10 Case Reports of Cotard’s Delusion


Cotard’s Delusion is a mental disorder where people suffer the nihilistic delusion that they are dead or no longer exist. First reported in the 1700s, the disorder is still largely a mystery today. The underlying cause isn’t understood; it’s been linked to bipolar disorder, depression and/or schizophrenia depending on the patient’s age. Here, ten people who went to their doctors and complained that they were dead.

1. In 1788, Charles Bonnet reported one of the earliest recorded cases of Cotard’s Delusion. An elderly woman was preparing a meal when she felt a draft and then became paralyzed on one side of her body. When feeling, movement, and the ability to speak came back to her, she told her daughters to dress her in a shroud and place her in a coffin. For days she continued to demand that her daughters, friends, and maid treat her like she was dead. They finally gave in, putting her in a shroud and laying her out so they could “mourn” her. Even at the “wake,” the lady continued to fuss with her shroud and complain about its color. When she finally fell asleep, her family undressed her and put her to bed. After she was treated with a “powder of precious stones and opium,” her delusions went away, only to return every few months.

2. Some 100 years after Bonnet met the old lady, French neurologist Jules Cotard saw a patient with an unusual complaint. Mademoiselle X, as Cotard called her in his notes, claimed to have “no brain, no nerves, no chest, no stomach and no intestines.” Despite this predicament, she also believed that she “was eternal and would live for ever.” Since she was immortal, and didn’t have any innards anyway, she didn’t see a need to eat, and soon died of starvation. Cotard’s description of the woman’s condition spread widely and was very influential, and the disorder was eventually named after him.

3. In 2008, New York psychiatrists reported on a 53-year-old patient, Ms. Lee, who complained that she was dead and smelled like rotting flesh. She asked her family to take her to a morgue so that she could be with other dead people. They dialed 911 instead. Ms. Lee was admitted to the psychiatric unit, where she accused paramedics of trying to burn her house down. After a month or so of a drug regimen, she was released with great improvement in her symptoms.

4. In 1996, a Scottish man who suffered head injury in a motorcycling accident began to believe he had died from complications during his recovery. Not long after he completed recovery, he and his mother moved from Edinburgh to South Africa. The heat, he explained to his doctors, confirmed his belief because only Hell could be so hot.

5. In 2012, Japanese doctors described a 69-year-old patient who declared to one of the doctors, “I guess I am dead. I’d like to ask for your opinion.” When the doctor asked him whether a dead man could speak, the patient recognized that his condition defied logic, but could not shake his conviction that he was deceased. After a year, his delusion passed, but he insisted on the truth of what happened during it. “Now I am alive. But I was once dead at that time,” he said. He also believed that Kim Jong-il was also a patient at the same hospital.

6. In 2009, Belgian psychiatrists reported the case of an 88-year-old man who came to their hospital with symptoms of depression. The man explained that he was dead, and was concerned and anxious that no one had buried him yet. His delusions subsided with treatment.

7. The same doctors also treated a 46-year-old woman who claimed to have not eaten nor gone to the bathroom in months, nor slept in years. She explained that all her organs had rotted, that she had no blood and that doctors who monitored her heart or took her blood pressure were deceiving her because her heart didn’t beat. After multiple admissions to the hospital and a lapse in taking her medication over the next 10 months, her condition gradually improved.

8. Greek psychiatrists received a patient in 2003 who believed he was literally empty-headed. He had attempted suicide years earlier because he thought it wasn’t worth living since he didn’t have a brain. He was not treated after the incident and simply returned to work. Once at the hospital he “claimed that he was born ‘without a mind,’ meaning that his head is empty without a brain and for this reason he is retarded.” He left against medical advice after several days, and was re-admitted the next year. This time he completed treatment and showed sustained improvement in a follow-up interview months later.

9. The Greek doctors also treated a 72-year-old woman who went to the ER claiming “all of her organs had melted; only skin had remained and that she was practically dead.” She was admitted to the hospital and her outcome not reported.

10. In 2005, Iranian doctors described what may be the most unusual case recorded. A 32-year-old man arrived at their hospital saying that not only was he dead, but that he had been turned into a dog. He said that his wife had suffered the same fate. His three daughters, he believed, had also died and had turned into sheep. He said that his relatives had tried to poison him, but that nothing could hurt him because God protected him even in death. He was diagnosed with Cotard’s and clinical lycanthropy, treated with electro-convulsive therapy and relieved of his major symptoms. (You can read more about this case at my website.)

Live Smarter
A Simple Trick for Keeping Lemons Fresher for Longer

Lemons don't get much respect in the average refrigerator. After taking a slice or two to punch up drinks or add to a recipe, the remaining wedges can often be pushed out of view by incoming groceries and left to go to waste.

But the folks at Food52 have come up with a solution to get more use out of those lemons by keeping them fresher longer. Because citrus needs moisture in order to remain fresh, all you need to do is place your lemon in a bowl of water before putting it in the fridge.

Another idea: Put them in a sealed plastic bag and make sure you remove all the air to prevent mold growth. You'll get up to three months of freshness with this method. If your lemons are already cut into wedges, you can expect they'll last three to four days.

The "hack" also works for oranges and grapefruits. As for freezing, you can do that, too, but the resulting mushy fruit is probably best left for making juices.

[h/t Food52]

The Body
13 Facts About Skin

Skin isn't just the outermost layer of our bodies. Without it, we couldn't do most of the things we take for granted, like breathing, moving, and keeping the body's inner workings where they belong. And while skin also evolved to keep pathogens and other bad stuff out of our bodies, consumers spend millions of dollars on products to penetrate that defense (with mixed results). Read on for more fascinating facts about the skin.


Skin is considered an organ in its own right. It's comprised of three layers: the waterproof top layer, the epidermis; a middle layer of tougher connective tissue, hair follicles, and glands called the dermis; and the inner layer, the hypodermis, which is mostly fat and connective tissue that supports the skin's structure and attaches it to muscles.


Those cells are known as melanocytes, which secrete a pigmented substance called melanin; the more melanin in the cells, the darker the skin. Having too little or too much melanin can lead to some skin color disorders: On one end of the spectrum are conditions like vitiligo—which occurs when some melanocytes lose the ability to produce melanin, resulting in whitish patches on the skin—and albinism, a condition in which melanocytes don't produce any melanin. On the other end is hyperpigmentation—the presence of excess melanin, which can cause darker patches of skin.


"Your skin accounts for 15 percent of your body weight," says Toral Patel, M.D., a board-certified dermatologist and supervising physician at D&A Dermatology in Chicago and a clinical instructor of medicine at Northwestern University. This makes it your body's largest organ.

According to that calculation and data from the Centers for Disease Control and Prevention, an average American woman weighs 168.5 pounds and carries more than 25 pounds of skin. An average man weighing 195.7 pounds will have nearly 30 pounds of skin.


New cells are created in that deep layer of the skin and take about four weeks to rise to the surface. There, they grow hard and then shed. This process, in which old skin is sloughed off and replaced by newer skin, might occur more than 1000 times over the average American's lifespan. But all skin is not created equal: Its thickness varies naturally among all areas of the body. Thickness can also be affected by age, gender, and habits (like smoking) that can change the cells' elasticity and other traits. According to Patel, the skin on the soles of your feet is up to seven times thicker than the skin of your eyelids.


If your skin cells shed every month, how do tattoos stick around? It turns out to be a function of your immune system. The puncture of the tattoo needle causes inflammation in the dermis, the skin's middle layer. In response, white blood cells known as macrophages are sent in to help heal the damage. These macrophages "eat" the dye and can pass it to newer macrophages when they die off, so the pigment is essentially transferred from one cell to another. Any leftover pigment is soaked up by fibroblasts, which are longer-lasting skin cells that don't regenerate as often. Only lasers designed for tattoo removal are strong enough to kill off the macrophages and fibroblasts that hold the dye.


Your skin hosts a microbiome that can contain more than 1000 types of bacteria (along with other microbes, viruses, and pathogens). These "tiny ecosystems," as Patel describes them, are mostly friendly bacteria that work in concert with our bodies for many beneficial purposes, including wound healing, reducing skin inflammation, and assisting the immune system to help fight infection. These bacteria were once thought to outnumber your own cells 10 to one, but more recent research has found the ratio is closer to 1:1.


Injuring or breaking the skin's dermis, the layer below the epidermis, can expose the inner tissues to pathogens. To prevent infections from reaching any further into the skin, body fat, or muscle, ancient Egyptians cared for topical wounds with salt (yes, really!), fresh meat, moldy bread, and onions.

While these may seem like unsanitary things to put on a cut, modern research has found that there was actually merit in their methods. With its high iron content, meat was a good blood coagulant and recommended for the first day of a wound, according to a 2016 paper in the Journal of the German Society of Dermatology. Salt and onions are both astringent, which can stop blood flow. Moldy bread likely had antibacterial properties—a very early form of penicillin, you might say. Skin wounds would then be sealed with a combination of oils, fats, honey, and plant fibers.


Your skin is a significant shield against billions of tiny microbes and pathogens. But just as importantly, skin keeps fluids in. Another way to think of this, Patel says, is that your skin resembles a brick and mortar pattern. The bricks are the cells. The mortar is made up of lipids, fatty acids, and other sticky proteins that form the watertight layer. "If you have any ‘holes' in skin where moisture can escape, which are more susceptible to damage, that leads to dryness, cracking, and inflammation," Patel says.

People who have suffered burns often have fluid-balance problems, says Robert T. Brodell, M.D., professor of dermatology at University of Mississippi Medical Center in Jackson, Mississippi. "Fluids are seeping out, and they can't keep them balanced internally," he tells Mental Floss. This can be incredibly dangerous, because fluid loss can cause the heart to stop pumping blood to the rest of the body. Dehydration, hypertension, and other problems may also occur when skin is injured.


Psoriasis is an autoimmune condition in which the skin cells in an affected area grow rapidly, leading to excess skin buildup, inflammation, and a red and scaly rash. While it can be uncomfortable to live with the condition on its own, studies [PDF] have shown that inflammation of the skin can lead to inflammation of other tissues and internal organs, and eventually certain diseases. For example, psoriasis has been linked to a greater risk for heart disease, as well as diabetes, Crohn's disease, metabolic syndrome, and other conditions thought to be correlated with inflammation.

Patel says that association makes treatment even more important: "If one organ is inflamed, you have to make sure another isn't."


Unless you live in the tropics, you've probably noticed that the skin of your lower legs becomes drier in winter—and there's a biological reason for that. "You have fewer oil glands on your legs than any other area of your body," Brodell tells Mental Floss. Oil (or sebaceous) glands, found near the dermis's border with the epidermis, secrete an oily substance called sebum that lubricates skin and hair. As people age, the glands secrete less oil, and that means drier skin. Winter's low humidity and our tendency to spend more time around heat sources dries out skin even more.

The solution is to install a humidifier or apply some moisturizer. Certain skincare products, such as those with emulsifiers like sodium laureth sulfate, can also dry out or irritate your skin, so read your labels carefully.


Both types of sweat glands are also located in the dermis. Eccrine glands, found all over the body, emit sweat directly through pores in the epidermis. Apocrine glands release sweat along hair follicles, so it's no surprise that these glands are concentrated in the hairiest parts of the body—head, armpit, and groin. Both types help regulate body temperature: In hot conditions, the glands release water and fatty liquids to cool the skin.

A lack of sweat glands puts people in danger of overheating. Those with a condition known as anhidrotic ectodermal dysplasia have few to no sweat glands, so they can't properly cool off when the body overheats. "They get heatstroke easily," Brodell says. A subset of people with this disorder suffer from immunodeficiency. They produce low levels of antibodies and infection-fighting immune T- and B-cells, so they are more prone to skin and lung infections.


The gut and the skin never come into direct contact with one another, yet research shows that the gut has a profound impact on the skin.

"The skin becomes very unhealthy when the microbiome of the gut goes into a state of dysbiosis," meaning when something attacks the gut's good bacteria, says Gregory Maguire, Ph.D., a former professor of neuroscience at UC San Diego and the founder and chief scientific officer of BioRegenerative Sciences, a stem-cell technology company.

Dysbiosis can lead to inflammation, irritation, rashes, and pain. "There's good evidence that eczema [or] atopic dermatitis is partially due to dysbiosis of the gut and skin," he says.

In a 2017 paper published in the Archives of Dermatological Research, Maguire writes that normal gut bacteria can actually calm the body's response to stress. A reduction in the release of the stress hormone cortisol, which is thought to cause breakouts, also reduces the chance of skin irritation—all thanks to microbes in your intestine.


When the skin's pores get clogged with sebum from the sebaceous glands and dead cells, a condition usually associated with hormonal changes, you've got acne. Clogged pores that stay closed are called whiteheads; if the pore opens and reveals the gunk inside, it's a blackhead. (The medical term for a blackhead, an "open comedo," stems from a Latin phrase alluding to "worms which devour the body." But don't worry, blackheads are not actual worms living in your face.)

While acne may seem like a rite of passage associated with puberty, researchers are experimenting with fighting "bad" bacteria (in this case, Propiobacterium acnes, which is linked to acne breakouts) with "good" bacteria, also known as probiotics. "One of the things [probiotics] do is ferment things on the skin like ammonia and nitrites, and metabolize it and turn it into other chemicals that are beneficial to the stem cells in your skin," Maguire explains. A 2015 study in the Journal of Women's Dermatology and other research has found that applying topical probiotics like Streptococcus salivarius and Streptococcus thermophiles inhibits P. acnes and may make skin more resilient against it in the long run.


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