Biomedical subjects
E Shorter
Publications and source records attributed to E Shorter.
Somatization and chronic pain in historic perspective.
Practitioners today are confronted with an avalanche of difficult to treat patients with chronic pain for 2 reasons: (1) The culture increasingly encourages patients to conceive vague and nonspecific symptoms as evidence of real disease and to seek specialist help for them; and (2) the rising ascendancy of the media and the breakdown of the family encourage patients to acquire the fixed belief that they have a given illness, often a trendy nondisease such as repetition strain injury or chronic fatigue syndrome. In historic terms, many of these complaints, especially sensory ones featuring chronic pain and chronic fatigue, are relatively new. Patients tend to adopt them on the basis of what the culture considers to be legitimate illness, whereby different patterns exist for men and women.
Multiple chemical sensitivity: pseudodisease in historical perspective.
Multiple chemical sensitivity as a "disease" has emerged as a descendant of food allergy, which, in the 1920s and 1930s, was considered to be responsible for much human suffering and symptoms of disease. After the onmarch of the clinical ecological movement in the 1950s, interest has been focused on the environment, and concern about food allergies and chemical sensitivity has reached epidemic proportions. "Active hazardous waste sites" and "workers exposed to toxic chemicals" are at the top of the list of public worries. The public believes manufactured chemicals to be more dangerous than natural ones, although toxicologists regard the risks as equal. Originally, symptoms of patients were explained as "allergies", but since the 1960s the concept of "chemical sensitivities" has become a big-time diagnosis. The ideas of the clinical ecologists diffused rapidly into the community aided by public media. Today organizations like "Chemical Victims" and "National Foundation for the Chemically Hypersensitive" have thousands of members. Although the diagnosis of the disease is very vague, suffering patients believe that the clinical ecologists can offer them something that traditional medicine cannot: sympathy, recognition of pain and suffering, a physical explanation for their suffering, and active participation in medical care. Ecologic medicine thus soared in the patients' esteem, not just because of the content of the objective diagnoses that ecologic practitioners were able to supply, but because of the subjective nature of the doctor-patient relationship they were able to offer.
Sucker-punched again! Physicians meet the disease-of-the-month syndrome.
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The borderland between neurology and history. Conversion reactions.
The epidemic of conversion reactions taking place at the end of the twentieth century is a result of long-term changes in the presentation of functional illness. These changes often are a response to deeper issues in the culture about what constitutes legitimate organic disease. This epidemic also is a response to short-term changes in the attributions to which patients ascribe their illnesses. Such attributions are heavily influenced by the media, and clinicians must be on guard against both long- and short-term changes as they affect the presentation and attribution of illness.
A century of radiology at the University of Toronto.
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[The growing need for health care of the middle classes in Central Europe 1880-1930].
After 1850 medicine took on a new character, switching from a remedy for desperation to an everyday lifestyle habit. By examining the increase in recourse to medical care and the data on the availability of beds in private nursing homes, it is possible to assess the economic and social changes which took place as well as the conditions of family life and relations to disease. In this context, the role of women and their influence on the other members of the family is fundamental.
Chronic fatigue in historical perspective.
Chronic fatigue as a presenting complaint, in the absence of other evident organic illness, was seldom reported historically before the second half of the 19th century. Its first eruption was the so-called 'bed cases' or 'sofa cases' among middle-class females in the period from 1860 to about 1910. 'Neurasthenia' does not necessarily represent an early forerunner of chronic fatigue. Many patients receiving that diagnosis did not complain of fatigue. Others with functional fatigue did not receive the diagnosis 'neurasthenia'. Both medical-anecdotal and quantitative sources make it clear that by the time of the First World War, chronic fatigue was a common complaint in Europe and North America. Medical concepts of chronic fatigue since the 1930s have run along four separate lines: (1) 'postinfectious neuromyasthenia', going back to an atypical 'poliomyelitis' epidemic in 1934; (2) 'chronic Epstein-Barr virus' infection, an illness attribution that increased in frequency after the discovery in 1968 that this virus caused mononucleosis; (3) 'myalgic encephalomyelitis', dating from an epidemic at the Royal Free Hospital in London in 1955; and (4) 'fibrositis', or 'fibromyalgia', used as a rheumatological description since the turn of the century. Recently, these four separate paths have tended to converge into the diagnosis of 'chronic fatigue syndrome'.
Inpatient treatment of persistent somatization.
Patients with disabling, persistent somatization pose significant challenges in clinical management. This study describes 92 patients treated on an inpatient psychosomatic medicine unit for persistent somatization. The most important factor in defining clinically significant subgroups of these patients was mood. Compared with depressed somatizing patients, nondepressed somatizing patients had chronic illnesses of early onset, had symptoms that were not correlated with current life stressors, and were generally unresponsive to treatment. There were few clinical predictors of treatment outcome apart from the duration of symptoms, the presence of mood disturbance, and a history of stable interpersonal relationships.
Private clinics in Central Europe 1850-1933.
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Mania, hysteria and gender in Lower Austria, 1891-1905.
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Women and Jews in a private nervous clinic in late nineteenth-century Vienna.
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Paralysis: the rise and fall of a "hysterical" symptom.
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The effects of health on the completed fertility of nonwhite and white U.S. women born from 1867 through 1935.
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Female emancipation, birth control, and fertility in European history.
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Illegitimacy, sexual revolution, and social change in modern Europe.
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