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Fifty years before germ theory revolutionized Western medicine, a linguist named John Gilchrist became convinced that his longstanding mental illness was caused by a microbial infection of his brain, and that microscopic pathogens cause most of the world’s diseases. The book that he wrote in 1833 to promote this theory is the earliest published germ theory of mental illness, and one of the earliest published germ theories per se. The work, portions of which are written in verse, was ignored in its time and has been forgotten in ours. Notwithstanding his mental illness, or perhaps even because of it, the author came remarkably close to an accurate description of microbiology—decades ahead of mainstream scientists. This forgotten text suggests some intriguing and hitherto unrecognized ways in which the histories of psychiatry, alternative medicine, and illness writing might be intertwined with the history of germ theory.