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[Studies on the history of psychiatric diagnosis of the western and the eastern medicine with special reference to the papers presented at the 16th Taniguchi Symposium on the Comparative History of Medicine East and West].

Scientific papers on the history of psychiatric diagnosis presented at the 16th International Taniguchi Symposium for Comparative History of Medicine-East and West which was held in 1991 in Japan were briefly reviewed and discussions and comments interchanged in this meeting were introuduced with some personal appreciation that the meeting was excellently organized and enormously successful. Particularly, the papers of medical historians and the expert in specific area like Indian medicine from North America and Europe were highly instructive. The informal gathering in the evening had offered a fascinating original report such as an old documentary film about Imu, a Japanese culture bound syndrome. One very important point was raised in this review that the comparisons between the Medicine-East and the West, particularly the translation of the Eastern medical descriptions of mental illness into the modern Western pschiatric terms should be very cautiously carried out, because by the crude identification of one medical system with the other system the uniqueness of the illness in a specific time and in a specific place might easily be overlooked. For both Japanese and Korean traditional medicine share with Chinese traditional medicine and yet they preserve their uniqueness, a small group study for comparative East Asian medicine was suggested for the more elaborated clarification of medical terms.

Americas↗

[Population history, medical and health history: fifty years of shared experiences].

The history of epidemics and health has been completely revised in France as a result of studies done by the Annales School and on the basis of the results of historical demographic research of the nineteen fifties and nineteen sixties. The discovery of peaks in mortality in long-term death rates and the construction of a model for the mortality crisis of the Ancien regime have led to the study of past epidemics and their relation with malnutrition. Effects related with the development of historical anthropology and the publications of Michel Foucault have also had an influence. This article notes the important place of the history of the eighteenth and nineteenth centuries in efforts to understand the marked decrease in mortality in developed countries, the disappearance of large epidemics, and the increase in endemics. Methods developed by population historians have made it possible to refine the analyses of this decrease despite variations in nosology. In addition, this article suggests especially promising avenues for future research.

Demography↗

Linear parietal skull fracture in a three-month-old without a history of injury--abuse or not? The issue of a corroborated history.

When the clinician is faced with an infant with a skull fracture and there is no history of injury, or the history is provided only by a caretaker, the available data would indicate that a simple linear parietal skull fracture without any accompanying neurologic injury is possible from a fall of at least three feet onto a hard surface. Any more serious, multiple or complex injuries should be treated as suspect and investigated by social services and law enforcement. The clinician should refrain from making any dogmatic statements about what may or may not have occurred. We simply do not have the data to say anything further. It is up to social services and the legal system to investigate and decide if child abuse has occurred.

Child Abuse↗

[Collapse of the nasal alae and instruments for treating this condition, especially with the Feldbausch nasal dilator. Pictures from the history of otorhinolaryngology, presented by instruments from the collection of the German Museum of Medical History in Ingolstadt].

Although the anatomy of the nasal muscles and the active movement of the nasal alae brought about by them, were already known in ancient times (Galenos), it was only at the end of the 19th century that the collapse of the nasal alae was recognized as a passive mechanism obstructing the inspiratory air passages. Since surgical methods for treating this condition were not available at that time, various small gadgets to be introduced into the nasal vestibulum were invented for stabilising the alae. Among these, Feldbausch's nasal dilator was the best known. It was in use up to the middle of this century, but then became completely obsolete. The history of this chapter of rhinology is related primarily by means of literal quotations of the phrases with which the authors presented their devices and praised their virtues.

Germany↗

[The history of the asylum--the history of "the great confinement"?].

Histoire de la Folie (1961) by the French philosopher Michel Foucault has profoundly influenced the general public's conception of the history of psychiatry, but the book is relatively seldom discussed among psychiatrists. Foucault views the core characteristics of psychiatry in the light of what he terms "the great confinement" of the mad and other outsiders. He maintains that the confinement took place all over central Europe from 1650 until 1800, and that the psychiatric asylum was designed on the basis of the confinement house. This paper discusses whether this great confinement actually took place and critically examines Foucault's interpretational model. There is a further discussion of the main reasons why the humanistic and creative spirit characteristic of the early nineteenth century asylum was replaced by stagnation and disillusionment 150 years later.

Commitment of Persons with Psychiatric Disorders↗

History of genital warts in 10,838 women 20 to 29 years of age from the general population. Risk factors and association with Papanicolaou smear history.

BACKGROUND AND OBJECTIVES: The most important risk factor for cervical neoplasia is genital infection with certain types of human papillomavirus (HPV). Genital warts (GW) are an easily recognizable condition caused by HPV. Although only a fraction of HPV infections are clinical, a history of ever having had GW could serve as a marker for exposure to HPV. GOALS: To study the risk factors for ever having had GW. The association of GW with abnormal Papanicolaou (Pap) smear and relation to cervical neoplasia is also discussed. STUDY DESIGN: A case-control study among 10,838 women aged 20 to 29 years and reporting at least one lifetime sexual partner. The women were participants in a prospective cohort study on the relationship between HPV and cervical neoplasia in Copenhagen, Denmark. Data were obtained by means of personal interviews using structured questionnaires. RESULTS: In all, 1,820 women (17%) reported ever having had GW. The most important risk factor was the number of lifetime of sexual partners (adjusted odds ratio 5.2; 95% confidence interval: 3.4-8.0) for at least 40 partners vs. 1 to 2 partners). The number of regular partners, sexually active years, a history of chlamydial infection, and smoking were also associated with the risk of ever having had GW. Women who had had GW were 1.9 times more likely than other women to report an abnormal Pap smear. CONCLUSIONS: The study confirms the sexual transmission of the infection. There is also good concordance between risk factors for ever having had GW and cervical neoplasia. A close relationship between having had GW and an abnormal Pap smear was observed.

Adolescent↗

Life history evolution in cichlids 1: revisiting the evolution of life histories in relation to parental care.

Empirical links between egg size and duration of parental care in fishes have generated a considerable amount of theory concerning life history evolution. However, to date, this link has not been investigated in relation to other important life-history traits such as clutch size and body size, or while controlling for shared ancestry between species. We provide the first phylogenetically based tests using a database with information on egg size, clutch size, body size and care duration in cichlid fishes (Cichlidae). Multiple regression analyses, based on independent contrasts on both the species and the genus level, showed that clutch size is the variable most closely related to duration of care. This pattern appeared to be driven by post-hatch care relationships. Our results show that, contrary to expectation, there is no positive link between egg size and care duration in Cichlidae. Instead, greater reproductive output through increased clutch size investment appears to have coevolved with greater care of offspring. We suggest that re-evaluation of the generality of current models of the evolution of egg size under parental care in fishes is needed.

Animals↗

Predicting adolescent violence: impact of family history, substance use, psychiatric history, and social adjustment.

OBJECTIVE: The aim of this study was to provisionally develop an efficient screening method to detect adolescents at high risk for committing a violent act by young adulthood. In addition, the authors sought to use this screening instrument, in conjunction with child and parent psychopathology and substance abuse data, to determine the accuracy of violent outcome predictions. METHOD: The probands were men with a lifetime history of DSM-III-R substance use disorder (N=38) and men with no adult psychiatric disorder (N=61). Their biological sons were studied at two time points. At age 12-14, the offspring completed a 13-item Violence Proneness Scale, which was derived by using items from the revised Drug Use Screening Inventory. The occurrence of violent acts was then assessed at a follow-up evaluation when the offspring were 19 years of age. RESULTS: Among the offspring, a DSM-III-R axis I psychiatric disorder and a Violence Proneness Scale score of 10 or higher at age 12-14 predicted a violent outcome by age 19. The overall accuracy of prediction was 77%. Sensitivity was 81%, and specificity was 76%. Substance use disorder or psychopathology in the probands or substance use frequency in the children did not contribute to the prediction of violence. CONCLUSIONS: The brief Violence Proneness Scale, which measures school and peer adjustment, in conjunction with a childhood psychiatric history may constitute an efficient screening procedure for identifying youth who are at high risk for committing acts of violence.

Adolescent↗

Gender differences in the development of substance-related problems: the impact of family history of alcoholism, family history of violence and childhood conduct problems.

OBJECTIVE: This study examined gender differences regarding the relative influence of family history of alcoholism (FHA) and family history of violence (FHV) on reported childhood conduct problems (CCP) and adult problems with alcohol, drugs and violence. METHOD: The participants were 110 men and 103 women with alcohol-related problems recruited within 30 days of enrolling in treatment for substance abuse or dependence. Participants completed self-report measures of pretreatment violence, FHV, CCP, substance use and consequences, and demographics; a semi-structured interview was used to assess FHA. RESULTS: Structural equation modeling (SEM) analyses revealed gender differences with regard to the influence of FHA and FHV as important factors in the development of childhood and adult behavioral problems. For women, the influence of FHA on subsequent childhood conduct problems and adult problems with alcohol was accounted for by FHV. For men, FHA was not directly associated with CCP or adult problems with alcohol and violence, but was associated with adult drug problems. For both men and women, FHV was associated with CCP, and CCP were associated with adult problems with drugs and violence. CONCLUSIONS: Overall, the analyses illustrate the relative importance of FHV as a risk factor in the developmental course leading to problems with drugs and violence among individuals with alcohol-related problems enrolled in treatment for substance abuse or dependence. Further, there was evidence that women may be impacted more than men by family background variables (both FHA and FHV) in terms of the development of adult problems with alcohol, drugs and violence.

Adolescent↗

Body-size perception, body-esteem, and parenting history in college women reporting a history of child abuse.

This study investigated the relations among physical, emotional, and sexual abuse up to adolescence and subsequent perception of body size, detection of changes in body size, and body-esteem. The role of parenting history in abused participants was also examined. 38 college undergraduate women, half of whom had been abused, reported instances of abuse, childhood parenting history, and current body-esteem. A recently developed software program of Gardner and Boice was used to present a series of distorted frontal profiles of each participant's own body for the women to rate as being too wide or too thin. A psychophysical procedure called adaptive probit estimation was used to measure the amount of over- and underestimation of these ratings and whether these changes were statistically significant. Analysis showed abused participants had distorted perceptions of body size, although the direction of the distortion was not consistent. There was no difference in detection of changes in body size. Abused and nonabused participants differed on measures of body-esteem and on ratings of most parenting experiences, including experiences with both mothers and fathers.

Adolescent↗

Family history of irritable bowel syndrome is the major determinant of persistent abdominal complaints in young adults with a history of pediatric recurrent abdominal pain.

AIM: To assess the late outcome of teen-agers with a previous history of recurrent abdominal pain (RAP) or irritable bowel syndrome (IBS). METHODS: A group of 67 children with RAP referred to the department from January 1986 to December 1995 was followed up between 5 and 13 years after the initial diagnosis by means of a structured telephone interview. We hypothesized that those patients with persistent adult IBS-like symptoms would be significantly more likely to report a family history of IBS in comparison with adults with no persistent abdominal complaint. RESULTS: Out of the 52 trackable subjects, 15 were found to present IBS-like symptoms at follow-up (29%) whereas the majority (37 subjects) did not. Subjects with IBS-like symptoms were almost three times more likely to present at least one sibling with similar symptoms compared to subjects not complaining (40.0% vs 16.0%), respectively (P < 0.05 at Student t test). Subjects with IBS-like symptoms also reported a higher prevalence of extra-intestinal symptoms, such as back pain, fibromyalgia, headache, fatigue and sleep disturbances. CONCLUSION: The study confirms previous observations indicating that pediatric RAP can predict later development of IBS. The latter appears to be greatly influenced by intrafamilial aggregation of symptoms, possibly through the learning of a specific illness behavior.

Abdominal Pain↗

Family history and pathophysiological mechanisms of primary hypertension. Studies in non-hypertensive young men with positive and negative family histories of hypertension.

In an attempt to explore pathophysiological mechanisms relevant for the development for future primary hypertension, we investigated young normotensive men with positive family histories of hypertension (PFH) regarding blood pressure, body weight, systemic and renal haemodynamics as well as cardiovascular hormones and sodium homeostasis. Sixteen subjects with PFH and thirteen controls with negative family histories (NFH), matched for age and body weight were investigated at age 31 and after five years. Blood pressure and heart rate did not differ between the two groups at the first or follow-up examination. At follow-up body weight had increased and a positive correlation between blood pressure and body mass index was found in subjects with PFH, while subjects with NFH had unchanged blood pressure and body weight. Initially, intraerythrocyte sodium content was increased in subjects with PFH, however, at follow-up intraerythrocyte sodium content did not differ between the two groups. At follow-up systemic and renal haemodynamics and sodium homeostasis were investigated in fifteen subjects with PFH and in twenty-nine controls matched for age (36 +/- 5 year) and with NFH. The control group was divided into one group matched for body mass index (n = 15) and one group with normal body mass index (n = 14). Blood pressure and central venous pressure were measured during bolus injections of phenylephrine and during an acute saline/fluid load (1000ml 0.9% NaCl within 10 min). Renal haemodynamics and blood pressure were measured during low doses (0.1 and 0.5 ng/min/kg) continuous infusions of angiotensin II (AII). At baseline blood pressure, body weight and sodium excretion were higher in subjects with PFH and matched controls as compared with lean controls. Calf and forearm haemodynamics (pletysmography), plasma catecholamines, plasma renin activity, angiotensin II, aldosterone, blood volume and erythrocyte sodium efflux rate constant did not differ between the three groups. Circulating atrial natriuretic peptide was higher in subjects with PFH than in the two control groups. In subjects with PFH there was a negative correlation between renal sodium excretion at baseline and the ouabain-sensitive sodium efflux rate constant. During the acute saline/fluid load central venous pressure and systolic blood pressure increased more and venous vascular compliance (ml/mmHg/kg) was reduced in PFH. Atrial natriuretic peptide release and renal sodium excretion were blunted during saline/fluid load in subjects with PFH as compared with the two control groups. Renal blood flow and renal vascular resistance did not differ at baseline. Glomerular filtration rate was somewhat higher in PFH.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[Treatment of acute and chronic laryngeal and tracheal stenoses in the 19th and beginning of the 20th century by tracheotomy, coniotomy, intubation and dilatation. Pictures from the history of otorhinolaryngology illustrated by instruments from the collection of the Ingolstadt Medical History Museum].

Although tracheotomy had been described in the Middle Ages and especially in the 17th century in writings (Fabricius d'Aquapendente 1620) and illustrations (Scultetus 1645), there was hardly any possibility of actually performing this operation as a life-saving intervention until the middle of the 19th century. It was only after suitable cannulae had been introduced by Trousseau in 1851 (double cannula with removeable insert) that tracheotomy became a routine procedure, and it was immediately carried out in a great many cases of diphtheria, croup, typhus, and lues, which often caused critical dispnea. Within the following 25 years, all technical modifications of cannulae were devised that are in use up to this day: the flap valve for the artificial larynx (1861), inflatable cuff (1871), and extra long flexible cannula. Beginning in 1885, O'Dwyer's method of intubation became established as an alternative to tracheotomy. Both procedures, like the underlying disease itself, frequently resulted in a permanent stenosis of the larynx or the trachea rendering decannulation impossible. Since about 1870 the treatment of these stenoses, primarily by bougienage, became an important issue in laryngology, which had just been established as a discipline in its own right. The history of this evolution and the therapeutic approaches by Schrötter in Vienna and Thost in Hamburg are described in detail, including their specially devised equipment. Apart from that, other medical aspects of historical interest around the turn of the century are mentioned, such as artificial nutrition by subcutaneous injections and tracheotomy in horses.(ABSTRACT TRUNCATED AT 250 WORDS)

Germany↗

'I remember it well': oral history in the history of pharmacy.

The reminiscences and personal testimony of retired pharmaceutical chemists provide a rich and valuable source of historical material, which can be used not only in tracing the history of the practice of pharmacy, but also for illuminating the social, political and economic context in which health care has been delivered during the course of the twentieth century. A wide range of accounts of the lives and work activities of pharmaceutical chemists now exists. Some of these are written, others have been recorded, and extracts from a number of these recordings have been published. The purpose of this paper is to describe and review the material currently available in relation to pharmacy in Great Britain.

Historiography↗

History's future: reflections on lesbian and gay history in the community.

From its beginnings in the nineteenth century, the lesbian and gay political movement has been linked to a search for lesbian and gay history. In the post-Stonewall period, community-based historians have been fostering interest in the lesbian and gay past and developing distinctive forms for disseminating their research--in particular, the lesbian/gay archive, the slide-lecture presentation, and the community-based audience. Analyzing the content of these forms reveals how the fascination of the artifact, the image, and the Other fosters the construction of both knowledge and identity. It is these forms of knowledge, rather than their content as such, that are in danger of being forgotten as lesbian and gay studies becomes academically institutionalized.

Female↗

333 Cedar Street: an oral history. A chapter in the history of contemporary medicine.

This paper contains excerpts and colloquies selected from interviews which will appear in a proposed book-length oral history of the Yale University School of Medicine. The book, which considers all the constituent members of the Yale academic medical community, is a statement about contemporary issues in medicine. Owing to space constraints, only excerpts from students appear in this paper. It is believed that these selections may be used as case studies to explore in depth issues of contemporary medical interest. The excerpts have been categorized into eight thematic clusters considering different aspects of premedical and medical school life.

Attitude↗