Noddle Pox: Syphilis and the Conception of Nosomania/Nosophobia (c. 1665-c. 1965).

Hypochondriac or phobic reactions to venereal disease, specifically syphilis, have invited over three centuries of medical reification and nosological reframing. This bibliographic overview establishes that the early specification and psychiatricization of early modern concepts of melancholy and hypochondriasis, imaginary syphilis or syphilophobia, animated the early respective territorializations of venereology, infectiology more broadly, neurology, and mental medicine. Together with mercuriophobia and a wider emergent clinical sensitivity to sexual angst, the diagnosis, while evidently only sporadically made, functioned as a durable soundboard in the confrontation of emergent medical rationale with various confounders and contenders: medically literate and increasingly mobile but possibly deluded patients; charlatans and putative malpractitioners; self-referral laboratory serology (after 1906); and eventually, through psychoanalysis, the patient's unconscious. Requiring medical psychology early on, syphilology became and remained self-conscious and circumspect, attentive to the casualties of overdiagnosis, overtreatment, and iatrogenesis. Finally, patient apprehension led to makeshift forms of "moral treatment," including fear-instilling and placebos.

Taphophobia and 'life preserving coffins' in the nineteenth century.

In 1891 the Italian psychiatrist Enrico Morselli (1852-1929) described taphophobia, defining it as an extreme condition of claustrophobia due to the fear of being buried alive. This rare psychopathological phenomenon reflects an ancient fear, and its origin is not known. Taphophobia is closely linked to the problem of apparent death and premature burial. In the nineteenth century, scientists and authors paid particular attention to the issue of apparent death, and special devices (safety coffins) were invented to ensure that premature burial was avoided. Nowadays taphophobia is quite a rare psychiatric disorder; different forms of social anxiety disorders are much more widespread. Its modern equivalent could be the fear of organs harvested from a patient who is still alive.

A modern conceptualization of phobia in al-Balkhi's 9th century treatise: Sustenance of the Body and Soul.

Morbid fears and phobias have been mentioned in religious, philosophical and medical manuscripts since ancient times. Despite early insights by the Greeks, phobias did not appear as a separate clinical phenomenon in Western medicine until the 17th century and has evolved substantially since. However, robust investigations attempting to decipher the clinical nature of phobias emerged in pre-modern times during the oft-overlooked Islamic Golden Era (9th-12th centuries); which overlapped with Europe's medieval period. An innovative attempt was made by the 9th century Muslim scholar, Abu Zayd al-Balkhi, in his medical manuscript "Sustenance of the Body and Soul," to define phobias as a separate diagnostic entity. Al-Balkhi was one of the earliest to cluster psychological and physical symptoms of phobias under one category, "al-Fazaá", and outline a specific management plan. We analyze al-Balkhi's description of phobias, according to the modern understanding of psychiatric classifications and symptomatology as described in the DSM-5.

Correcting the record on Watson, Rayner, and Little Albert: Albert Barger as "psychology's lost boy".

In 1920, John B. Watson and Rosalie Rayner attempted to condition a phobia in a young infant named "Albert B." In 2009, Beck, Levinson, and Irons proposed that Little Albert, as he is now known, was actually an infant named Douglas Merritte. More recently, Fridlund, Beck, Goldie, and Irons (2012) claimed that Little Albert (Douglas) was neurologically impaired at the time of the experiment. They also alleged that Watson, in a severe breach of ethics, probably knew of Little Albert's condition when selecting him for the study and then fraudulently hid this fact in his published accounts of the case. In this article, we present the discovery of another individual, Albert Barger, who appears to match the characteristics of Little Albert better than Douglas Merritte does. We examine the evidence for Albert Barger as having been Little Albert and, where relevant, contrast it with the evidence for Douglas Merritte. As for the allegations of fraudulent activity by Watson, we offer comments at the end of this article. We also present evidence concerning whether Little Albert (Albert Barger) grew up with the fear of furry animals, as Watson and Rayner speculated he might.

Edith Wharton's threshold phobia and two worlds.

The American novelist Edith Wharton suffered an unusual childhood neurotic symptom, a fear of crossing thresholds, a condition that might be called a "threshold phobia." This symptom is identified and examined in autobiographical material, letters, diaries, and selected literary fiction and nonfiction left by Wharton to arrive at a formulation not previously drawn together. A fascinating theme-living or being trapped between "two worlds"-runs through much of the writer's life and work. The phobia is related to this theme, and both can be linked more broadly to certain sexual conflicts in women. This understanding of Wharton's phobia, it is argued, throws new light on the developmental issues and conflicts related to the female "oedipal" or triadic phase, characterized by the need to negotiate the two worlds of mother and of father.

"Phthisiophobia": the difficult recognition of transmission of tuberculosis to health care workers.

BACKGROUND: Even if the contagious nature of tuberculosis was universally accepted during the nineteenth century, its transmission to health care workers (HCWs) was initially denied by the scientific community. Working among TB patients was not considered dangerous for healthy adults, so the potential risks for HCWs were branded as unwarranted "phthisiophobia" (fear of contracting tuberculosis). OBJECTIVES: This study aims at analyzing the problem of tuberculosis transmission among health care workers from an historical perspective, particularly highlighting the contribution made by the Italian Occupational Medicine community. METHODS: Scientific literature and historical sources on different theories regarding tuberculosis transmission were investigated, specially focusing on the period at the turn of the 19th and 20th centuries. RESULTS: At the beginning of the twentieth century, Luigi Devoto (1864-1936), an Italian pioneer in the field of Occupational Medicine, was one of the first scientists to conduct research on the transmission of tuberculosis among nurses. Since the 1920s several studies, conducted mainly on medical and nursing students, confirmed the risk for HCWs. However an international consensus on this issue was only achieved during the 1950s, when the institution of mandatory chest radiographs on admission for all patients significantly decreased the cases of tuberculosis among HCWs. CONCLUSIONS: Devoto was one of the first scholars who postulated the transmission of tuberculosis to HCWs. He also theorized that hospital personnel with active disease could also be a source of contagion to patients. Nowadays, "third party risk" and latent tuberculosis infection pose a new challenge for occupational physicians in hospitals.

[Melancholic syphilophobia: on the cultural history of venerology]. / Melancholia syphilidophobica: Zur Kulturgeschichte der Venerologie.

In the second half of the nineteenth century venereal diseases attained more attention and explosiveness in public discourse than ever before. Collective fear of the so-called French disease culminated in the emergence of melancholic syphilophobia a previously unknown form of hypochondriac suffering. This paper addresses the question of how this development occurred and focuses more specifically on the epistemological implications of the pathological fear of syphilis and highlights the systematic significance of etiological interpretation and nosological conceptualization of venereal disease.

Hysterical paralysis and premature burial: a medieval Persian case, fear and fascination in the West, and modern practice.

Premature burial (taphophobia) is an ancient fear, but it became especially common in 18th and 19th century Europe and may have a modern-day counterpart. Examination of a well-documented case from medieval Persia reveals the importance of funeral practices in the risk of actual premature burial and sheds light on the question of why taphophobia became so prevalent in Europe during the early industrial revolution period. The medieval Persian case was attributed to hysterical paralysis (conversion). We discuss the relationship between hysterical paralysis and premature burial more generally and show that although understanding of conversion syndrome remains incomplete, modern knowledge and practices have limited the risk of any similar tragedy today.

Obsessive compulsive disorder and psychopathic behaviour in Babylon.

BACKGROUND: The history of obsessive compulsive, phobic and psychopathic behaviour can be traced to the 17th century AD. METHODS AND RESULTS: We draw attention to these behaviours in a Babylonian cuneiform medical text known as Shurpu. These three categories were united in the Babylonian mind around the concept of the mamit 'oath' idea, the behaviour habits being so unbreakable it appeared that the subject had sworn an oath to do or not to do the action involved. The behavioural accounts were entirely objective, including what we would call immature, antisocial and criminal behaviour, and obsessional categories of contamination, aggression, orderliness of objects, sex and religion. They do not include subjective descriptions of obsessional thoughts, ruminations or the subject's attitude to their own behaviour, which are more modern fields of enquiry. CONCLUSIONS: The Babylonians had no understanding of brain or psychological function but they were remarkable describers of medical disease and behaviour. Although they had both physical and supernatural theories of many medical disorders and behaviours, they had an open mind on these particular behaviours which they regarded as a 'mystery' yet to be 'resolved'. We are not aware of comparable accounts of these behaviours in ancient Egyptian or classical medicine. These Babylonian descriptions extend the history of these disorders to the first half of the second millennium BC.

Narrativas médicas do medo: do coração ao cérebro / Medical narratives of fear: from heart to the brain

Desde a síndrome do coração irritável, passando pelas diversas síndromes do fin de siècle e chegando ao triunfo das teorias neurocientíficas sobre a “hipersensibilidade dos centros cerebrais de resposta ao alarme e sufocação”, a Medicina buscou teorias para explicar a experiência de pavor. Investiga-se o modo como ocorreram, ao longo da história, as transformações da atenção médica sobre o medo e os estados mórbidos que o acompanham. Ao se buscar na literatura médica vestígios de análises científicas sobre o mal-estar intenso, do meio do século XIX ao fim do XX, não se pretendeu construir uma história triunfalista, de modo que as teorias atuais pudessem ganhar status de superioridade em relação às do passado. Evidenciou-se, sim, a importância cultural e a força histórica de cada uma delas, salientando as possíveis continuidades e rupturas de sentido que elas assumiram.

Space travels of the Wolfman: phobia and its worlds.

In this paper, we present a spatial reading of Freud's famous case study, "The Wolfman" (1918). By reading the Wolfman and his phobias spatially, we want to show how psychoanalysis is not a linear story of personal development, but reveals instead the unconscious estates and competing places that our desires both travel in, but also get stuck and waylaid in. The unconscious "estates" that the Wolfman travels through, constituting his phobias, is something we aim to illuminate. These worlds are not simply "many," they are specific -- but they nonetheless unfold in plural and non-linear ways. Phobias are the policemen of our desires keeping us safe and at home, within certain boundaries. And yet the Wolfman's phobias, his unconscious territories are arguably spaces that need opening up, not hypnotizing away. As Freud travels alongside the Wolfman through his worlds, he can never by sure where he is, where they are. And this is a good thing because if space travel in psychoanalysis is going to work, it has to be alive to the uncanny nature and the uncertain boundaries that constitute our desires. As a touchstone case study in psychoanalysis, the Wolfman's case points to the very uncertainty with which analysis must proceed. Psychoanalysis, in this view, is more about companionable travelling, without either a fixed point of origin or a predetermined destination, than about knowing where you have been, where you are and where you are going; more about creating a geography of possibilities than about determining which ones should or should not be taken.

The hawk/goose story: the classical ethological experiments of Lorenz and Tinbergen, revisited.

We present a historical account of the story behind the famous hawk/goose experiments of Lorenz and Tinbergen in a wider context of cognitive ethology. We discuss their significance, for ethological experimentation in general, and specifically for understanding innate constraints on cognition. As examples of the continuing significance of the hawk/goose paradigm of selective habituation, we discuss its relation to "exposure therapy" of human phobias and the use of hawk silhouettes as deterrents for songbirds. Finally we rephrase Uexküll's thesis of taxon-specific worlds ("Umwelten") as a "Theory of World."

Little Hans: masculinity foretold.

Joining the centennial reexamination of Freud's "Analysis of a Phobia in a Five-Year-Old Boy" (I909a), the author returns to Little Hans as the Ur psychoanalytic boy. Hans's construction and acts of consciousness continue to endow the psychoanalytic construct of masculinity with meaning. It is suggested that Freud moved in his discussion of the case to regulate the unsettled conditions of masculinity that he articulated through his clinical observations of Hans. The case is viewed as an exemplary illustration of how masculinity is foretold--a normative narrative that has changed little in the last 100 years. The author offers a contemporary view of masculinity as a dilemma of boundary--neither fully interior nor fully exterior, neither fully fantastic nor fully socially constructed.

Little Hans: a centennial review and reconsideration.

Freud's "Analysis of a Phobia in a Five-year-old Boy" has stimulated interminable "reanalysis." The case of Little Hans, an unprecedented experimental child analytic treatment, is reexamined in the light of newer theory and newly derestricted documents. The understanding of the complex overdetermination of Hans's phobia was not possible in the heroic age of psychoanalysis. Current analytic thought, as well as distance de-idealization vis-à-vis the pioneering past, has potentiated a reformation of the case. The severe disturbance of his mother had an adverse impact on Little Hans and his family. Her abuse of Hans's infant sister has been overlooked by generations of analysts. Trauma, child abuse, parental strife, and the preoedipal mother-child relationship emerge as important issues that intensified Hans's pathogenic oedipal conflicts and trauma. With limited, yet remarkable help from his father and Freud, Little Hans nevertheless had the ego strength and resilience to resolve his phobia, resume progressive development, and forge a successful creative career.

Little Hans "analyzed" in the twenty-first century.

Freud's monograph on the analysis of Little Hans is examined from a perspective aimed at highlighting elements of current thinking that would be considered mutative from those originally emphasized at the time it was written, and with a specific focus on the relative importance of verbal versus nonverbal interventions.

Trauma and abuse in the case of Little Hans: a contemporary perspective.

Newly available interviews with Max and Herbert Graf describe the severe pathology of Little Hans's mother and her mistreatment of her husband and her daughter, who committed suicide as an adult. Reread in this context, the text of "A Phobia in a Five-year-old Boy" provides ample evidence of Frau Graf's sexual seduction and emotional manipulation of her son, which exacerbated his age-expectable castration and separation anxiety, and her beating of her infant daughter. The boy's phobic symptoms can therefore be deconstructed not only as the expression of oedipal fantasy, but as a communication of the traumatic abuse occurring in the home. Through subliminal, indeed unconscious, injunctions conveyed in abusive behavior, parents can confirm the child's worst imaginings and immature views of the world and thereby render the child's oedipal conflicts and fantasies pathogenic.