Phrenitis and the pathology of the mind in western medical thought (fifth century BCE to twentieth century cE).

Phrenitis is ubiquitous in ancient medicine and philosophy. Galen mentions the disease innumerable times, Patristic authors take it as a favourite allegory of human flaws, and no ancient doctor fails to diagnose it and attempt its cure. Yet the nature of this once famous disease has not been properly understood by scholars. My book provides the first full history of phrenitis. In doing so, it surveys ancient ideas about the interactions between body and soul, both in health and in disease. It also addresses ancient ideas about bodily health, mental soundness and moral 'goodness', and their heritage in contemporary psychiatry, offering a chance to reflect critically on contemporary ideas about what it means to be 'insane'.

The Pragmatist roots of scientific medicine: Reassessing Abraham Flexner's report on medical education.

Abraham Flexner's 1910 report on medical education is widely regarded as a watershed moment in the history of modern medicine in the US and beyond. Most commentators focus on its administrative and managerial impact, despite Flexner dedicating a sizeable portion of his report to a theoretical account of the kind of medicine that he seeks to implement. Close attention to these sections reveals a surprisingly coherent account of medicine that, based on a Deweyan Pragmatist philosophy of science, unites scientific investigator and medical practitioner in a new experimental paradigm of science. Flexner can develop an account that goes beyond a mere epistemic redefinition of medicine, providing the profession with a social, cultural, and ethical identity that avails itself of the extremely wide purview that Dewey granted to modern science. Due to the subsequent narrowing of philosophy of science to a delimited academic subdiscipline, these broad Pragmatist philosophical commitments at the roots of Flexner's scientific medicine remained a largely unexplored intellectual legacy.

In the Tradition of William Osler: A New Biohumanistic Model of Psychiatry.

William Osler (1849-1919) is often considered the most influential physician in the emergence of science-based medicine. However, his approach to clinical medicine tends to be misunderstood, and its relevance to psychiatry has not been explored systematically. Osler's approach to the patient had four components: biological reductionism about disease, a scientific approach to clinical diagnosis, therapeutic conservatism, and a humanistic approach to the person. These concepts conflict with the pragmatic, eclectic, anti-reductionistic assumptions of contemporary psychiatry, as codified in its interpretation of a "biopsychosocial" model. This model leads to unscientific practice, with excessive use of medications given for symptoms, and inattention to identifying and treating diseases. This article suggests that implementing Osler's philosophy of medicine in psychiatry would greatly benefit the latter. It would inaugurate a new "biohumanistic" approach to psychiatry.

Philippe Pinel and the foundations of modern psychiatric nosology.

Philippe Pinel (1745-1826) played a major role in the foundation of modern psychiatric nosology. Much of his contribution, historically contextualized within the enlightenment generally and post-Revolutionary France more specifically, can be summarized through five themes in his background, education and writings. First, he applied an inductive, enlightenment-informed natural science approach to classification adapted from the biological sciences, which he had studied, and applied this to large samples of mentally ill individuals in Parisian asylums, frequently referring to 'varieties' and 'species' of insanity. Second, Pinel's classificatory approach rejected metaphysical and highly speculative etiologic theories in favor of a Baconian inductive approach utilizing observational data. Third, Pinel advocated repeated assessments of patients over time, feasible given long in-patient stays. Fourth, trained in philosophy, Pinel relied on philosophically informed models of the mind and of insanity. Fifth, Pinel extensively utilized faculty psychology to understand and classify mental illness. He anticipated further developments of nineteenth-century psychiatric nosology by challenging the then-dominant intellectualist models of insanity, adopting a humanistic-informed emphasis on the importance of symptoms alongside signs, arguing that passions could be the primary cause of mental illness, and trying to infer causal inter-relationships in psychiatric patients between disturbances in affect and understanding.

Scatological Asklepios: The Use of Excrement in Graeco-Roman Healthcare.

In the classical world, "official" rationalistic medicine made therapeutic use of excrement, urine and other substances that modern humans normally regard as repulsive (this was even true of Galen, the culminating authority); and popular medicine seems to have done so on a large scale. Such practices, which finally lost their professional though not their popular acceptability in the 18th century, have been studied to good purpose by other historians, but they have never been explained in a satisfactory fashion, partly because the relevant evidence is highly diverse. The present paper, by considering the long term (pre-Greek as well as Greek and Roman) and all the relevant contexts, including ancient feelings of disgust and the general state of ancient pharmacology, and by probing people's subconscious motives, attempts to establish a multi-factor explanation. This explanation balances traditions, beliefs about the inherent qualities, physical and magical, of natural substances, and the psychological needs of both healers and the sick.

Wild melancholy. On the historical plausibility of a black bile theory of blood madness, or hæmatomania.

Nineteenth-century art historian John Addington Symonds coined the term hæmatomania (blood madness) for the extremely bloodthirsty behaviour of a number of disturbed rulers like Ibrahim II of Ifriqiya (850-902) and Ezzelino da Romano (1194-1259). According to Symonds, this mental pathology was linked to melancholy and caused by an excess of black bile. I explore the historical credibility of this theory of 'wild melancholy', a type of melancholia that crucially deviates from the lethargic main type. I conclude that in its pure form Symonds' black bile theory of hæmatomania was never a broadly supported perspective, but can be traced back to the nosology of the ninth-century physician Ishaq ibn Imran, who practised at the Aghlabid court, to which the sadistic Ibrahim II belonged.

Osler Centenary Papers: Would Sir William Osler be a role model for medical trainees and physicians today?

If Sir William Osler were alive and practising as one of our contemporary colleagues, would he be viewed as a role model by medical trainees and other physicians? Recently published literature has sought to define clinical excellence; this characterisation of physician performance establishes a context in which role models in medicine can be appraised. Building on this framework, we present rich anecdotes and quotes from Sir William Osler himself, his colleagues, and his students to consider whether Osler would have been regarded as a role model for clinical excellence today. This paper illustrates convincingly that William Osler indeed personified clinical excellence and would have been appreciated as a consummate role model if he were alive and on a medical school's faculty today. However, a century has passed since his death, and he is not sufficiently visible today to serve as a role model to modern medical trainees and physicians. Moreover, we speculate that Osler himself would not have wanted to be a role model for today's trainees, as he emphasised that medicine is best learned from teachers at the bedside-a place where he cannot be. Reanimating Osler through rich stories and inspiring quotes, and translating his example of clinical excellence into modern clinical practice, can remind us all to carry Oslerian virtues with us in our professional work.

Ferments and the AIDS virus: interspecies counter-conduct in the history of AIDS.

In the first three decades after AIDS started infecting people in the USA and Canada, before, during and after the emergence of anti-retroviral therapies, numerous "alternative and holistic treatments" for AIDS were debated, tested, circulated, written about and taught. This paper, taking a narrow focus, examines documents that reveal how some people with AIDS developed a logic of care predicated on intimate interactions with microscopic lifeforms-the AIDS virus and the bacteria involved in fermentation, in particular. Focusing on the writings of Jon Greenberg and Sandor Katz, two former members of ACT UP/NY, I show that the men did not just dissent from management by biomedical authority but found new authority about how to care for themselves as people with AIDS from their interactions with non-human microscopic life. The practices and writings of both men demonstrate that Foucault's theory of counter-conduct exists in the history of AIDS as an interspecies process in which microscopic existents lead humans. From Katz and Greenberg, I argue there is an interspecies dimension to counter-conduct that exists as a frame for understanding people who find in non-human life a guide towards unconventional forms of care, revised forms of human behaviour and philosophies for persisting with illness.

[SALERNO HEALTH CODE AS A SOURCE OF MEDICAL AND PHILOSOPHICAL KNOWLEDGE].

The purpose of the article is to comprehensively disclose the meaning and relevance of the Salerno Health Code as a medieval source of medical and philosophical memo. In the process of writing a scientific article, the authors have used theoretical, empirical, and historical methods of scientific knowledge, in particular, methods of analysis, synthesis, deduction, comparison, the historical method, and the description method. In addition, the analysis of medical legislation, publications in the media and scientific periodicals, allowed us to study the essence and features of the Salerno Health Code. The article gives reason to a correspondence between the treatment methods proposed by the Salerno Health Code and the methods of modern medicine and the reflection of the basic standards of sanitary and epidemic well-being. The individual components of the Salerno Health Code were analyzed, which contributed to the development of bioethical views on sanitation, gerontology, dietetic, pharmaceuticals, disease prevention, medicine philosophy and more. The attention is focused on the author's approach to the formation of a positive worldview by a person and its relationship with the state of his physical health. The author symbolism of the poetic presentation of medical and philosophical ideas is analyzed. The treatise considers the author's approach to the formation of a positive worldview by a person and his relationship with his state of health. The article notes insufficient attention to the work of Arnold de Villanova in the scientific works of modern Ukrainian scientists in medicine and the humanities, which determines the relevance of further scientific research aimed at revealing the importance and potential of this source of medical and philosophical knowledge. Noted the relevance of certain parts of the Salerno Health Code for solving the problems of modern medical science.

René Girard and the Mimetic Nature of Eating Disorders.

French historian and literary critic René Girard (1923-2015), most widely known for the concepts of mimetic desire and scapegoating, also engaged in the discussion of the surge of eating disorders in his 1996 essay Eating Disorders and Mimetic Desire. This article explores Girard's ideas on the mimetic nature and origin of eating disorders from a clinical psychiatric perspective and contextualizes them within the field of eating disorders research as well as in relation to broader psychological, sociological and anthropological models of social comparison and non-consumption. Three main themes in Girard's thinking on the topic of eating disorders are identified and explored: the 'end of prohibitions' as a driving force in the emergence of eating disorders, eating disorders as a phenomenon specific to modernity, and the significance of 'conspicuous non-consumption' in the emergence of eating disorders.

Reception of the cell theory at Gaceta Médica de México in the 19th century / La recepción de la teoría celular en Gaceta Médica de México en el siglo XIX.

In the 18th century, a series of pro-independence movements took place in America against the order established by European dominant powers. This gave way to the concept of "national" and "international or foreign" affairs. In parallel, "the cell theory" emerged in the scientific world, based on the idea that living beings, both plants and animals, were constituted of anatomo-functional units, the cells, where vital functions take place. This theory was headed by the botanist Mathias Jacob Schleiden and zoologist Theodor Schwann. Gaceta Médica de México was founded in 1864, when the cell theory was already mature. The purpose of this manuscript is to document how this theory was received and disseminated in Mexico through articles published in Gaceta Médica de México.

En el siglo XIX se llevó a cabo en América una serie de movimientos independentistas en contra del orden establecido por las potencias europeas dominantes. Esto dio lugar al concepto de "lo nacional" y "lo internacional o extranjero" En forma paralela, en el mundo científico surgió "la teoría celular", basada en la idea de que los seres vivos, tanto vegetales como animales, estaban constituidos por unidades anatomofuncionales, las células, en las que se realizan las funciones vitales. Esta teoría fue encabezada por el botánico Mathias Jacob Schleiden y por el zoólogo Theodor Schwann. Gaceta Médica de México, fue fundada en 1864, cuando la teoría celular se encontraba en su madurez. El propósito de este escrito es documentar cómo fue recibida y divulgada esta teoría en México a través de los artículos publicados en Gaceta Médica de México.

[The Patriarch (in memory of prof. V.S. Ulashchik)].

The Patriarch (in memory of prof. V.S. Ulashchik).

Gastroenvironmental distress: metaphorical antecedents of the gut microbiome.

The human gut has been viewed for centuries as a potential mediator of systemic disease. The theory of autointoxication, which found its clearest articulation in the late nineteenth and early twentieth centuries, focused on altered bowel habits as the cause of widespread physical decay and advocated for the pursuit of health through regular defecation. More recently, under the banner of the microbiome, research on commensal bacteria makes a similar case for associations between alimentary dynamics and illness manifestations far outside the gastrointestinal tract. Surface distinctions between these two conceptual frameworks are apparently antipodal, the former championing emptiness and sterility, the latter abundance and restoration. Within both models, however, persists a common anxiety about the detrimental effects of civilisation on the body in relation to the natural world. As scientific understanding of the microbiome continues to mature, acknowledging the historical and moral parameters of its borrowed ecological idiom may facilitate critical distinctions between what is true and what feels like it should be.

Informed consent in the ethics of responsibility as stated by Emmanuel Levinas.

In this paper we analyze some of the major difficulties of informed consent (IC). We consider insufficient to base IC on the principle of autonomy. We must not forget that the patient may be in a situation of extreme vulnerability and the good doctor should assume a degree of commitment and responsibility with his/her decisions. Our aim is to introduce the ethics of responsibility of Levinas in practice and theory of IC in order to generate a beneficent medical practice in which the supervision and overseeing of the patient do not undermine his/her autonomy.

Time, space and form: Necessary for causation in health, disease and intervention?

Sir Austin Bradford Hill's 'aspects of causation' represent some of the most influential thoughts on the subject of proximate causation in health and disease. Hill compiled a list of features that, when present and known, indicate an increasing likelihood that exposure to a factor causes-or contributes to the causation of-a disease. The items of Hill's list were not labelled 'criteria', as this would have inferred every item being necessary for causation. Hence, criteria that are necessary for causation in health, disease and intervention processes, whether known, knowable, or not, remain undetermined and deserve exploration. To move beyond this position, this paper aims to explore factors that are necessary in the constitution of causative relationships between health, disease processes, and intervention. To this end, disease is viewed as a causative pathway through the often overlapping stages of aetiology, pathology and patho-physiology. Intervention is viewed as a second, independent causative pathway, capable of causing changes in health for benefit or harm. For the natural course of a disease pathway to change, we argue that intervention must not only occupy the same time and space, but must also share a common form; the point at which the two pathways converge and interact. This improved conceptualisation may be used to facilitate the interpretation of clinical observations and inform future research, particularly enabling predictions of the mechanistic relationship between health, disease and intervention.

"SAFEGUARDING THE INTERESTS OF THE STATE" FROM DEFECTIVE DELINQUENT GIRLS.

The 1911 mental classification, "defective delinquent," was created as a temporary legal-medical category in order to identify a peculiar class of delinquent girls in a specific institutional setting. The defective delinquent's alleged slight mental defect, combined with her appearance of normalcy, rendered her a "dangerous" and "incurable" citizen. At the intersection of institutional history and the history of ideas, this article explores the largely overlooked role of borderline mental classifications of near-normalcy in the medicalization of intelligence and criminality during the first third of the twentieth-century United States. Borderline classifications served as mechanisms of control over women's bodies through the criminalization of their minds, and the advent of psychometric tests legitimated and facilitated the spread of this classification beyond its original and intended context. The borderline case of the defective delinquent girl demonstrates the significance of marginal mental classifications to the policing of bodies through the medicalization of intellect.

[Scientific legacy of I.V. Davydovsky - philosophical foundations of general pathology].

The vast empirical material on pathogenesis of diseases has thus far been accumulated. However, its systematization and philosophical interpretation have not been given due attention since the time of I.V. Davydovsky. The value and topicality of I.V. Davydovsky' ideas need a fresh view andfurther development in the context of knowledges of the XXI century. The analysis of the selected provisions of I.V. Davydovsky offered in the article will hopefully contribute to their introduction into applied medicine.

[The scientific revolution in medicine of second half of XX - early XXI centuries: occurrence of new conceptions about human organism and essence of diseases].

The article presents the results of analysis of works of supreme Russian physiologists and pathologists of XX-XXI centuries. The analysis was applied on the basis concept of structure and dynamics of scientific cognition developed by one o the authors of the present article. The applied analysis permits affirming that during second half of XX-early XXI centuries in medicine occurred and continues to occurring transformations whose character and scope totally corresponds to scientific revolution and occurring and establishing in medicine new conceptions have all signs permitting referring them to post-neoclassic type of scientific rationality.