Tracing the impact of sports slang on modern perceptions of neurodegenerative disease

Throughout the twentieth century, being "punch drunk" was a commonly encountered condition—one denoted by an equally pervasive term. Similar turns of phrase, like "slugnutty" and "punchy," persisted for decades in books, newspapers, and magazines. Even today, "punch-drunk," "goofy," and "slap-happy" can be found scattered across different media.

This slang originated among working-class populations in the United States and Britain to mock the diminished mental and physical capacity of an individual who had received too many blows to the head. "Punch-drunk slugnuts" exhibited mental decline, grogginess, irritability, and slurred speech.

In "Punch-Drunk Slugnuts: Violence and the Vernacular History of Disease," published in Isis: A Journal of the History of Science Society, Stephen T. Casper, professor of history at Clarkson University, illustrates how slurs and insults characteristic of a violent interwar culture served as descriptors of debilitating head trauma, and how this language was incorporated into medicine. Casper examines the role slang terms—many associated with the world of contact sports—played in conceptualizing and treating brain injuries and resulting neurological illnesses. Given widespread observation of head trauma and its effects, colloquialisms allowed the illness to be recognizable. At the same time, they inhibited its conceptualization as a serious disease requiring medical intervention.

Casper's analysis draws on various sources containing vernacular terms to describe damage from repetitive brain injuries, including interviews from the Folklore Project by the Works Progress Administration (WPA), literary descriptions, journalistic pieces, court documents, autobiographical accounts, and medical texts.

Medical professionals studying brain injuries and neurodegenerative disease established connections between their observations and slang circulating in the public sphere. Beginning with Harrison Martland's essay "Punch Drunk" in 1928, subsequent clinical research included slang terms. Use of this vernacular, in turn, led to the classification of neurological disease induced by repetitive head trauma as "chronic traumatic encephalopathy." However, the colloquialisms' myriad connotations allowed for ambiguity in diagnosing the disorder and prevented it from achieving medical legitimacy.

Tracing the history of this vernacular economy reveals a culture that stigmatized sufferers and normalized male violence.

Sports presented a venue where brain injuries were visible, but attempts to medicalize trauma symptoms were challenged. Head trauma was a regular occurrence in high-contact sports, like football and boxing, but the everyday nature of injury was used to downplay its severity. Popular conceptualizations of sports at the time, especially boxing, were predicated on the relationship between masculinity, honor, and violence. Athletes were expected to withstand pain, embody stoicism, and inflict violence as a measure of masculinity. Inability to do so was viewed as a deficiency in one's manhood. "Punchy" individuals who lost their athletic prowess were objects of derision and fell in social standing. Rather than acknowledge that repeated trauma caused deterioration, society employed racist, classist, and eugenic rationales, casting "punch-drunk slugnuts" as inherently inferior, as subpar fighters, and as dull-witted well before their injuries.

Accepting the affliction as a disease and treating these individuals, Casper argues, would have constituted a critique of mainstream culture and placed blame on its violent practices.

While highlighting the history of impact-related neurodegenerative disease and its lexicon, Casper also elaborates on "a disease population experience that fought against its own discovery" and how tendencies to dismiss the effects of recurrent head trauma continue today.

"Having originated from culture, been contested by culture, and remade by culture, the disease's treatment demanded an impossible unmaking of culture. From its rough linguistic and anthropological origins to the uncovering of its biological specificity, the history of this disease traces our chronology of normal violence as entertainment, reveals its legacies in donated brains, and, above all, foretells tragic futures."