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Descartes' pineal neuropsychology.

The year 1996 marked the quattrocentenary of Descartes' birth. This paper reviews his pineal neuropsychology. It demonstrates that Descartes understood the true anatomical position of the pineal. His intraventricular pineal (or glande H) was a theoretical construct which allowed him to describe the operations of his man-like "earthen machine." In the Treatise of Man he shows how all the behaviors of such machines could then be accounted for without the presence of self-consciousness. Infrahuman animals are "conscious automata." In Passions of the Soul he adds, but only for humans, self-consciousness to the machine. In a modern formulation, only humans not only know but know that they know.

Famous Persons↗

Jacobus Schroeder van der Kolk (1797-1862): his resistance against materialism.

Schroeder van der Kolk is regarded as the founder of Dutch psychiatry and neurology. This paper describes his vitalistic views on the relation between body and soul, as formulated by him in a series of lectures. These lectures were intended to counteract the materialistic tendencies of some of Schroeder van der Kolk's French and German contemporaries. It is argued that Schroeder van der Kolk can be regarded as the transition in Holland from the "Naturphilosophie" approach to the modern experimental approach in physiology.

History, 18th Century↗

Mutations in the zebrafish unmask shared regulatory pathways controlling the development of catecholaminergic neurons.

The mechanism by which pluripotent progenitors give rise to distinct classes of mature neurons in vertebrates is not well understood. To address this issue we undertook a genetic screen for mutations which affect the commitment and differentiation of catecholaminergic (CA) [dopaminergic (DA), noradrenergic (NA), and adrenergic] neurons in the zebrafish, Danio rerio. The identified mutations constitute five complementation groups. motionless and foggy affect the number and differentiation state of hypothalamic DA, telencephalic DA, retinal DA, locus coeruleus (LC) NA, and sympathetic NA neurons. The too few mutation leads to a specific reduction in the number of hypothalamic DA neurons. no soul lacks arch-associated NA cells and has defects in pharyngeal arches, and soulless lacks both arch-associated and LC cell groups. Our analyses suggest that the genes defined by these mutations regulate different steps in the differentiation of multipotent CA progenitors. They further reveal an underlying universal mechanism for the control of CA cell fates, which involve combinatorial usage of regulatory genes.

Animals↗

Restricted expression of cardiac myosin genes reveals regulated aspects of heart tube assembly in zebrafish.

The embryonic vertebrate heart is divided into two major chambers, an anterior ventricle and a posterior atrium. Although the fundamental differences between ventricular and atrial tissues are well documented, it is not known when and how cardiac anterior-posterior (A-P) patterning occurs. The expression patterns of two zebrafish cardiac myosin genes, cardiac myosin light chain 2 (cmlc2) and ventricular myosin heavy chain (vmhc), allow us to distinguish two populations of myocardial precursors at an early stage, well before the heart tube forms. These myocardial subpopulations, which may represent the ventricular and atrial precursors, are organized in a medial-lateral pattern within the precardiac mesoderm. Our examinations of cmlc2 and vmhc expression throughout the process of heart tube assembly indicate the important role of an intermediate structure, the cardiac cone, in the conversion of this early medial-lateral pattern into the A-P pattern of the heart tube. To gain insight into the genetic regulation of heart tube assembly and patterning, we examine cmlc2 and vmhc expression in several zebrafish mutants. Analyses of mutations that cause cardia bifida demonstrate that the achievement of a proper cardiac A-P pattern does not depend upon cardiac fusion. On the other hand, cardiac fusion does not ensure the proper A-P orientation of the ventricle and atrium, as demonstrated by the heart and soul mutation, which blocks cardiac cone morphogenesis. Finally, the pandora mutation interferes with the establishment of the early medial-lateral myocardial pattern. Altogether, these data suggest new models for the mechanisms that regulate the formation of a patterned heart tube and provide an important framework for future analyses of zebrafish mutants with defects in this process.

Animals↗

A Day in the Life of Dr K. or How I Learned to Stop Worrying and Love Lysozyme: a tragedy in six acts.

About the play: In modern drama, the agonizing nature of membrane protein work has not been adequately acknowledged. It is perhaps significant that the first attempt to bring this darker aspect of human existence into focus comes from a Scandinavian author, writing in the tradition of Ibsen and Strindberg but with a distinctly turn-of-the-millenium approach to the inner life of his characters: the despairing Dr K; the cynical Dr R with his post-modernistic life credo; the ambitious but unfeeling Dr C; the modern Ubermensch, Dr B. , with his almost Nietzschean view of human nature. This is a play that is brutally honest, yet full of empathy for the poor souls that get caught between the Scylla of unreachable scientific glory and the Charybdis of helpless mediocrity.James Glib-Burdock, drama critic for The Stratford Observer.

Drama↗

Reflections on Tamazai, a Tuareg idiom of suffering.

In this essay, I explore ways in which the theatrical and the medical are inextricably mixed and affect each other, in the Nigerien Tuareg idiom of tamazai. Tamazai is locally-described as "an illness of the heart and soul, not curable by Koranic verses," but by exorcism of spirits. A case study and analysis of healing rituals demonstrate how this idiom communicates women's relationships and empowers dramatic framing.

Adult↗

Periorbital aesthetic surgery with the KTP laser.

The eyes are regarded as the windows to the soul. Many expressions of mood may be derived from the appearance of the eyes--mad, sad, bad, criminal, sweet, friendly, mystic. In addition, love and flirtatiousness, self-consciousness, pride, modesty, anger, youth, and age are shown in the expression of our eyes. The eyes and the periorbital region therefore challenge our surgical skill to improve the patient's overall well-being to be looked at each day in the mirror. The potassium titanyl phosphate (KTP) laser in many indications helps us to fulfill the patient's expectations concerning pain, oozing, bruising, swelling, outpatient surgery, and early return to work and normal social activities. With the cutting fiber device, an accurate removal of skin and fat or even tumors is possible in this region with practically no side effects. The frontal lift, eyebrow lift, direct or through coronal incision, as well as temporal lifting are easily accessible and carried out by this device. Glabellar frowns may also be removed endoscopically. Further, the KTP laser may be used for transconjunctival blepharoplasty.

Adult↗

"Lord of the Mirrors" and demon lover.

Repeated object loss drove Sylvia Plath to create, and what she created were her greatest, and best-known poems, collected in the book Ariel. Yet the compulsion to create alternated with the compulsion to destroy. Her suicidal impulses were as intense as her poetic impulses (see Bach, 1985, on the "Marquis de Sade"). How these two contrasting impulses counter-balanced each other, until self-destruction took the lead, is the story of Sylvia Plath. What remains with us is the puzzle of her despair. This puzzle can only be pieced together by looking at the internal object relations of the father-daughter bond, which germinated like a ghost and spector within Sylvia Plath's soul.

Creativity↗

Don Pasquale, Fidelio, and psychiatry.

Donizetti's Don Pasquale and Beethoven's Fidelio are discussed in order to illustrate how two very different operas can illustrate the human quest for authenticity. Through their music and dramatic presentation they are able to convey experiential insights into profound philosophic and psychologic truths. Along with other experiential communications, such as myths, folklore, poetry, humor, and art, they can be especially helpful--not only but also--in psychotherapy, in providing access to potentials that ordinarily are sealed off, in enhancing the awareness of inauthentic attitudes, in facilitating the acceptance of seemingly paradoxical aspects of human existence, and in providing a deeper sense for life's meaningfulness. Music is invaluable in opening our soul to the story's thoughts, feelings, and commitments.

Drama↗

[Surgery within the scope of technical perfection and humanitarianism].

The question whether everything that is technically feasible in surgery may be performed has at no time motivated responsible physicians as it does today. Specialisation and applied technology in the medical profession are prerequisites for progress in diagnostics and therapy. Nevertheless, the physician must not overlook the oneness of the patient's body and soul. Thus, the surgeon must humanize the technology in his field and only utilize it where it can perform humane deeds. Compared to former times, technology has made such progress that the term "perfect surgery" is justified. Technology and humanitarianism together with medical-natural science and thought are the pillars of optimal surgery.

Altruism↗

[Subject health concepts and health-related quality of life--is there a correlation?].

OBJECTIVES: The aim of this study was to explore associations between lay concepts of health, quality of life and the health-related evaluation of daily activities. METHODS: A total of 221 persons (patients from general practice and adult as well as young members of sporting clubs) participated in the study (response rate: 84%). RESULTS: Health was often defined as "highest value of life"; "normal functioning of body and soul" and "complete well-being". Many persons considered sports, sleeping and leisure time being highly important for their health. The single dimensions of quality of life were associated with some health-related evaluations of daily activities, e.g., bodily functioning and health-related evaluation of television. Dividing the sample into persons who did or did not consider a certain concept of health (e.g., well-being) to be highly important had the following consequences: The quality of life was associated with different evaluations of daily activities in different strata; this association was sometimes negative, sometimes positive in different strata; more variance was explained by dividing the sample into different strata. CONCLUSIONS: The often contradictory associations between evaluation of everyday activities, lay concepts of health and quality of life should warn us not to think of health concepts and health actions in form of linear relations. Rather, health promotion should be more stronger oriented towards the individual's life conditions and his or her attitude to health.

Activities of Daily Living↗

[The anesthesia of anesthesia].

Viewed from a cultural-ethical perspective, anesthesiology can be understood as a comprehensive concept of medicine in general. As such it contains two dilemmas: very often pain must be inflicted in order to alleviate pain and this can only be done by somebody who is himself relatively free of pain. The necessary apathy or anesthesia of the anesthetist is correlated with a general twentieth century-type of perception: the cool observer. Nevertheless, it is also a modern variation of the original religious constellation of the priest in relationship to the sick person. Curing occurs by representation. The weak self of the sick person is able to take over the strong self, represented by the therapist. In twentieth century art and literature this process of self-therapy by representation was often illustrated. On the background of a phenomenological philosophy that process can be understood as the regaining of a balance between body and soul. In the psalms of the biblical Book of Job there a variety of fundamental forms of pain which may be helpful even in this secular age.

Anesthesia↗

[Heinrich Damerow (1798-1866). Comments on the title page].

Heinrich Philipp August Damerow was one of the most important German psychiatrists of the nineteenth century. His most notable achievements were in the field of institutional psychiatry. With the construction of a clinic for the mentally ill in Halle-Nietleben, Germany, he realized the concept of a "relatively integrated Mental Hospital and Asylum." As an editor of the Allgemeine Zeitschrift für Psychiatrie und psychischgerichtlichen Medicin (Journal of Psychiatry and Psychic-Legal Medicine), he exerted considerable influence. Ideologically, Damerow was a representative until about the mid-nineteenth century of the holistic approach of medicine during the Romantic period, and he was largely influenced by the ideas of Hegel. He found justification for his service to the then ruling Prussian state in the concept of the state as manifestation of divine reason. He supported a holistic approach to treating the mentally ill in which the patient is viewed as a union of body, soul, and mind. This viewpoint was evident in his critical stance toward Esquirol's concept of monomania.

Germany↗

[Morita therapy--a Japanese method for treating neurotic anxiety syndrome].

In Japan, the traditional Morita therapy is indicated for "shinkaishitsu" personalities, i.e., patients with neurotic anxiety disorder, especially with phobic and hypochondriac symptoms. The substantial theoretical basis and therapeutic principles were taken from Zen Buddhism, such as the development of the ego in the "space" between subject and object, the unity of body and soul, the distinction of inner and outer nature, and the principles of emptiness and nothingness. The treatment consists of an initial 7-day period of strict and isolated rest in bed followed by step-by-step occupational therapy and final reintegration into job and family. The founder of this therapy, Morita, sees the healing of the patients not in the removal of their fears but in the inner acceptance (arugamama) of the fears they have experienced--corresponding to an essential principle in Zen Buddhism. Nowadays, the method is used in a modified form adjusted to the change in mentality of Japanese patients.

Anxiety Disorders↗

Soemmerring's work on the nervous system: a view on brain structure and function from the late eighteenth century.

Samuel Thomas Soemmerring (1755-1830) was an encyclopaedic anatomist and one of the most experienced and renowned neuro-anatomists in the late eighteenth century. His description and illustration of the brainstem with its still accepted classification of cranial nerves (1778), the discovery of the acervulus in the epiphysis (1785), his demonstration of the crossing of the optic nerve fibres (1788), and of the macula lutea in the retina of the eye he had discovered in 1791, won him great recognition. Probably, unaware of Francesco Gennari's (1750-1797) and Félix Vicq d'Azyr's (1748-1794) observation, Soemmerring in the final years of the eighteenth century saw the broad white line running through the calcarine cortex of the occipital lobe. Soemmerring's comprehensive textbooks on the nervous system Vom Hirn and Rückenmark, 1788/1792, and Hirn- und Nervenlehre as part of his anatomical handbook Vom Baue des menschlichen Körpers, 1791/2nd edn, 1800, comprise all the knowledge in the field of neuro-anatomy at his time. Although the structure-function relationships mentioned are generally hypothetical, Soemmerring was convinced that mental faculties are executed in certain brain regions. In his treatise Uber das Organ der Seele, 1796, he localized the functions of the soul within the cerebrospinal fluid, which should come into close contact with the demonstrated and presumed nerve endings in the walls of the ventricular cavities. This last attempt of a synthesis of anatomy and metaphysics provoked passionate discussions and was criticised for epistemological reasons. Nevertheless, Soemmerring had moved the brain into the centre of the science of man what led to far-reaching consequences in the complexity of the discourse about man.

Brain↗

A reminiscence.

The founding of the William Carlos Williams poetry competition for medical students is recounted. A few highlights from its nearly twenty-five years of operation are offered. Gleanings from the hearts and souls of some of the winning poets are shared.

Acquired Immunodeficiency Syndrome↗

Grappling with affliction: autism in the Jewish ultraorthodox community in Israel.

In this essay we seek to examine the cultural tool kit employed in the Jewish ultraorthodox community to cope with autism, a predicament deemed resistant to massive cultural molding. Through 30 open-ended interviews with ultraorthodox mothers of children with autism we portray the mothers' emerging recognition of the disorder, their care seeking activities, and their construction of explanatory models. The health care system on which the ultraorthodox mothers rely is extremely diverse, including mainstream medical and educational services, various alternative therapies, therapies specific to autism, and spiritual and mystical interventions. The outcome of these endeavors is a dual system of illness perception in which bio-medical and spiritual-religious frames of references coexist. This duality cuts across all the facets of the explanatory system: etiology, pathophysiology, treatment, and prognosis. Metaphysical accounts, and especially the notion of the transmigration of souls, serve as meta-accounts, bridging the epistemological gap between God's mysterious intention and the specific bodily mechanisms underlying the disorder. The religious and moral theme of suffering is highlighted in the narratives as a salient constituent of the ultraorthodox mothers' attempts to understand and come to terms with their plight.

Adaptation, Psychological↗

The psychosocial function of reincarnation among Druze in Israel.

To gain an understanding of the psychosocial function of reincarnation among Druze, interviews were conducted with nine male subjects who had experienced reincarnation (Notq) and with one or two of their family members. Analysis of these interviews revealed that the onset of Notq typically occurs at between two and five years of age. Five of the subjects had displayed psychological distress in their childhood that was alleviated after the Notq. Once the child has displayed initial indications of reincarnation, such as mentioning names that the family construes as being from a past life, the family takes an active role in constructing the past-life story and matching it to a known real story involving a tragic death. This match creates a new order in the life of the child, the family, and the past-life family. All parties benefit from this new order: the child receives new special attention and love and becomes able to control and manipulate the parents; the parents are relieved because they see the child happy, and benefit from the social attention and regard they receive; and the grieving of the bereaved past-life family is alleviated by the realization that the soul of their lost son still lives. The findings support the sociocognitive notion of the constructing of past memories by the social environment. Additional research that should include data collection from the past-life family and examination of the affinity of reincarnation with dissociation and child abuse is recommended.

Adolescent↗