Functional neurology after the Second World War: The beginnings of neurology on screen (III).

Treatment of functional symptoms has a long history, and interventions were often used in soldiers returning from battle. On the 75th anniversary of the end of the Second World War, I review the portrayal of neurology in documentary film. Two documentaries were released in 1946 and 1948 (Let There Be Light and Shades of Gray, respectively), which showed a number of soldiers with functional neurology including paralysis, stuttering, muteness, and amnesia. The films showed successful treatments with hypnosis and sodium amytal by psychoanalytic psychiatrists. These documentaries link neurology with psychiatry and are remarkable examples of functional neurology and its treatment on screen.

[Advice and treatment from the clairvoyant Croiset]. / Adviezen en behandeling van de paragnost Croiset.

Around 1960, the Dutch clairvoyant Gerard Croiset (1909-1980) was consulted by 'people with symptoms - considered to be unexplained - such as paralysis or neurological disorders'. I searched the archive of the Johan Borgman Fund Foundation for the effect of Croiset's advice and treatment in patients with these symptoms who might have had the diagnosis of conversion disorder. Contrary to my expectations, Croiset treated no patients with conversion disorder. His advice and treatment were successful in patients with poliomyelitis, epilepsy, lumbar disc prolapse and infantile encephalopathy. Four of his patients had been insufficiently stimulated by the first person who treated them to improve their remaining muscular strength through exercise; symptoms of anxiety had not been investigated sufficiently in two patients; and in one patient the treating professional had adhered too rigidly to the set treatment. Alternative healers are apparently not only successful with patients with unexplained symptoms, and their success is not always the result of a placebo effect.

The Dancing Manias: Psychogenic Illness as a Social Phenomenon.

The dancing mania erupted in the 14th century in the wake of the Black Death, and recurred for centuries in central Europe - particularly Germany, the Netherlands, and Belgium - finally abating in the early 17th century. The term "dancing mania" was derived from "choreomania," a concatenation of choros (dance) and mania (madness). A variant, tarantism, was prevalent in southern Italy from the 15th to the 17th centuries, and was attributed at the time to bites from the tarantula spider. Affected individuals participated in continuous, prolonged, erratic, often frenzied and sometimes erotic, dancing. In the 14th century, the dancing mania was linked to a corruption of the festival of St. John's Day by ancient pagan customs, but by the 16th century it was commonly considered an ordeal sent by a saint, or a punishment from God for people's sins. Consequently, during outbreaks in the 14th and 15th centuries, the dancing mania was considered an issue for magistrates and priests, not physicians, even though the disorder proved intractable to decrees and exorcisms. However, in the 16th century Paracelsus discounted the idea that the saints caused or interceded in the cure of the dancing mania; he instead suggested a psychogenic or malingered etiology, and this reformulation brought the dancing mania within the purview of physicians. Paracelsus advocated various mystical, psychological, and pharmacological approaches, depending on the presumptive etiologic factors with individual patients. Only music provided any relief for tarantism. Later authors suggested that the dancing mania was a mass stress-induced psychosis, a mass psychogenic illness, a culturally determined form of ritualized behavior, a manifestation of religious ecstasy, or even the result of food poisoning caused by the toxic and psychoactive chemical products of ergot fungi. In reality, dancing manias did not have a single cause, but component causes likely included psychogenic illness, malingering, and ritualized behaviors.

Experiencing, Exploiting, and Evacuating Bile: Framing Fashionable Biliousness from the Sufferer's Perspective.

This article examines how sufferers experienced, understood, and expressed themselves as bilious, focusing on the late Georgian era when the disease became one of the most fashionable and oft diagnosed amongst the elites. We show that responses to bile were more complex, varied, and less credulous than contemporary diatribes and subsequent historiography imply. Nonetheless, we foreground the socioculturally negotiated elements of the malady rather than its "reality." Applying Rosenberg's framing diseases model reveals biliousness as one of the most problematic conditions to frame, but one of the most malleable to self-fashion. We demonstrate how Georgian Britons found functionality in their bile and "performed" being bilious. Articulate, literate sufferers deployed a range of strategies to vent or master their bile, or to render it social and serviceable, deriving various compensatory "secondary gains." We illuminate their variable success in reifying and sublimating bile, and differentiating the boundaries of biliousness vis-à-vis other complaints.

Recipe Collections and the Realities of Fashionable Diseases in Eighteenth-Century Elite Domestic Medicine.

This chapter focuses on the individualistic nature of medicine by considering manuscript recipe collections, and the concerns and rhetoric of the elite patients who wrote about fashionable diseases and experienced them. Domestic medicine in the eighteenth century was a facet of elite health care that included commercial medicine and professional assistance. Looking broadly at the fashionability of health care, including the fashionability of the consumer goods and services linked to self-management and leisure time, reveals the realities of fashionable diseases in elite lives. The sociocultural rhetoric of fashionable diseases was incorporated into the recipe collecting tradition, but experiences of suffering and a need for care continued to be at the forefront of the discourse in domestic medicine and this writing tradition. This essay argues also that domestic rhetoric and experiences of fashionable disease were significantly driven by consumerism.

"The History of Half the Sex": Fashionable Disease, Capitalism, and Gender in the Long Eighteenth Century.

This essay examines the way in which disease was framed and narrated as fashionable in the long eighteenth century, and argues that the intensifying focus on women's fashionable disorders in the period grew in tandem with the rise of an unstable capitalism in its manifold forms. Using the satirical articles written by Henry Southern in the London Magazine-"On Fashions" (August 1825), "On Fashions in Physic" (October 1825), and "On Dilettante Physic" (January 1826)-and the literature that led to them, I analyze the role that women were now taking in the newly capitalized world of the early nineteenth century. This world was characterized by a burgeoning medical market, a periodical and print market which could adequately reflect and promote fashionable diseases and the medical market that spawned them, and the nexus of actors in the whole drama of the production, maintenance, and dissolution of fashionable diseases.

"All the World Is Gone to the Assembly": Elizabeth Carter's Headaches, Nerves, and (In)Sociability.

Elizabeth Carter suffered from severe headaches all her life. Her letters are peppered with references to fits of "head-ach" so bad they made her bold enough to demand her own room wherever she visited, and to cherish a preference for solitude contrary to the ideal of Bluestocking sociability. Following her friends and physicians, she bowed to fashionable diagnoses in considering these headaches the result of a nervous constitution, and she was prescribed the usual remedies, including sociable trips to fashionable watering places. While positioning her sufferings within the frame of fashionable diseases, Carter tried to dissociate herself from fashionable sensibility, and struggled to gain acceptance for her pain as part of her body's "mechanism" by using a more old-fashioned, religious interpretative frame. This case study of Carter's headaches thus charts Carter's own understanding of her constitution, her body, and her pain within-and without-the framework of eighteenth-century fashionable diseases.

Authenticity and Fashionable Disease in Eighteenth-Century Britain.

Throughout the eighteenth century the issue of authenticity shaped portrayals of fashionable diseases. From the very beginning of the century, writers satirized the behavior of elite invalids who paraded their delicacy as a sign of their status. As disorders such as the spleen came to be regarded as "fashionable," the legitimacy of patients' claims to suffer from distinguished diseases was called further into question, with some observers questioning the validity of the disease categories themselves. During the early and middle decades of the century, criticism was largely confined to periodicals, plays, and poetry, while medical writers wrote in defense of the authenticity of such conditions. The adoption of fashionable ailments and nervous sensibility grew increasingly popular, however, and from the 1770s onwards practitioners and novelists increasingly suggested that such diseases should not be trusted as signifiers of personal qualities or social status.

The Fashioning of Fashionable Diseases in the Eighteenth Century.

This essay considers why the eighteenth century has particular significance for anyone concerned with the cultural forces necessary to render a disease fashionable. A brief overview of a pervasive cult of sensibility addresses the role of popular medical writing, imaginative literature, and spas in circulating a romanticized model of nervous disorders as signs of intellectual and moral superiority. Attention is drawn to the ambiguity in the term "fashionable" implying "popular," but also something that might be contrived; to what extent were Georgian fashionable diseases merely cultural constructs? Here the medicalization of masturbation suggests a limit-case. The discussion concludes with an individual case history as reported to the leading academic physician William Cullen.

Pain, objectivity and history: understanding pain stigma.

The primary claim of this paper is that understanding the stigma so commonly endured by chronic pain sufferers today in the USA and the UK is unlikely without proper appreciation of the history of pain. Ameliorating such stigma is an ethical imperative, and yet most approaches eschew even an attempt to trace connections between historical attitudes, practices and beliefs towards pain and the stigmatisation so many pain sufferers currently endure. The manuscript aims to help fill this gap by framing pain in the modern era in context of two crucial intellectual schemes that waxed in the 19th and 20th centuries: mechanical objectivity and somaticism. The analysis explains these frameworks and applies them to exploration of primary sources connected to contested pain conditions such as railway spine. By properly situating the historical roots of what it means to cite the 'subjectivity' of pain as a problem, the modern roots of stigmatising attitudes and practices towards chronic pain sufferers become much clearer. The manuscript concludes by suggesting that interventions expressly intended to target the root causes of such stigma are much more likely to be successful than approaches that proceed in ignorance of the historical forces shaping and driving pain stigma in the present.

Sydenham on Hysteria.

This historical essay outlines early ideas and clinical accounts of hysteria. It reproduces verbatim parts of a remarkable text of Thomas Sydenham. This provides the most detailed description of hysterical symptoms, contemporary treatment and particularly Sydenham's opinions about the nature of the disorder. His portrayal is compared to later and modern concepts and classification.

Toxic Texts and Reading Remedies: Literary Medicine in Eighteenth-Century Print Cultures.

Today the idea of reading for health is perhaps most commonly associated with the term bibliotherapy. This seemingly new practice might be considered a significant shift of public and professional medical attitudes when compared with historical interpretations of the impact of reading on individuals' health. Much historiography concerning the reception of popular literature in eighteenth-century print culture has focused on the belief that readers of fiction, most often women, were at risk of corrupting their own minds and bodies through their reading choices. Yet, although popular, this view was not exclusively subscribed to by either medical practitioners or the wider public. This article reveals perspectives that warned against and celebrated the effects of reading on human health during the eighteenth century. Unlike what we see from much contemporary scholarship there is, in fact, a range of evidence which demonstrates that eighteenth-century medical practitioners were already engaging with the concept of reading as a therapeutic activity.

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.

DSM-5: ¿Cambios significativos? / DSM-5: Significant changes?

El DSM-5 salió a la luz en mayo de 2013, generando gran expectativa y controversia por sus cambios e inclusiones, como la eliminación de los ejes diagnósticos, la organización del manual en un modelo de “ciclo vital”, la aparición de nuevas entidades y el ajuste en los criterios de diagnóstico de muchos trastornos. El objetivo del presente artículo es presentar una aproximación al manual desde una perspectiva latinoamericana, exponiendo las opiniones personales de los autores respecto a los principales cambios (AU)

Since that DSM appeared on may of 2013, was generated an important expectative and controversy because of its changes in inclusions, the elimination of diagnostic axes, the manual’s organization in a model of “life cycle”, the emergence of new entities and the adjust in the criteria of diagnosis of many disorders. The aim of this paper is show an approach to manual from a Latin American perspective, and exposes the opinions of the authors regarding the major changes (AU)

[Oswald Schwarz: a pioneer in psychosomatic urology and sexual medicine]. / Oswald Schwarz : Ein Pionier der psychosomatischen Urologie und Sexualmedizin.

Oswald Schwarz, a urologist from Vienna, was a scholar of Anton Ritter von Frisch and Hans Rubritius. As a physician during World War I, he was confronted with numerous bullet wounds to the spinal cord. In 1919, he completed his professorial thesis"Bladder dysfunction as a result of bullet wounds to the spinal cord". Oswald Schwarz was known as a committed surgeon. As an urologist he also treated patients with sexual dysfunction. Besides his practical and scientific urology-related work, he was also interested in psychology and philosophy. He held lectures on both subjects earning himself the nickname, the Urosoph. In the 1920s, Oswald Schwarz belonged to the inner circle of Alfred Adler, the founder of Individual Psychology, and was editor of the first psychosomatic textbook published in German, "Psychological origin and psychotherapy of physical symptoms" (1925). In addition, Schwarz wrote numerous articles and several books on sexual medicine. He also made many valuable contributions to the development of medical anthropology. Altogether, his work includes over 130 publications. Faced with the rise of fascism and National Socialism in Europe, Oswald Schwarz, who was of Jewish origin, emigrated to England in 1934. There he died in 1949. Unfortunately his scientific work has largely been forgotten. The aim of the following article is to remind us of his important contributions to the field.

'Hysteria' today and tomorrow.

'Hysteria' (conversion disorder) remains in modern humanity and across cultures, as it has for millennia. Advances today in tools and criteria have afforded more accurate diagnosis, and advances in treatments have empowered patients and providers, resulting in a renewed interest in somatoform disorders. Future progress in understanding mechanisms may be influenced by developments in functional neuroimaging and neurophysiology. No animal model exists for somatoform symptoms or conversion disorder. Despite the absence of a known molecular mechanism, psychotherapy is helping patients with conversion disorder to take control of their symptoms and have improved quality of life, shedding light on what was once an enigma.