not well understood either, the view that autism was a type of the latter prevailed for another thirty years, though it was disproved in the early eighties with the advent of research using magnetic resonance imaging.

In the early 1980's, Margaret Bauman and Thomas Kemper, medical researchers at Massachusetts General Hospital, found specific brain abnormalities during an autopsy of a twenty-nine year old autistic individual, confirming for the first time that the condition was biological in nature rather than psychological. What they found was that the nerve cells in the forebrain were smaller than expected and densely packed in the amygdala and the hippocampus, indicating an immature brain. In studies involving animals, the removal of the amygdala resulted in social withdrawal, difficulty handling the wealth of information brought in by the various senses, and difficulty dealing with change in the environment. In the area known as the neocerebellum, the team also noted a significant shortage of specialized nerve cells known as Purkinje cells. However, what this deficiency meant was still a mystery. (4)

In the mid-1980's, autopsy research scientist Dr. Eric Courchesne discovered that these Purkinje cells worked to filter out incoming, but redundant, sensory information. Without an adequate number of these "filters," the cerebral cortex, the area of the brain involved in thinking and judgment, would quickly get overwhelmed, as a small dam would be by flooding upstream. Bright lights become painful. Attention shifting becomes difficult. (5) Information from the various senses get misrouted, making it difficult to tell what sense is giving what information.

By the late 1980's Courchesne had introduced magnetic resonance imaging into the field of autism research. In his search for structural abnormalities in the brain structures of diagnosed autistic individuals, he found wide discrepancies from what was expected. In most, the area of the brain known as the cerebellum was significantly smaller than expected; whereas in others, the same area was much larger than expected. It has long been known that the cerebellum is important for muscle coordination, fine motor control, speech, and balance. What Courchesne found was that, through its connections to the hippocampus, the cerebellum also coordinates attention shifting. Thus, any injury in this area of the brain would affect an individual's ability to shift his attention in a timely manner, as is the case in autism. (6)

Another group, led by Dr. Toshiaki Hashimoto, conducted a study based on age and overall brain development. He found that during infancy this area of the brain is much smaller in the autistic than in the non-autistic group. He also found steady rates of development of this area of the brain in both groups, with the rate of development in the autistic group being much steeper. (7)

According to experts, the hippocampus provides a memory of context, vital for emotional meaning. While the hippocampus remembers the dry facts, the amygdala retains the emotional flavor that goes with those facts. The hippocampus is crucial in recognizing the face of a familiar person, while the amygdala gives you the emotional feeling about that person. The amygdala is made up of two almond- shaped clusters of inter-connected structures just above the brain stem. It serves as a storehouse of emotional memory. Without it we would have a life without personal meaning, without a sense of our own biography. (8)

As to what caused this prenatal interruption in development, some studies point to a deficiency in the neurotransmitter serotonin as the culprit. It is well documented that many, if not most, autistic individuals have elevated platelet serotonin, indicating a deficiency of this valuable neurotransmitter in the brain, causing such individuals to function well below their potential. (9) Scientists have long theorized that serotonin is vital to early brain development, long before it is needed as a neurotransmitter, as well as proper functioning throughout life. Recent studies, using the latest in state of the art technology, have borne this out. Thus, a deficiency of serotonin during the mid- trimester, at a time in which it is ordinarily at a peak, could also help explain the interruption in development. (10)

Other experts, not quite satisfied with the serotonin deficiency as the sole cause for the initial interruption in development, looked to a connection with the hormone interferon. In a pilot study, Gene Stubbs found abnormally high levels of the hormone in all ten of his autistic patients, whereas none was expected since the children were otherwise healthy. Ordinarily, the body produces this hormone only during viral infections. It serves a vital purpose in that it temporarily inhibits cell growth and replication while the rest of the immune system gets involved. Since the ten individuals were otherwise healthy, then this production of interferon must be due to immune system dysfunction. (11)

Meanwhile, Dr. William Shaw noted that several of his patients with autism had yeast-produced compounds in their urine. This hinted that there was an over-population of yeast-turned-fungus in the body, causing small fissures in the mouth and intestinal wall. The implication was that food substances were entering the individual's blood stream prematurely. He also noted that antifungal drugs, such as Nystatin, seemed to have dramatically decrease the negative behaviors in these same children. (12)

Doctors have long known that when proteins are properly digested, the body takes the resulting amino acids and creates new proteins. However, recent evidence indicates that if these proteins, gluten in particular, are not completely broken down, due to these rips, then the result is a series of compounds with opiate-like effects. Partially digested vitamins and minerals also causes problems for the immune system. (11)

What will the future bring? One can only hope that it will bring greater understanding of this complex disorder. Whether the gene is ever identified or not, those with the disorder will have a better quality life, with more appropriate therapy and less sensory torture.



(1) Delacato, Carl. (1974). The ultimate stranger; the autistic child. Garden City, NY: Doubleday, p. 32.

(2) Kanner, Leo. (1948). Child psychiatry. Springfield, IL: Charles C Thomas.

(3) Furneaux, Barbara, and Roberts, Brian. (1977). Autistic children: teaching, community and research approaches. Boston: Routledge and Kegan Paul.

(4) Bauman, Margaret and Kemper, Thomas (1994). The Neurobiology of Autism. Baltimore: The John Hopkins University Press.

(5) Belmonte, Matthew. (1992). Life Without Order: Literature, Psychology, and Autism [Online]. Available HTTP: http;//www.slc.edu/pages/m/mbelmont/LwO/

(6) Edelson, S. (1997) Cerebellum and autism [Online]. Available HTTP: http;//www.autism.org/cerebel.html

(7) Hashimoto, Tokiashi, et. al. (1995) Development of the brainstem and cerebellum in autistic patients. Journal of Autism and Developmental Disorders, 25, 1-18.
(8) Anandalakshmy, S. (1997). Fifth National lecture in child development: thinking with the Heart and Feeling with the Brain. [Online]. Available HTTP: http://ecdgroup.harvard.net/guestdoc/indiaecd.html

(9) The Serotonin System in Autism [Online]. Available HTTP:http://www-psy.bsd.uchicago.edu/~student/5htrev.html

(10) Serotonin: Roles in Development [Online]. Available HTTP: http://academic.uofs.edu/student/osmanskim1/paper.html

(11) Stubbs, Gene. (1995). Interferonemia and autism. Journal of Autism and Developmental Disorders, 24 , 17.

(12) Shaw, W. Interview with Dr Shaw about microbial metabolites in autism and other developmental disorders [Online]. Available HTTP: http://www.autism.com/shaw- yeast/interv.html

(13) The Candida Albicans Mystery [Online]. Available HTTP: http://ephca.com/ca_mys.htm

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