ABSTRACT
Considering its strong symbolic connotations and its rich history, syphilis could be regarded as the perfect example of venerian disease. It could also be seen as a representative disease of the whole medical history and the evolution of both medical ways of thinking and curing. In this work we will briefly discuss the history of the syphilitic disease and try to show how this condition has affected the life and works of some of the most famous artists of the 19th century. Moreover, we shall try to evoke the complex relationship between art and pathology.
Par ses connotations historiques et symboliques, la syphilis constitue la maladie vénérienne par excellence. Elle peut également être considérée à plus d'un titre comme une maladie représentative de l'histoire de la médecine et paradigmatique de l'évolution de la pensée médicale. Au travers de ce petit historique, nous tenterons de dresser une brève histoire de la maladie et de son traitement avant d'envisager la façon dont elle a pu influencer le parcours créatif de plusieurs figures artistiques majeures du XIXème siècle. Plus encore, nous discuterons brièvement des liens complexes que peuvent entretenir l'art et la maladie.
Subject(s)
Medicine in the Arts , Syphilis , Art/history , History, 15th Century , History, 16th Century , History, 18th Century , History, 19th Century , History, 20th Century , Humans , Medicine in the Arts/history , Syphilis/diagnosis , Syphilis/history , Syphilis, Congenital/diagnosis , Syphilis, Congenital/historyABSTRACT
Diagnostic criteria and pathophysiology of narcolepsy-cataplexy have evolved considerably over the last 10 years. The main cause, already mentioned in a previous paper, in the Revue Médicale de Liège (65), in 2002, is based, in human beings, on a destruction of specific cells located in the lateral and posterior part of the hypothalamus (the perifornical nuclei, containing some 70,000 neurons), producing peptides which stimulate the central nervous system; they are called hypocretins or orexins. The role of autoimmunity in their disappearance becomes more evident. The treatment is simplified, but remains symptomatic. It is mainly based on Sodium Oxybate or Gamma-Hydroxybutyrate, syrup, prescribed for the night. The authors report on their own experience in this regard and on future therapeutics more targeted towards the cause of the disease.
Subject(s)
Narcolepsy/diagnosis , Narcolepsy/therapy , Diagnosis, Differential , Humans , Narcolepsy/epidemiology , Narcolepsy/physiopathologyABSTRACT
In some patients, impulse control behaviours can be triggered by dopaminergic replacement therapy, particularly dopamine agonist drugs: hobbyism, punding (stereotyped behaviours), compulsive buying, binge eating disorder, pathological gamgling, hypersexuality, hedonistic homeostatic dysregulation syndrome ... The pathogenesis of these behaviours: is not well understood, but likely involves aberrant changes in the dopaminergic pathways that mediate motivation i.e., a dopaminergic "overdose" in meso-cortico-limbic circuits, An early diagnosis is difficult, but mandatory to prevent the occurrence of devastating familial, marital, professional, socio-economic, medical and medico-legal consequences. Their management is not yet well standardized. Patients and caregivers should be warned about impulse control behaviours before starting dopamine agonists and monitoring for such behaviours while on therapy is requested.