In 1852, a man was admitted to the Asile d’Aliénés de Maréville, an asylum in France, claiming that his body had gone through a strange transformation.

Though he appeared to be physically normal, he told his doctors that he had cloven feet and sharp fangs, and that his body was covered in long hair. He was convinced that he had turned into a wolf, and asked the doctors to put him on a diet of raw meat. The staff obliged him, but he refused to eat what he’d been given because it wasn’t “rotten enough.” He later asked the doctors to end his torment by taking him into the forest and shooting him. They did not honor that request, and the man eventually died in the asylum.

A few years ago, another man came to Dutch psychiatrist Jan Dirk Blom with a similar problem. He complained of increased hair growth on the arms (as visually perceived by him, not by others), a “hardening” of his jaws and facial muscles and the growth of fangs that caused small wounds on the corners of his mouth—none of which Blom could see. The patient had searched the Internet for information about his condition before going to the hospital and reported his self-diagnosis to Blom. While it was a far-fetched idea, he wouldn’t accept any other explanation. He was a lycanthrope, or werewolf.

Blom’s patient, the Frenchman with the cloven feet, and other self-professed lycanthropes that have made their way into the medical literature aren’t like Larry Talbot, Scott “Teen Wolf” Howard, or other werewolves from scary movies and folklore. These guys didn’t actually turn into beasts when the full moon came up, and in most cases their doctors couldn’t perceive any of the physical changes they complained about. Rather, they suffered clinical lycanthropy or lycomania, a rare psychiatric disorder marked by hallucinations and delusions that one can transform into a wolf.

After treating his patient, Blom was curious about how often the condition had been documented and how it had been treated in the past, so he dug into the scientific literature. Between 1850 and 2012, he found just 52 papers and 56 original case descriptions on “delusional metamorphosis into an animal,” only 15 of which involved clinical lycanthropy (the rest of the animals ran the gamut from cows and rhinos to bees, birds, and gerbils).

The earliest reported case of clinical lycanthropy Blom could find was the Frenchman in 1852. Before that, he says, lycanthropy was “conceptualized as an actual conversion of humans into wolves and vice versa, linked with such wide-ranging themes as lunar influences, witchcraft and demonology.” Even in times when metaphysical and supernatural explanations prevailed, though, Blom’s search turned up a few “explanations of a more rational nature.” As early as the second century, he says, the Greek physicians Galen and Marcellus of Side appear to have “considered lycanthropy a disease rather than a manifestation of evil possession.” Later, in the Early Middle Ages, medical cures for lycanthropy—including “dietary measures, complex galenical drugs, hot baths, purgation, vomiting, and bloodletting to the point of fainting”—were prescribed by Greek and Byzantine physicians who variously classified it as a type of melancholia or mania, or attributed it to epilepsy, an imbalance of the humors or drug use. And although he was late to the party by a few hundred years, the 16th century Dutch physician Johannes Wier came to the same conclusion as the Greeks and “has been lauded for being the first to designate lycanthropy as a natural rather than a supernatural affliction.”

These medical explanations didn’t catch on right away, and for a long time, Blom says, “isolated instances of proto-scientific thought” existed alongside the “traditional, metaphysical” interpretations of lycanthropy, even after the scientific revolution. Medical diagnoses for supposed werewolves weren’t always the product of scientific reasoning, either. In 17th-century England, for example, Blom says that lycanthropes were “generally considered victims of delusion due to excessive melancholy—not because English doctors were so far ahead of their Continental colleagues at the time, but rather because wolves were then already extinct in their country, and the werewolf theme had been supplanted by similar myths involving the cat and hare.”

By the 19th century, supernatural explanations had been tossed aside and Western physicians generally considered clinical lycanthropy a delusional belief best treated with pharmaceuticals. Even today, though, the underlying cause of the condition isn’t well understood and cases aren’t very well documented. And because, as Blom says, it usually occurs along with other symptoms that point doctors to “more conventional diagnoses such as schizophrenia, bipolar disorder and so on,” clinical lycanthropy may be underreported, with doctors not crying wolf as often as they should.

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