Vehement Experiences: The Inscription and Description of Delusion in Nineteenth-century French Asylums.

This essay explores the differences in the narrative forms of mental illness, depending on whether the sources consulted come from published medical histories or archival material. Based on the study of dozens of clinical cases contained in, above all, the institutions of Charenton and Bicêtre, from the late eighteenth century to the 1850s, I argue that the distinctive feature of the clinical case was vehemence rather than delirium. My methodological approach is based on the conceptualization of the forms of experience proposed by the philosopher of history Reinhart Koselleck.

Freud, Griesinger and Foville: the influence of the nineteenth-century psychiatric tradition in the Freudian concept of delusion as an 'attempt at recovery'.

This article aims to situate the Freudian concept of delusion in psychosis as an 'attempt at recovery', within the context of the classical psychiatric theories prevalent in the nineteenth century. Freud's theoretical thinking on the psychopathology of psychosis presents elements of continuity with, and divergence from, the psychiatric theories of his time. We will thus demonstrate the singularity of Freud's own theory. We will discuss the possible influence that the theory proposed by Griesinger, with its description of a temporal evolution in the psychotic process, may have had on Freud's thinking, and consider the theory of 'deductive logic' prevalent in nineteenth-century French psychiatry. Finally, we will discuss the vehement critique Freud made of both these theories.

Tracing the Roots of Dementia Praecox: The Emergence of Verrücktheit as a Primary Delusional-Hallucinatory Psychosis in German Psychiatry From 1860 to 1880.

While the roots of mania and melancholia can be traced to the 18th century and earlier, we have no such long historical narrative for dementia praecox (DP). I, here, provide part of that history, beginning with Kraepelin's chapter on Verrücktheit for his 1883 first edition textbook, which, over the ensuing 5 editions, evolved into Kraepelin's mature concepts of paranoia and paranoid DP. That chapter had 5 references published from 1865 to 1879 when delusional-hallucinatory syndromes in Germany were largely understood as secondary syndromes arising from prior episodes of melancholia and mania in the course of a unitary psychosis. Each paper challenged that view supporting a primary Verrücktheit as a disorder that should exist alongside mania and melancholia. The later authors utilized faculty psychology, noting that primary Verrücktheit resulted from a fundamental disorder of thought or cognition. In particular, they argued that, while delusions in mania and melancholia were secondary, arising from primary mood changes, in Verrücktheit, delusions were primary with observed changes in mood resulting from, and not causing, the delusions. In addition to faculty psychology, these nosologic changes were based on the common-sense concept of understandability that permitted clinicians to distinguish individuals in which delusions emerged from mood changes and mood changes from delusions. The rise of primary Verrücktheit in German psychiatry in the 1860-1870s created a nosologic space for primary psychotic illness. From 1883 to 1899, Kraepelin moved into this space filling it with his mature diagnoses of paranoia and paranoid DP, our modern-day paranoid schizophrenia.

Historical and clinical considerations on Ekbom's syndrome.

Ekbom's syndrome represents a relatively uncommon neuropsychiatric condition characterized by the recurrent and bizarre fixed delusional belief to be infested by small organisms or even unanimated materials ('Morgellons disease'), without any objective evidence of infestation/parasitosis. The condition, mainly diagnosed in a nonpsychiatric setting, is supposed to be largely underestimated and, hence, undermanaged. The present comprehensive review aims at investigating Ekbom's syndrome, from a historical, epidemiological, clinical and therapeutic perspective, by providing diagnostic-treatment strategies in managing this condition in routine psychiatric clinical settings. The prototypical patient is a middle-aged woman (or a younger subject in those cases in which substance and/or alcohol abuse is implicated), often single, divorced or widowed (loneliness component and social withdrawal), who has already consulted several specialists due to skin lesions associated with a firm and delusional belief to be infested. The identification and diagnosis are challenging due to poor patient's insight, poor knowledge and collaboration between specialists and differential diagnoses to be considered before asking for a psychiatric referral. Management and treatment strategies mainly derive from isolated case reports or observational studies with a small sample size. Further randomized clinical trials should be performed to evaluate the efficacy of newer antipsychotic drugs, including long-acting injectable formulations.

Neurology versus Psychiatry? Hallucinations, Delusions, and Confabulations.

Hallucinations, delusions, and confabulations are common symptoms between neurology and psychiatry. The neurological diseases manifesting with such symptoms (dementia, epilepsy, Korsakoff's disease, brain tumors, Parkinson's disease, migraine, right hemisphere stroke and others) would be the key to understand their biological mechanisms, while the cognitive sciences, neuropharmacology and functional neuroimaging would be the tools of such researches. It is possible to understand the perceptive rules of the mind and the mechanisms of the human consciousness based on these symptoms. However, hallucinations and delusions manifest with extraordinary vehemence with psychiatric disorders such as psychosis and schizophrenia, with which there is no evidence of brain lesions. Furthermore, they are subjective symptoms, and they do not have biological markers. Hence, they are prone to high inter-individual variability and depend on other variables (such as education, history of trauma), and are therefore difficult to reduce to unequivocal constructs. Causative mechanisms are probably multiple. For understanding these symptoms, a common framework between neurology and psychiatry is still missing. The psychopathology of French alienists over the 19th century, of S. Freud, and of Henry Ey over the 20th century gave way, in the second half of the 20th century, to the adoption of the DSM and neurosciences, to pursue a pure neurological perspective. However, although psychodynamic models seem nowadays (in a technological era) less influential, detailed clinical evaluations focusing on emotional-cognitive paradigms are probably the only way to lead to new neurobiological researches.

Are Drugs Always the Proper Solution to Therapeutic Dilemmas? Non-drug Approaches to the Post-traumatic Stress "Waking Corpse" Syndrome.

Jules Cotard (1840-1889), a Parisian neurologist, described a syndrome of delirium negations which was later named after him. Some physicians in antiquity and medieval times, especially in Asia, have noticed this syndrome and categorized it as a symptom of melancholy. They have presented it as a "walking corpse syndrome", inflicting most probably veteran soldiers after suffering during ferocious battles, presenting the first cases of a post war traumatic stress disorder. Philotimus (3rd-2nd century BC) was the first to record it around 3rd century BC, and proposed a simple but pioneering treatment, by just putting a lead hat on the men's heads. Although various combined treatment strategies were proposed by modern psychiatry including pharmaceutical, electroconvulsive therapy, behavioural therapy and supportive psychotherapy, it seems that in antiquity a simple external intervention of supportive therapy was the main concept of confrontation, while drug administration was to be avoided.

[Accessory symptoms of schizophrenia: E. Bleuler's concept]. / Aktsessornye simptomy shizofrenii: kontseptsiia E. Bleuler.

The analysis of E. Bleuler's concept of accessory symptoms of schizophrenia: delusions, hallucinations, depersonalization disorders, splitting of the ego, memory disorders, catatonic symptoms and acute syndromes (manic and melancholic states, acute paranoia, twilight states, clouding of consciousness, confusion, fugues and dipsomania) is presented. The relationship of accessory symptoms with primary and secondary schizophrenic symptoms according to the second concept of E. Bleuler is highlighted. The mechanisms of the origin of psychopathological accessory symptoms and E. Bleuler's understanding of many schizophrenic psychopathological symptoms as a quantitative increasing of a normal psychic phenomenon are discussed.

[Doctrine of psychopathy typology: E. Kretschmer's concept of 'key experience' and inherited defect]. / Uchenie o tipologii psikhopatii: kontseptsiia É. Krechmera 'kliuchevogo perezhivaniia' i vrozhdennogo defekta.

The author analyzes the first concept of E. Kretschmer which preceded his famous concept of cycloid and schizoid temperaments: specific 'root' or 'key' experience characteristic of the personality type. This concept was built on the clinical data of patients with delusions but E. Kretschmer assumed that the difference in the degree of disease was not essential ('neurosis of reference' and 'sensitive delusion of reference' were more close than 'sensitive delusion of reference' and 'expansive delusion'). For a sensitive psychopath, the key and specific experience is 'shameful defeat', for expansive psychopath - 'the violence over will by the common will'. Explanations of the phenomenon of psychopathic personalities made by E. Kraepelin and E. Kretschmer are compared as well as the relationship of psychopathic types determined by E. Kretschmer to 'the general psychopathic constitution'.

History repeating itself: Arnaud's case of pathological déjà vu.

We present a translation of Arnaud's (1896) case report of Patient Louis, a case he describes as having a pathological form of déjà vu. Louis has the delusional belief that the present moment is a repetition of an exact same previous event. Arnaud's paper is critical for two reasons. Firstly, it is amongst the first articles in the scientific literature to describe the déjà vu experience using the term 'déjà vu'. Secondly, the case report of someone with delusional and persistent déjà vu, anticipates recently reported cases with similar symptoms, which are beginning to gain interest as a particular form of memory disorder. We offer a contemporary analysis of Louis and conclude that, whilst the article was critical in the development of déjà vu as a scientific concern, Louis's distorted memory is not best described as déjà vu, but rather as a form of reduplicative paramnesia described as recollective confabulation.

[Syndrome of «delusional fantasies¼ in the concept of K. Birnbaum]. / Sindrom «bredopodobnogo fantazirovaniya¼ v kontseptsii K. Birnbauma.

The author analyzes the features of the syndrome of «delusional fantasies¼ (delusion-like fantasies) in the concept of K. Birnbaum. According to this concept, psychopathic constitutions, due to the presence in the structure of dissociation, are the basis for the development of delusions per se. «Dreamer¼ and «vershroben¼ types are predisposed to the syndrome of «delusional fantasies¼. It is emphasized that initially the syndrome of «delusional fantasies¼ was described as a peculiar phasic episode of delusions in psychopaths, aged between 20-30 years. In the current domestic literature, delusion-like fantasies are regarded as non-delusional bizarre fantastic ideas in children and adolescent patients.

Esquirol's change of view towards Pinel's mania without delusion.

We recount how Jean-Étienne Dominique Esquirol (1772-1840) gradually changed his position towards what Philipe Pinel (1745-1826) referred to as mania without delusion. Between 1805 and 1838, Esquirol moved from outright rejection, questioning the very idea of insane persons committing motiveless acts of violence without delusion, to relative acceptance. He eventually incorporated the clinical characteristics of mania without delusion in his description of homicidal monomania, dividing them between reasoning monomania and instinctive monomania. We examine this change by detailing each of Esquirol's points of disagreement, which decreased sharply between the completion of his thesis in 1805 and the publication of his chapter on homicidal monomania in 1838.

Miscarriages of transmission: body, text, and method.

An introductory and exploratory attempt to examine the possibility of viewing the famous writings of Judge Daniel Paul Schreber as the intimations of translawyering. Volubly convinced he was becoming a woman, Judge Schreber announced that he would nail his flag to the feminine and was incarcerated as mad for his pains and his pleasures. It is time to release him and to read his work not as madness but as a unique conjunction of desire and law.

'Paranoia and its historical development (systematized delusion)', by Eugenio Tanzi (1884).

This was the first paper by the Italian alienist Eugenio Tanzi (1856-1934). It surveyed existing works and provided an analysis of clinical categories such as monomania, sensory madness, moral insanity, Wahnsinn, Verrücktheit and systematized delusions, which had been used in France, Germany, Britain and Italy since the early nineteenth century to deal with paranoia. As pointed out by Tanzi, discrepancies and discontinuities in diagnostic concepts affected both psychiatric nosology and practice. Paranoia (from the Greek παρά and νοια) made for greater clarity in psychiatric terminology, and denoted a broad category, including both acute and chronic delusional states which were considered to be distinct from mania and melancholia, and usually not to lead to mental deterioration.

[Spanish neuroscience in times of Don Quixote]. / Neurociencia Española en tiempos de Don Quijote.

INTRODUCTION: Miguel de Cervantes Saavedra published his immortal work Don Quixote of La Mancha in a time of crisis and decadence in Spain that occurred during the transition between the 16th and 17th centuries. AIMS: In 2016 we commemorate the fourth centenary of the death of our distinguished man of letters, and thus in this article we analyse the status of Hispanic neuroscience, both in the Quixote itself and in other works by the most significant contemporary writers of that time. DEVELOPMENT: Despite the adverse historical circumstances, the shift from the Renaissance to the Baroque periods, in the Crown of Castile, was a flourishing period for literature (Spanish Golden Age) and other Hispanic arts (painting, sculpture, architecture and music), as well as bearing witness to a prodigious creativity in the field of neuroscience, including the field of natural philosophy. In his book Antoniana Margarita the physician Gomez Pereira laid the foundations for brain mechanism and the concept of conditioned reflexes several decades ahead of his time. The apothecary Miguel Sabuco also anticipated the concept of neurotransmission centuries ahead of his time in his New Philosophy. The physician Juan Huarte de San Juan was the founder of neuropsychology and experimental psychology, and his Examination of Men's Wits has been one of the most influential and widely translated scientific texts of all times. Its concepts are clearly reflected in Cervantes' Quixote. CONCLUSION: This analysis of Cervantes' work within the cultural setting of the book is intended as a homage to the immortal figure of our 'Prince of Wits' in the fourth centenary of his death.

TITLE: Neurociencia española en tiempos de Don Quijote.Introduccion. Miguel de Cervantes Saavedra publico su inmortal obra Don Quijote de la Mancha en plena epoca de crisis y decadencia en la España de la transicion entre los siglos XVI y XVII. Objetivo. En 2016 se conmemora el cuarto centenario del fallecimiento de nuestro insigne literato, por cuyo motivo analizamos en este articulo el estado de la neurociencia hispana, tanto en el texto quijotesco como en la obra de los autores coetaneos mas relevantes. Desarrollo. A pesar de las peyorativas circunstancias historicas, en la epoca de la transicion del Renacimiento al Barroco se produjo en la Corona de Castilla un florecimiento de la literatura (Siglo de Oro español) y de otras artes hispanas (pintura, escultura, arquitectura y musica), asi como una prodigiosa creatividad en el campo de la neurociencia, incluida en la filosofia natural. El medico Gomez Pereira, en su libro Antoniana Margarita, se adelanto en decadas a las bases del mecanicismo cerebral y del concepto de reflejo condicionado. El boticario Miguel Sabuco, en su texto Nueva filosofia, anticipo en siglos el concepto de neurotransmision. El medico Juan Huarte de San Juan fue el fundador de la neuropsicologia y la psicologia experimental; su texto Examen de ingenios ha sido uno de los textos cientificos mas influyentes y traducidos de todos los tiempos; sus conceptos quedan patentemente reflejados en el texto cervantino. Conclusion. Este analisis de la obra cervantina dentro del entorno cultural de la obra pretende ser un homenaje a la inmortal figura de nuestro 'Principe de los ingenios' en el cuarto centenario de su fallecimiento.

[In process]. / À la recherché de la mélancolie en Mésopotamie ancienne.

This "article romancé" interprets the clinical section of the Assyrian text BAM I-234 in psychiatric terms, arguing that it describes a melancholic state with delusions of ruin and persecution. From this interpretation, the question arises of whether the words of the insane were regarded as omens.

The Visceral Novel Reader and Novelized Medicine in Georgian Britain.

The article introduces "the visceral novel reader" as a diachronic, context-sensitive mode of novelistic reception, in which fact and fiction overlap cognitively: the mental rehearsal of the activity of seeing, hearing, smelling, tasting, and touching while reading novels and, vice versa, the mental rehearsal of novels in the act of perceiving the real world. Located at the intersection of literature, medicine and science, "the visceral novel reader" enhances our understanding of the role that novels played in the dialectic construction of erudition in English. In Georgian Britain, reading practices became a testing ground for the professionalization of physicians, natural philosophers, and men of letters. While it was in the professionals' common interest to implement protocols that taught readers to separate body from mind, and fact from fiction, novels came to stand for "debased" (visceral) reading. Novels inverted these notions by means of medicalization (regimentation, somatization, and individuation) and contributed to the professional stratification of medicine and literature.

French Hoffmania: Théophile Gautier's "Onuphrius" (1833) and the Critique of the Etiology of Pathological Reading.

"Of unknown cause"- in the conclusion of the eponymous tale written by Théophile Gautier in 1833, it is not clear what exactly the protagonist Onuphrius dies of after his infatuation with E. T. A. Hoffmann drove him mad. Thus, the reference to the possibility of "Hoffmania" is both highly medicalized, as Hoffmann appears as a case study of the sick author, while all its causes and mechanisms are left unexplored. With this suppression of the etiology of pathological reading, Gautier separates himself from both the tradition of literary discourses on pathological reading and from the new etiology of mental disorders. This allows him to expound the premises of his theory of "art for art's sake," as it echoes the paradox this theory is based upon, which contends that art is free and independent, yet its effects are deeply felt on the subject's body, in a way that must remain unclear.

The nature of delusion: psychologically explicable? psychologically inexplicable? philosophically explicable? Part 1.

The debate about the nature of delusion has rumbled on for over a century without resolution. The current situation is a stand-off between psychologists, who propose various theories as to the psychological explicability of delusion, and psychiatrists, who generally regard delusion as inexplicable. Our main aim in this 2-part article is to reprise the intellectual atmosphere of German psychopathology in the inter-war and immediate post-war years, when the issues concerning delusion were formulated with more sensitivity to the actual delusions encountered in clinical practice. In Part 1 we mount a critique of psychological and psychiatric theories of delusion.

Richard Dadd: the patient, the artist, and the "face of madness".

Richard Dadd (1817-1886) was a well-known Victorian artist who murdered his father, compelled by the delusion that a demonic force possessed his father's body. He was one of the first to bypass execution by reason of insanity and spent the remainder of his life in the Bethlem and Broadmoor asylums. Dadd is rare both as a patient and an artist because he left behind nearly a 40-year record of artwork and journals, which constitute a unique medical and psychiatric resource at a time when the ideas on the relationship of facial expression and madness were changing. Sir Charles Bell's (1774-1842) widely accepted views that the "face of madness" is bestial and anatomically distinctive were being challenged by such physicians as Sir Alexander Morison (1779-1866), who was also Dadd's own "alienist" (i.e., psychiatrist). The purpose of this article is to explore the nature and extent of the influence of Bell and Morison on Dadd, which has not been brought out in the existing studies. By a comparative analysis, it will be shown that Dadd may have conveyed a different view in his works that foreshadows subsequent developments that are closer to a modern understanding.