Stuff You Should Know - Selects: How Itching Works

Episode Date: February 1, 2025

It was only in the last few decades that science became aware that itches aren't just low-level pain. And in that time, the mystery of how we itch and why we scratch has gotten even more baffling. Explore the mystery with Josh and Chuck in this classic episode.See omnystudio.com/listener for privacy information.

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Apple Podcasts or wherever you get your podcasts. Welcome. My name is Paola Pedroza, a medium and the host of the Ghost Therapy Podcast, where it's not just about connecting with deceased loved ones. It's about learning through them and their new perspective. I think God sent me this gift so I can show it to the world. And most of all, I help people every single day. Listen to the Ghost Therapy Podcast on the iHeartRadio app, Apple Podcasts or wherever you get your podcasts. Hi everybody, Chuck here. It's May 9th, 2017 and podcast time. I know it's really 2025,

but we're going all the way back to May of 2017 to talk about itching. Oh boy, just seeing that title probably makes you itch. And that's one of the deals with itching, if I remember correctly. So I hope you dig it, and I hope you're not too itchy right now. Welcome to Stuff You Should Know, a production of iHeartRadio.

Hey, and welcome to the podcast. I'm Josh Clark. There's Charles W. Chuck Bryant and there's Jerry Rowland. So this is Stuff You Should Know, scratching edition. Yeah, this is one of many. You remember when we did Yawning? Yeah. Well, that's the only one I can think of where just researching something makes you do the thing you're researching.

This definitely happened with this one. Yeah. Well, we ran across that in Poison Ivy and Scabies for sure and talked about some of this stuff, but I think itch, we had an itch we needed to scratch with this particular topic. Well, I'm glad. I've been wanting to do this one for a while. Yeah, you did a video about this, right?

Yes. A short video. No, it was three, four hours long. Okay. If I remember correctly. Does that mean we have to do this, do I have to be here for the next four hours? Yeah, we have to just play the whole thing

and then we'll talk about it for an hour after. That sounds good. Okay, I think it was a Brain Stuff video, wasn't it? Yeah, I watched it. Did it scratch your itch? Yeah, I watched it yesterday. Oh, okay. Nice work.

Thank you very much. You're just like. Now we finally arrive at what I was after. Compliment. Yeah. No, it was great. Thanks, man. So I guess the point of all that is to say

you guys are going, you're going, alright, my videos are the best, that you're going to scratch, you're gonna feel an itch. Which is one of the great mysteries of itches. It turns out, we only very, very recently have started to get a handle on what itches are. And there's still plenty of mysteries left to it. Like for example, it's bizarre and there's really no

evolutionary reason as far as anyone can tell why just hearing about itches or seeing someone else scratch can make you itch. That's odd, that's weird. Like think about it. Or seeing a video of an ant crawling up an arm will make you itch. It will. But I mean think about it. Or seeing a video of an ant crawling up and an arm will make you itch. It will.

But I mean think about it, if somebody is sitting there, you see a video of some schmoe who's got his hand like near an oven and he pulls it away really quick. It doesn't hurt your hand. It doesn't make you feel like your hand is burned. No. That doesn't happen.

I don't even think that would excite mirror neurons like a leg break would. No. You're just like, what a stupid idiot. That's what it excites, you know? I hope that guy's hand just burns clean off. That's what I think, right? Right. Yeah. You sourced a couple of, well, we had our own article on HouseStuffWorks.com.

Yeah. But you also sent this great New Yorker article written by Dr. Atul Gawande. One of the best names in writing today. Yeah, that may be my new hotel name. Well, you may be thronged by science fans, because that guy's pretty well known. Actually, I've never used an alias at a hotel, that's dumb. And I don't even know if you can, can you?

I guess if you're a big shot, you can. Yeah, but you have to be like, I'm not Brad Pitt, I'm Atul Gawande. Right. But we'll get to some of the more interesting aspects of that article later, specifically a very specific patient that's quite distressing.

So calm down for now, Atul's mom. But- We'll get to it eventually. He did include a couple of neat historical tidbits. Like in 1660, there was a... and Germans are all over this thing for some reason. Yeah? You know, researchers that they're all German. They had the itch to explain the itch.

I guess so. The itch. Right. But there was a physician in 1660 named Samuel Hoffenreffer. Actually, that's my new hotel name. Yeah. That's a good one. He kind of, well, he defined it by saying an itch is an unpleasant sensation that provokes

the desire to scratch. Pretty simple. Yeah. But right on the money. It is and actually it's so on the money that anywhere you look in the medical literature, whenever they define itch, word for word, that's the definition they use.

The Haffenreffer? Yeah, although poor Haffenreffer doesn't get credit for it all the time, but that's the one. The only expansion of that that I've seen is that can occur anywhere on the body, which apparently is true. I think Huffin Reffer, he felt that was implied.

Right. He's like, it goes without saying. I'm scratching right now, by the way. Are you? Yeah. It started. I don't know if I just noticed more, because as I was doing it, I was thinking, well, now I'm scratching.

Then I thought, do I always scratch this much or itch this much? Oh, I hadn't thought about that. I'm pretty sure that I was, I don't think I scratch as much as, I don't know. You raise a really good question. Maybe we can get an intern to follow us around and just record our scratching. Right. I'm surprised that that's not already a TV show, frankly. Josh and Chuck scratch. Just being followed around.

Yeah. Oh, you know, no one wants to see that. Well, that's probably why it's not. You're scratching. See, that's what I'm saying. I don't think I scratch this much. I don't notice it. All right. Moving on to Dante's Inferno. It was in Dante's Inferno the burning rage of fierce itching that nothing could relieve is how falsifiers were punished Yeah, do you know what a falsifier is?

us I Know really like isn't that that's somebody who like bears false witness or somebody who falsifies a document or? I don't know, is it just a fancy name for liar? Maybe. Oh, I thought you were going to tell me. You were just wondering? Yeah, I don't know. All right. Well, I don't know what Dante meant, but they're bad people. Sure, apparently. There's a special place in health for them, literally.

Well, I guess actually not literally. Figuratively. Sure. Literarily. Oh, very nice. So itching scientifically is known as pruritus. P-r-u-r-i-t-i-s. Yeah. It's one of those tough to pronounce things, for me at least.

And for, well actually they still believe that the evolution of the itch was to help humans survive, basically, because so many things that can kill you in nature are things like mosquitoes or flies or spiders or fleas that can have malaria or the plague or any number of diseases attached to their tiny little insect bodies. Right. So, hey human, you've got a mosquito on your neck that could kill you, you might want to slap it or scratch. Yeah, and that's still as far as I know the evolutionary hypothesis for why we experience itching.

Yeah. And it's not just us either. Boy, you're scratching like crazy now. It's found throughout the animal kingdom. From us to, apparently, fish have shown scratching behavior. Yeah, that's crazy. Fruit flies. How does a fish scratch, you might ask? It rubs up against rocks.

Yeah, it's kind of cute. It is a little cute. I remember my dad did the... Who was the bear in Jungle book? Was that Baloo? Yes. He would do the Baloo where he would get up against a tree or a wall. And then I did it probably because of that.

I'm sure that's where I got it and realized that it works. And I still do it every now and then. Oh yeah? Yeah, I look kind of silly, but. Do you sing while you do it? Yeah, bear necessities. That's still my favorite. What else are you gonna sing?

like Mambo number five I'm gonna start doing that actually You'd be like think something's wrong with Chuck. Yeah, so like you said though, it was up until almost What was it 1987 the mid to late 80s? Yeah, but another German H.O. Handwerker And his gang sure toughs They started to do actual like research about it They were puzzled and wanted to solve it right because up to this point up to Actually 1987 everyone thought that an itch was just a low-grade pain stimulus.

Yeah, I guess they were just happy with that. That's just what they thought it was. And Han Verker said, you know what, let's find out if this is actually true. I'm tired of sitting around just assuming this is fine. I'm Han Verker. And he got to Verk-ker with his hands testing this. I know it was like Jonathan Strickland level. What he did was, this is just awful. He introduced using like electrical stimulation I guess, he introduced histamine to skin cells.

Histamine is a natural, I don't know if it's a protein, but it's a natural chemical, right? That the body releases in response to certain stimuli, say for example, like a mosquito bite or something, and it triggers the inflammation and immune response in that area, right? So histamine is associated with itch and it had been for a very long time.

So this guy was using electrical stimulation to introduce histamine in increasing amounts in these poor study participants. And it went from barely noticeable to, this is a quote, the maximum imaginable itch. And they never felt pain. Yeah, like even though they ramped it up to 11, no one ever said like, holy crap, that hurts. They said, please, please for love of God, stop, let me out of this and Han Verker just cackled and cackled. Right. These men with like black leather gloves were holding the participants down.

Yeah, they said this is not worth the five Deutschmarks that I'm getting for this lousy study. Yeah, that's nice, man. This would have been pre-Euro, I think. Oh, yeah. Even though the EU was around, I don't think the Euro was around in 87, right? No, no. Because the 90s? I traveled to Europe in 1997, and I was still on all that weird money. Oh, okay.

Yeah, so it was a while after that. So now scientists, I think this sort of introduced an itch to the scientific community because after hundreds and hundreds of years, Hanvuka sort of disrupted the thought process of the itch and the scratch. And all of a sudden scientists were like, oh, well, maybe we should start looking into this. Maybe we can actually isolate the nerve and figure this thing out. Yeah, because I mean, if it's not just a low-level pain sensation, then that means it's its own thing. And if it's its own thing, it probably has its own system and we need to know more about it.

So they got to study in it. Yeah. I wonder if all of this was under the notion that they were trying to cure itching. I don't know because from what I was reading, and all this was pretty recent stuff, there is a real unmet medical need in dealing and addressing chronic itch. Because most people who go through life just experiencing itch under normal circumstances, right? Let's say you or me, we're like an itch, yeah, they suck for a second and then it goes away. Imagine it not going away ever, whether you're asleep or awake or swimming or in outer space or doing whatever, you're itching constantly.

Supposedly it has as much of a pronounced effect on a patient's life as chronic pain does. It's constant, persistent, and agonizing. And it's not being met or treated because it's not understood. So they're just now starting to get into pain, or itch research. I saw somebody put it where pain research

was about 20 years ago. So it's starting to really heat up, but we're still just starting to understand it. So I would think that they weren't looking to cure it. I think it was just pointed out that there was this whole branch of neuroscience that was totally not understood. So get to work, neurologists. I wonder, I never really thought about it until just now, but I wonder what happens

when a performer or somebody that is in the public eye or on TV or on stage or like the president giving a address like what what what do they do if they have poison ivy or some other kind of contact dermatitis like have you ever thought about that like what if Lin-Manuel Miranda has a really bad case of poison ivy, I guess they can get an understudy in that case. Sure. But you can't have an understudy as president. No.

Which is too bad. You just go out there with your hands bandaged up just holding them up. Like how do you fight that? You've got the poison ivy on your— On camera. Or like a news anchor when they're just like, oh my god, I'm dying. I don't know. I guess a news anchor can tape things.

But I'm talking about live—what does Tom Petty do, for God's sakes Tom Petty grins and bears it he had a hard scrabble childhood He sure did prepared him for that. I'm going to see him tomorrow night. Oh, yeah He's not performing Anyway, I was just curious about that. Well, it's a good question Thanks. Do you remember when Costas had red eye at the Olympics and he was so dedicated to being the commentator, the anchor for the Olympics, they finally were like, you have to stop. No one can look at you anymore.

People are writing him and you're disgusting them. It was gross. One thing that made me think of that is I had recently, you can still kind of see it on my forearm, the scars, but I did a cement job. I was building this fence, putting in a gate at my house. And Scotty, you know Scotty, he and I built this thing together and we sank these huge posts for this gate and I didn't know that cement could cause contact dermatitis or even burns.

Never knew this. And we were, it was kind of a tight spot and we couldn't get shovels in there in the hole so we were literally mixing this stuff up to our elbows with our arms and I was like, this kind of feels good, I even said, like oatmeal or something. And then two days later, my right arm was just covered in the nastiest dermatitis I've ever seen. Wow. And then he got it.

Yeah, it's still kind of hanging around. So I went and got a prescription for steroids, which made me a little crazy for a week and a half. Okay. Did you trash the gate and have to start over? No. In droid rage? I think I was probably not the best husband, though. I see.

Over that time period. Yeah. Judging from Emily saying, hey, you're a real a-hole. Get off the steroids. Gotcha. Get off the juice. And I was like, shut up! Watch this. Watch me hit this homer. So, long story short, I experienced this recently and it was awful and I can't imagine like shooting a TV show or something or like doing anything or performing live.

Like I would have to address it. Because I would scratch and smack it was what I usually do. That's what you're supposed to do, not scratch. We'll just cut to the chase here, this is why everyone's listening. How do you scratch a niche correctly? You rub it. Yeah, I didn't do, you know what really did it was the,

we have a handheld implement in the shower, along with a regular shower head. Okay, yeah. And put that sucker on the tightest, hardest, most penetrating flow and just put that hot water on it, man. And that was like, I think I spent half my days in the shower over that week and a half. Are you biting down like a broomstick while you were doing that? No, it felt so good, man.

I was just like, I couldn't get enough of it. And then the cortisone and all that junk too. So we'll talk about this because you're raising some great points here. Well I just kind of ruined the spoiler. No no this is good stuff we're gonna analyze what was going on with your arm after this break. How about that? Sounds good. Welcome. My name is Paola Pedroza, a medium and the host of the Ghost Therapy Podcast, where it's not just about connecting with deceased loved ones. It's about learning through them and their new perspective. Join me on the Ghost Therapy podcast.

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Follow The Big Take podcast on the iHeart Radio app, Apple podcasts, or wherever you listen. Apple Podcasts or wherever you listen. So Chuck, you had contact dermatitis, right? I thought it was poison ivy because that area has some poison ivy. But each of us, Scotty and I had it just on the arm that we sunk in cement. And then we researched and found out that could happen. Yeah. So lesson learned on that. Yeah. So what happened was you, something in the cement, and I'm not sure what it was, reacted

chemically with the mast cells in your skin. Yeah. And histamine was released, right? Apparently. And so the histamine sent a signal through specialized nerve cells called C fibers. Yeah, which C fibers aren't just limited to itching. I think only about 5% handle that and most of the rest are for pain. Right, right.

So they use the same type of neural pathway as pain, but for itch it's basically it's just like no these these are just for itches only. Yeah. And it sent a signal through your spinal column and in your spinal column it released a neurotransmitter called gastrin releasing peptide receptor and so the skin, the histamine would have released a neurotransmitter called what? Natura uretic polypeptide B. Okay. So that says, itch signal coming your way along those C fibers. Yes. Okay. It makes it to the spinal column, and I guess in about 2007 they found that there's another neurotransmitter in the spine that

I guess accepts the NPPB. The invitation. And says, I'm going to transfer this along up to the brain. That's gastrin-releasing peptide receptor that shoots up to the brain and it starts this cascade of activity, right? Because when they, like after Handwerker said, hey, you know, itching's its own thing, these other researchers went to town and traced and figured out that there were specific types

of itch receptors that were dedicated just to itches. More Germans. More Germans. And Swedes. Couple of Swedes, but mostly Germans. Just for good measure. Yeah. And what they found eventually from tracing this pathway, they were able to follow it into the wonder machine.

And apparently they made some people itch and would not let them scratch it. And then they had them lay down in an MRI and they took a brain scan. And they found that there's this whole galaxy of stuff going on in your brain that combined is the itch sensation. Yeah, it was pretty interesting too.

There's a signature pattern in the brain when you get an itch and a few specific areas light up. One is a cortex, and it all makes sense when you put it together. The cortex, in this case, just sort of geo-locates where on your body you're getting that sensation. So that helps. It's like left elbow. Yeah, or in my case from right elbow to wrist.

And then a little bit in other places, but not too bad. That was the main area. Is this your cortex still saying this? Yeah, very complex conversation going on And then the region I thought this is interesting the region that governments governments that governs emotional response So basically this is your brain saying like I don't like this. This makes me feel bad Yeah, it's the worst thing ever do something and then finally the limbic and motor areas, and I thought this was the most interesting. Those areas process irresistible urges. The same ones that say,

I want to smoke crack or I want to eat too much cake, says you have an itch that is unbearable and you need to scratch it. Right, and maybe go smoke some crack and eat some cake while you're at it. Because that'll help. So I just, I don't know, I thought that was all very super interesting when you combine that pattern. Yeah, that's an itch and then followed by the irresistible urge to scratch it, which apparently research has shown,

those two do not happen independently. They're part of a cycle. Yes. There's something called the itch scratch cycle, right? And so you have an irresistible urge to called the itch scratch cycle, right? And so you have an irresistible urge to scratch the itch. It's weird if you think about it. Like, on the one hand it makes sense where you sense that there's a really hot heat source that your hand is really close to. So you have an irresistible

urge to pull it back, but it doesn't feel like an urge, it almost feels like an involuntary reflex. Yeah, how do you get that quick? A scratch is almost like, I'm going to kill this itch, I can't wait to scratch it. Like you're almost exacting revenge on the itch for itching you, right? So a scratch is, it's an irresistible urge, whereas like pulling your hand back from a hot source or something is like an involuntary reflex. It just feels different.

Like a scratch is its own thing. Well it is. They kind of found that out. And Dr. Gawande pointed out something interesting too that I never thought about, is that you can have that short collar rubs against your neck all day and you might never notice it, but if there's like one little string that's just poking one little area,

that might trigger an itch. Right, and so you would think that, you know, itch receptors are super finely tuned and they cover just this one tiny like micron of skin. That's what it would seem like. As a matter of fact, no. Apparently an itch receptor can sense itch stimuli like three inches away from it on the skin.

That's crazy. Yeah. So they're really sensitive. Yeah, whereas pain receptors are that specific. Right. Down to like millimeters. Yeah. And the other thing they found out too

is that not only can they sense it from a few inches away but it's a very slow acting thing, which as opposed to like heat on the hand, like a candle on your hand, almost a candle in the wind. That's super fast, but that explains why an itch like is kind of slow to come and then slow to resolve by scratching. Yeah, it's not like you scratch it You're like, oh, it's all better now. Yeah, it helps a little bit So so the itching is a it's a good strategy if you think about Say you're you're there's a mosquito on you and that's what's making you itch when you go to scratch it You're getting rid of the mosquito maybe even smushed it or something like that

The problem is taken care of the issue issue is that that itch-scratch cycle eventually becomes a vicious cycle because when you scratch, this is what they think is going on. This is another mystery with itches. We don't understand how scratching alleviates an itch or why we scratch really. an itch or why we scratch really, right? What they think the current hypothesis is that when you scratch an itch, you're stimulating other receptors in the area that aren't itch receptors. Yeah, so I got that, but what does that do to sort of like say, hey, body, don't worry about that for a minute. I think so.

A pain receptor is now active. Right, exactly. It's sending feedback to the brain saying it's being taken care of. You can settle down with the itch. Gotcha. I think the problem is that neurologically or neurochemically, when you scratch an itch,

you're activating those pain receptors in the area, pain pressure, that kind of thing. You're causing serotonin to be released. Right. Natural pain reliever, right? Yeah. Or at least mood enhancer. And what they found is that serotonin, among other neurochemicals, actually exacerbates

the itch sensation. So your itch not only comes back, it gets worse. So you go to scratch it again, and then the same thing happens over and over again. That's the itch-scratch, which it's not the best cycle around. No. You can make a better cycles. Not a bad band name. Yeah.

It's okay. A little too cute. Maybe prog? Folk prog? Well, they'd have to be German probably. German folk prog. Okay. Another interesting thing they learned too was that, I guess we're kind of jumping around,

but who knows? I think it's a good thing. I think it's a good thing. I think it's a good thing. I think it's a good thing. I think it's a good thing. I think it's a good thing. I think it's a good thing. I think it's a good thing. probably. German folk prog, okay. Another interesting thing they learned too was that, I guess we're kind of jumping around, but who cares, right? If you scratch, you don't have to scratch the point of the itch to relieve it apparently. Right. Like if you have, I had that itch on my right forearm and I could scratch maybe, it doesn't have to be the left forearm,

it's not like you have to mirror it, but I could scratch like it doesn't have to be the left form so it's not like you have to mirror it but I could scratch like my neck and apparently that might help relieve it yeah I tried it didn't work for me no no but I think the reason why there's that's it's possible that it could have that effect is supposedly scratching also activates like your pleasure center. Yeah, you bet it does. But there's different places where you're scratching on your body have different amounts of pleasure associated with them.

Did you know that? I mean, I guess so, but... Yeah, interesting. Yeah, but I mean, think about it. It's like if you scratch your clavicle like your clavicle who cares? It's nothing right, but then you scratch like your head right above and behind your ear It's great. Well, and they I think they did find that like You're back in your ankles supposedly or some of the most rewarding places to scratch exactly and I

Don't know never really thought about the ankles, but my mom would give me back scratches when I was a kid. And it was always like one of my favorite things ever. And so I don't get those anymore now that I'm a grown up because that's gross. Mom, scratch my back. I'm 46 years old. Lay down. But yeah, it was like,

I think I prefer to back scratch to a back rub even. Oh yeah? When I was younger, but now, you know, a massage is probably way better. Sure. But if a masseuse could include a little back scratch in there, get ready for a huge tip for me. Yeah, I guess so.

Or does that, what, is that sexual? I think it crosses a line once they're potentially clawing away skin cells. I think that's no longer in the masseuse range or masseur range. Yeah, I get that. Once skin cells are involved under the nails, then you're a murder suspect. Right, exactly. All right, well, should we take another break and talk a little bit about one of the most You know under the nails sure then you're a murder suspect right exactly All right, well should we take another break yeah and talk a little bit about one of the most distressing Articles I've ever read

Welcome my name is Paola Pedroza a medium and the host of the Ghost Therapy Podcast, where it's not just about connecting with deceased loved ones. It's about learning through them and their new perspective. Join me on the Ghost Therapy Podcast. Whoa, my lights in my living room just flickered. I'm a little nervous. I'm excited. I'm excited, nervous. You know, I'm a very spiritual person, so I'm like, I'm ready and open. That was amazing. I feel so grateful right now. I got to speak to my great grandmother, Abuela, and she gave me a lot of really good advice that I'm going to have to really think about. Wow, okay. That's crazy. Yes, that is accurate. and she gave me a lot of really good advice that I'm gonna have to really think about.

Wow, okay, that's crazy. Yes, that is accurate. Listen to the Ghost Therapy Podcast as part of the MyCultura Podcast Network available on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. I'm Tisha Olin, former golf professional and the host of Welcome to the Party, your newest obsession about the wonderful world that is women's golf.

Featuring interviews with top players on tour like LPGA superstar Angel Yin. I really just sat myself down at the end of 2022 and I was like, look, either we make it or we quit. Expert tips to help improve your swing and the craziest stories to come out of your friendly neighborhood country club. The drinks were flowing, torquing all over the place, vaping, they're shotgunning. Women's golf is a wild ride full of big personalities, remarkable athleticism, fierce competition, and a generation of women hell bent on shaking that glass ceiling. Welcome to the Party with Tisha Olin is an iHeart Women's Sports production in partnership with

Deep Blue Sports and Entertainment. Listen to Welcome to the Party. That's P-A-R-T-E-E on the iHeart radio app, Apple podcast, or wherever you get your podcasts. Presented by Elf Beauty, founding partner of iHeart Women's Sports. Hey, you guys, I'm Catherine Legg. I'm a racing driver who's literally driven everything with four wheels across the planet. And I've got a new podcast. It's called Throttle Therapy. This season, I'm gearing up to make history competing in some of the world's most notorious racing events, starting at the Indy 500.

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reporter. Courts are not supposed to decide elections. Courts are not really supposed to play a big role in Choosing our elected leaders. That's for the voters to decide Follow the big take podcast on the I heart radio app Apple podcasts or wherever you listen Alright, so we've referenced this article from the New Yorker, from Dr. Atul Gawande, and he talked a lot about itching and just had good information on the science of it all. Well, that's what he does. But most of the article was focused on a patient, a woman in Massachusetts, that they named

M for the article. Just M. The letter M. Right. In other words, you know, she's anonymous. And I think she was anonymous because she kind of had a rough go after her divorce. She ended up getting HIV from getting on heroin. Kind of spun out, it seems like.

But then got her life back by all accounts. But ended up getting shingles as a result of HIV complications. And the shingles went away, but the itching did not, to say the least. Yeah, I think the itching came after the shingles even. And at first her physicians were like, well, I mean, you must have damaged some nerves in there. So, T.S. for you, I guess. Yeah. And then eventually after treating it

like all these different ways and it's still being scratching, they said, okay, you're crazy. How about that? Right. And she said, well, whatever. I still have this itch. Do whatever you need to to treat it

because I'm literally scratching this itch in my sleep. It was on her scalp, wasn't it? Yeah, it was on her head and she kind of managed to control it during the day. But like you said, at night she couldn't control it to the point where I think she was restrained in her sleep. That came after. Oh, okay. After they realized it's a problem because your brain is oozing out of your head.

Yeah. Can you believe that? She scratched her scalp so much that she scratched through her skull, and she went into her doctor one day and said, they've got this green fluid coming down. And then apparently the doctor didn't even say anything. He was just, she or she was like, excuse me. Went and called an ambulance and came back

and said, please lay down and don't talk or move or do anything else. And they finally told her after she was at the ER, you scratched through to your brain. Like that's your brain you're touching right now. The doctor's like, very interesting. Just give me a second here. Or, please excuse me.

Oh my God. Well, they gathered up all the other doctors and nurses and was like, yeah, you gotta come see this. She said also in this article, she said that she had a, what do they call them, a roommate. Okay, a roommate. Yeah. So she had a roommate while she was, like they treated it, gave her a skin graft and then she itched, she scratched away the skin graft.

Oh man. And then they finally were like, okay, you're going to an asylum. And she's like, do they even call it that anymore? And they're like, just shut up. And they put her in this asylum and restrained her, like you said, while she was sleeping. And she had a roommate in there. She said in the article, she heard didn't survive. He had scratched through his carotid artery and died, blood death.

So they never really got to the bottom of this. She finally got a doctor, like the doctors were like, it's something that had to do with the shingles. This is what we think happens at our doctors, that the nerve endings around the area where she had shingles were so devastated by the shingles that there were just a couple of nerve endings left and it just so happened that they were itch receptors. Yeah, itch receptors. Bad luck.

And that those were like really exacerbated by the fact that there was no other competing sensations. Ipso facto, there's your problem. So they said, well, we'll just cut the main nerve to your face and that should solve the problem. They cut the main nerve to her face and... She said, thanks a lot. Yeah.

And then the itch came back. And she's like, you have to be kidding me. So finally she met a doctor who said, I don't think it's your receptors or the nerve transmission. I think it's your brain. Yeah. Not psychologically. I don't think it's a psychosis. I think that the actual itch signal in your brain is being set off without any stimulation or transmission going on. And apparently she was right. But then they were like, good luck treating that.

Right. Yeah. I didn't see much follow-up on this. I did read one article that, a follow-up with Dr. Gawande, because there were a lot of skeptics after that article came out that said, it's impossible with your fingernail, because she said she didn't use an implement. It's not like she got out of metal file to scratch through your skull. And he said that his theory was that bacteria that became infected had eaten it away such that the skull became soft. Turned into mush?

Yeah. Yuck. And then people also said, you know, you don't have men and women in the same room in hospitals or asylums. That's false. And he said that it was like the room next door and quit being pedantic. Yeah, really? Man.

I think people just didn't believe it. So all these folks wrote into the New Yorker. Yeah, really. Man. I think people just didn't believe it. So all these folks wrote into the New Yorker, all these coastal elites, said no way. They said, Atul, Atul, come on. So the idea though that even if this woman was hypothetical, I think Atul Gawande is pretty upstanding cat and didn't make this up. But even if, say she was hypothetical,

her problem, what the doctors initially thought it was, was that she had a neuropathic itch, type of chronic itch. But then the doctor who apparently figured it all out said no, no, no, it's a neurogenic itch, another type of chronic itch. And it has to do with whether it's the brain going off or the nerve transmissions going off. Either way, you don't actually have an itch,

although you're experiencing the itch sensation. Well, and they also then said at some point she had a psychogenic itch. Right. So they basically covered three out of the four kinds of itches, the last one being, man, I have such a hard time, pruriceptive, and that's what you get from like a mosquito bite or if you have a skin disorder like eczema or something. So they basically ruled out the most common one and at various stages said, you've got this other one for the other three.

Right. Finally. And then again, they said, there's really nothing we can do to treat it. The one that they've got down pretty well is prereceptive. We've got all sorts of stuff to treat that because that's basically histamine is being released and your skin is itching. So you can treat histamines with antihistamines. You can reduce that response and then your itch will go away. Well, I took Benadryl at night and they also make this Benadryl spray, a topical spray that just, it really helps. So between that and Cortisone,

and then the Benadryl at night, I did okay. And those awesome showers. So the pruriceptive itch, we've got treatment for basically. The other three, you're in trouble, it turns out. As far as it stands right now. Maybe five or ten years from now, there'll be something. Apparently there is a lot of movement right now on treating this stuff, but it's like they're having to figure out how to block some really otherwise important chemicals in the body, like that NPPB, right?

Yeah, that one, what does it help, can regulate your blood pressure as well? Yeah, right. You can't just switch that off. Right. Just turn off the gene that produces that. You won't itch, but you might die early. Right. Not worth it.

The one that really, I mean they're all sad, but the psychogenic, when you have a mental illness where you feel like you have parasites and bugs on your skin. You remember our morgalons disease? Yeah. How did you said it? Morgalons, right? And I said morgalons? I can't remember.

I know that I said it the way everyone else says it though. That's all I remember. Morgalons. That's right. That's how I said it. Man, but all this stuff, it just had so much empathy for Em. Yeah. And wanted to follow up so bad to see how she was doing.

You know? Yeah. And if she kept scratching holes in her skull. I don't know. Jeez. So there's, I read another article called Accidental Therapists. It's by a guy named Eric Broodman and it was published on a website called stat and it's all about delusional parasite Parasitosis, but how it's treated sometimes by

Entomologists, you know like those Extension services at universities. Yeah here in the u.s. Like state universities have word called extension services at universities. Here in the US, state universities have what are called extension services where a scientist will basically be there for the public to come talk to about whatever. Usually it's household stuff or farm stuff, something like that. And apparently entomologists frequently are approached with people who are like,

I've got these bugs crawling all over me. Here's a sample of them. And it turns out it's like carpet fiber or something like that. And these people just can't stop itching or whatever. But it turns out they have a delusion. They don't actually have parasites. My question is, is that our understanding of it now? And in five or 10 years, we're going to know that they had

neurogenic itches. And we just treated them like they were crazy, even though they weren't. And it's going to be like a real blemish on the history of Neuroscience maybe or will this idea of psychogenic itches, you know hold up Yeah, I wonder did you ever see the Todd Haynes movie safe with Julianne Moore? No, it's one of his first movies after the Karen Carpenter thing he did that wasn't like, I mean it was a real movie but it wasn't released. But Safe was very disturbing.

It was about a woman who kind of slowly drifted into madness from believing that the world was poisoning her. Wow. And like household chemicals and everything and it kind of started slow and eventually she ended up at this kind of safe camp for people like her. Very distressing movie and one of her first movies too. I'll have to check it out. Yeah, it's really good.

Oh, it's old? Yeah, it was early 90s I think. I know what you're talking about. It's called The Road to Wellville. Is that what you mean? No, it's called safe. Okay, I'll check it out. Yeah, it's it's good very distressing I'm trying to think of any and that wasn't necessarily itching but it was just like that psychogenic thing

of like I think everything in my house is killing me yeah I mean have you ever like stopped and thought about something and thought there's there's the path to madness right there I'm staring down it right now I should probably not keep thinking about this mmm I don't really get like that oh no. I'm staring down it right now. I should probably not keep thinking about this. I don't really get like that. Oh no? No, I'm very easily kind of led on to the next shiny thing. I get you.

I'm like a bird. Yeah. Yeah. Basically. That's probably for the best. It is. It has its drawbacks though. What else you got? Well, one thing it says in here is that having someone else scratch your itch does apparently does not do the trick. So you have to scratch your own itch.

Yeah, I mean somebody can. Like obviously, like, you know, if you're like, a little left, a little left, up, up, up. Yeah, see, I agree with that. Oh, man. Not you. Them saying, I think it definitely helps I think what they're saying is is it doesn't have quite the same relieving properties as if you do it yourself. Oh

Yeah, and if you could reach that area of your back, it would be better than that. Yeah, I guess so I got a pretty good back scratcher now though. Oh, yeah, what's it made of bamboo? No, it's it's metal But it's a telescope telescoping so it's not you know two feet long gotcha, but it can be but it's metal Yeah, it looks like a like what are the bear claw not the pastry but a real bear claw which actually looks like the pastry Yeah, I guess that's why they call it that I never thought about that. Why do you think that was called? Actually should call it a bear paw it looks more like a bear paw I'm gonna try and bring that bring that around unless you get somebody like really goes the extra mile and puts almonds on the tips To make it look like the claw. Yes

And not just haphazardly scattered about the bear paw exactly. Yeah, that's the difference between a baker who loves their job and one who's just in it for the money. Yeah Couple more things Charles like we said, there's a still plenty of mysteries around itches Yeah, why say does a feather tickle sometimes but itch other times? Big question. They don't know. But I'd like to know. Maybe the Germans will get active on this again. Yeah. They're the only ones who can solve it.

Only the Germans can save us. You got anything else? No, I don't. I don't either. Itching. Nice work. Thanks, man. Same to you. Thank you. And you haven't either. Itching, nice work. Thanks man, same to you. Thank you, and you haven't scratched in a while, so.

No, I'm actually, I've been scratching the same spot and it's starting to get a little tender, so I'm stopping. Man, there's nothing worse than a movie. And I've seen, I feel like I've seen this a few times in movies where someone is compulsively like scratching until it becomes a sore and then they're scratching it, it's just like, ugh. I can't watch that. Through their brain?

Well, yeah. So, I guess the moral of this one is, what would Tom Petty do? I'll ask him tomorrow. If you want to know more about itching or what Tom Petty would do, you can type those words in the search bar at howstuffworks.com and since I said search bar, it's time for listener mail. I'm gonna call this one of the many emails we got on the swearing episode. Did you notice that? People really seemed to like that one. Yeah, they did. A lot of response. Yeah. From, mostly from fellow potty mouths, which were very filthy emails too, which were great.

Yeah. And I responded in turn by cursing at them. Sure. And my replies. Sure. Which I hope they enjoyed. In all caps? No.

I didn't want to be too aggressive. So this is from Emily Allen. Hey guys, long time listener. First time writing in. Writing about swearing, aggressive. So this is from Emily Allen. Hey guys, long time listener, first time writing in. Writing about swearing, I should start by saying that it's funny I'm writing about this episode because I almost never curse and when I do it's normally not a very offensive swear. However, your intro made me think of something interesting I wanted to share. You talked about how you really censor

yourself during recording in order to keep your show family-friendly. It got me thinking about how our jobs really shape our vocabulary, how we express ourselves. I noticed a major change in the way I speak since becoming a teacher. I primarily teach kindergarten to second grade students, and I found this really changed the way I express myself. For example, I try to avoid even saying things are dumb or stupid around kids. I'll often say, well, isn't that silly instead?

This works in the classroom, but I often get laughs from friends and family when I refer to a situation as silly, like a disagreement with a colleague or something a politician does. There are other expressions I use with kids that often slip into regular conversation as well. The most embarrassing, when I'm out and excuse myself to go potty. That always gets a laugh. Anyway, I just wanted to share and thank you for all the great work you do.

Learned so much from listening each week and I'm always excited to see the new episode offerings every Tuesday and Thursday. That is from Emily Allen. Thank you Ms. Allen. Very silly. That was a very nice email. Yeah. If you want to get in touch with us like Ms. Alan did, you can send us an email at stuffpodcastathowstuffworks.com.

And as always, join us at our home on the web, stuffyoushouldknow.com. Stuff You Should Know is a production of iHeartRadio. For more podcasts, my heart radio, visit the iHeartRadio app, apple podcasts, or wherever you listen to your favorite shows. Catch John Stewart back in action on the daily show and in your ears with the daily show years edition podcast from his hilarious satirical takes on today's politics and entertainment to the unique voices of correspondents and contributors, it's your perfect companion

to stay on top of what's happening now. Plus, you'll get special content just for podcast listeners, like in-depth interviews and a roundup of the week's top headlines. Listen on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Welcome. My name is Paola Pedroza,

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