The Inexplicable Outbreak
In July 1374, a peculiar affliction seized the residents of Aachen, Germany. Without warning or explanation, dozens of people took to the streets and began to dance. This was no celebration—the dancers moved with wild, frenzied movements, screaming and contorting their bodies in apparent agony. Most disturbing was their inability to stop. The dancing continued for days, with participants collapsing from exhaustion, only to rise and continue their involuntary choreography until many died from heart attacks, strokes, or dehydration.
This phenomenon, known as choreomania or dancing plague, spread throughout the Rhine Valley and eventually across much of Western Europe. The 1374 outbreak alone affected thousands in Germany, the Netherlands, Belgium, and northeastern France. Historical records document that some dancers continued their involuntary movements for weeks, with the most severe cases persisting for months.
Contemporary chronicles describe scenes of extraordinary distress. In Cologne, dancers formed circles, holding hands and leaping wildly until they fell to the ground, gasping. Witnesses reported dancers crying out the names of saints, particularly St. John and St. Vitus, begging for deliverance from their affliction. The medieval chronicler Jean de Venette described how “in their frenzy they made the sign of the cross and leaped high in the air, as if they had been possessed by demons.” Most alarming to medieval observers was the dancers’ apparent immunity to pain during their episodes—many sustained severe injuries from their exertion, but continued dancing regardless.
The contagious nature of the phenomenon was particularly troubling. Observers who came merely to witness the spectacle frequently found themselves overcome with the same compulsion to dance. In some communities, the dancing spread through entire families, with children as young as six and adults as old as seventy joining the macabre performance. Ecclesiastical authorities often interpreted this as evidence of demonic influence, while civic leaders feared the breakdown of social order that accompanied these episodes.
Medical Mysteries and Cultural Context
Unlike modern epidemics with identifiable pathogens, dancing mania defies straightforward medical explanation. Dr. John Waller, historian at Michigan State University, has documented how these outbreaks typically occurred in communities experiencing severe psychological stress. The 1374 outbreak followed closely after devastating waves of the Black Death, during which approximately 40% of the European population perished.
Contrary to popular misconception, choreomania was not caused by ergot fungus poisoning (which produces convulsions rather than coordinated dancing). Recent analysis of medieval medical records by historian Robert Bartholomew suggests these were instances of mass psychogenic illness—what earlier generations called mass hysteria—amplified by the prevailing belief systems of the time.
Particularly revealing is that many dancers reported visions of being submerged in rivers of blood or seeing the heavens open before them, reflecting the apocalyptic religious imagery dominating 14th-century European thought. Local authorities in Strasbourg commissioned musicians to play alongside the afflicted, believing structured music might cure their chaotic movements—a treatment that sometimes temporarily alleviated symptoms.
The socioeconomic context of these outbreaks deserves careful consideration. The 14th century represented a period of unprecedented hardship for the European peasantry. Beyond the Black Death, the continent suffered from widespread famine, political instability, and the ongoing Hundred Years’ War. Archaeological evidence from mass graves of the period reveals that severe malnutrition was commonplace. Professor Andrew Cunningham of Cambridge University has noted that dancing mania predominantly affected lower socioeconomic groups, suggesting a connection between material deprivation and psychological vulnerability to such phenomena.
Medical practitioners of the time were utterly baffled. Paracelsus, the renowned Swiss physician, traveled to observe choreomania outbreaks and concluded they resulted from “hot blood” that required physical release through movement. Others blamed astrological influences, poisoned water, or demonic possession. The medical treatise “De Choreis Sancti Viti” from 1514 recommended bloodletting and isolation as treatments, though neither proved effective.
The Strasbourg Dancing Plague of 1518
The most thoroughly documented instance occurred in Strasbourg in July 1518, beginning with a woman identified in municipal records as Frau Troffea. She stepped into the street and began dancing uncontrollably. Within a week, 34 others had joined her. By August, the epidemic had grown to include approximately 400 dancers.
Unlike modern responses to public health crises, Strasbourg’s magistrates made the fateful decision to encourage the dancing, establishing a wooden stage and hiring professional musicians. Their reasoning, based on the medical understanding of the time, was that the afflicted must be allowed to dance out the mysterious malady. This decision proved catastrophic—contemporary chronicles report that up to 15 dancers died each day at the height of the outbreak.
Archival records from the Strasbourg city council reveal extraordinary expenditures for musicians, medical care for the dancers, and the construction of a specialized shelter for those too weak to return home but still compelled to dance. The council’s records also document debates about whether the affliction represented divine punishment or demonic possession.
The Strasbourg outbreak occurred during a period of severe grain shortages and inflated food prices. Municipal records indicate wheat prices had increased sixfold in the months preceding the dancing plague. The city’s guilds were engaged in bitter disputes with the nobility, and religious tensions were rising with the early stirrings of what would later become the Protestant Reformation. This perfect storm of stressors created fertile ground for psychological contagion.
Physician Paracelsus visited Strasbourg shortly after the outbreak and documented his observations, noting that many dancers appeared to enter trance-like states. He controversially claimed the women initiated the dancing as a form of protest against restrictive social conditions—an early recognition of potential sociopolitical dimensions to the phenomenon. While his interpretation was dismissed at the time, modern sociologists have found evidence that choreomania outbreaks often coincided with periods of heightened gender restrictions and limited female autonomy.
Modern Interpretations and Cultural Legacy
Neurologist Kaptchuk of Harvard Medical School has proposed that choreomania might represent a culture-specific manifestation of Sydenham’s chorea, a neurological disorder characterized by rapid, uncoordinated movements. However, the scale and specificity of the outbreaks suggest something beyond purely physiological causes.
Anthropologist Erika Bourguignon’s cross-cultural studies of trance states suggest dancing mania represents an extreme form of ritualized dissociation that became pathological in the context of medieval European social stress. Her comparative work with trance dance traditions in Haiti and Brazil indicates that while voluntary trance dancing serves therapeutic functions in many cultures, the medieval European outbreaks lacked the cultural frameworks to contain and direct such states.
Perhaps most intriguing is the complete disappearance of choreomania after the 16th century. No documented cases exist in the modern era, suggesting the phenomenon was uniquely tied to medieval European cultural contexts and stress responses. The dancing plagues represent a fascinating example of how psychological distress manifests differently across historical periods and cultural contexts.
Recent neuroimaging research by Dr. Valerie Voon at Cambridge University has illuminated how extreme stress can inhibit regions of the brain responsible for voluntary movement control while activating motor pathways typically involved in emotional expression. This research suggests a neurobiological mechanism by which psychological distress could manifest as involuntary dancing. Sociologist Robert Bartholomew has documented over 600 cases of mass psychogenic illness worldwide between 1566 and 2001, noting that symptoms consistently reflect cultural expectations of how distress should manifest—dancing in medieval Europe, fainting in Victorian factories, and mysterious odors in contemporary schools.
The legacy of these events persists in European folklore and idioms. The Pied Piper of Hamelin legend may have roots in dancing mania outbreaks, while the German expression “Sankt-Veits-Tanz” (St. Vitus’s Dance) still refers to chaotic, uncontrolled movement—a linguistic fossil of a time when thousands danced themselves to death in the streets of medieval Europe. The phenomenon continues to fascinate medical historians as a powerful example of the intersection between psychological, social, and cultural factors in human health and behavior, challenging our modern tendency to separate mind from body and individual experience from collective consciousness.