Medical constructions of long-term exhaustion, past and present (original) (raw)
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Sickness and health: A problematisation of the concept of symptoms and diagnosis within history
The view of illness has evolved along the human race, accelerating through the 20th century. From a personal family matter, the care of sick has developed into an effective industrial social mechanism. Through this change in how we provide care, another dilemma has appeared: The view of sickness in it self. The Modern era has introduced a new range of sickness, which mostly lies within work-related damages both in a physical, but mostly, on a psychological plane. This has been prominent during the last 20 years since our workforce has been redirected from mainly physical tasks to a prominent psychological world. Therefor our workplace injuries has gone through a replacement. Occupational burnout is considered an acceptable reason for sick-leave at most companies today and it is an increasing dilemma for the modern world.
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This paper uses an historical approach to elucidate two alternative modes of conceptualizing the relation between social factors and psychological phenomena perceived as pathological. The core features of Neo-Kraepelinian psychiatric nosology associated with the introduction of DSM-III in 1980 were also at the center of a debate in early 20th century Germany. The protagonists were Emil Kraepelin and Oswald Bumke. Kraepelin's empirical research selectively focused on somatic factors as independent variables, such as alcohol, syphilitic infection, and heredity. The ensuing nosology marginalised social factors which might contribute to the etiology and symptom formation of psychiatric conditions. For Bumke, the disorders in question (including the category of neurasthenia) did not represent qualitative deviations from normal psychological states, but quantitative variations of ubiquitous psychological functions caused by a multitude of somatic, psychological, and social factors. The main arguments of the historical debate are reconstructed, with special regard to the professional and political context. The paper illustrates the importance of context-bound pre-'scientific' decisions for the process of formulating theoretical concepts in psychiatry and related disciplines.
História, Ciências, Saúde-Manguinhos, 2009
Analisa alguns dos elementos sociohistóricos que configuraram condições de possibilidade para a emergência da neurastenia como categoria nosológica, na segunda metade do século XIX, bem como os aspectos que influenciaram seu declínio em meios médicos e leigos. Propõe breve apresentação dessa categoria médica e discussão mais detalhada sobre alguns debates em que ela encontra sustentação, tais como a ideia do desgaste do suprimento nervoso, os estudos e as preocupações novecentistas sobre a fadiga e a pressuposição da somatogênese da doença. Analisa, por fim, o processo de declínio da categoria ressaltando alguns elementos que alteraram seu estatuto e sua utilidade como diagnóstico.
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The study of 'mental diseases' and 'psychology' in ancient Mesopotamia has attracted the attention of scholars for the last half century. This label, however, poses several problems when applied to cuneiform sources, the most evident of which regards the absence of such a category in the cuneiform material. Mesopotamian nosology did not recognise the stand-alone presence or existence of 'mental diseases' in a way that would be parallel to the present biomedical model of classification, which has resulted in a forced imposition of some biased concepts onto ancient populations. Despite this fact, terms such as 'mental disturbances', 'neuropsychiatry', 'Babylonian psychiatry' and 'psychology' are artificial labels that have often been used in Assyriology to approach a rather heterogeneous set of symptoms and conditions characterised mainly by the alteration of behaviour, perception, feeling and mood in the patient. The artificiality and the strangeness of these concepts have made research difficult and challenging, bringing into evidence the tensions that exist between the emic and the etic perspectives, between studying a society or human group from within and taking the distance of an outside observer. Attempts to bridge the gap between the emic and the etic have been made by anthropological schools, most prominently the Harvard Medical School and its narrative-based understanding of illness as personal experience. 1 In this model, 'illness' refers to personal experience of suffering; 'disease' is the biomedical recognition of that suffering; and 'sickness' alludes to the social recognition of affliction. By proposing a three-fold model that distinguishes between sickness, illness and disease, medical anthropology has consciously brought to the fore the complexities and tensions that come up when health and disease are dealt with from different, and sometimes even opposing, cultural backgrounds. These three dimensions of the complex phenomenon of infirmity make clear the key position the observer-researcher plays in the process of analysis. That is, because of the scholar's role in selecting the object of study, posing questions, dissecting materials and interpreting results within an epistemological framework, the observer always brings to the field a determining etic component. 2
Journal of the History of the Neurosciences, 2014
The volume edited by L. Stephen Jacyna and Stephen T. Casper, "The Neurological Patient in History," is a long-needed book on the social history perspective of the patient-doctor relationship and of patients’ experiences in the development of modern neurology in Europe and Northern America. As the editors adequately describe in their introduction to this volume, the patient perspective had long been neglected in modern medical historiography before London-based social historian Roy Porter (1946–2002) brought it back onto the map of many scholars in the history of medicine and health care field (Porter, 1985). “In what quickly became a classic article in the history of medicine, Roy Porter drew attention to patient agency and called for a realignment of the history of medicine around the patient’s perspective. At first glance, Porter appeared to be writing in 1985 from a vaguely leftist perspective. His paper could be read as an attempt to give a voice to a constituency that had been effectively silenced through the tyranny of medical power. The concept of the ‘patient’ was thus configured as akin to other repressed groups, such as women and the working classes, that had been effectively marginalized in conventional historiogra- phy” (p. 3).
Exhaustion and the pathologization of modernity.pdf
This essay analyses six case studies of theories of exhaustion-related conditions from the early eighteenth century to the present day. It explores the ways in which George Cheyne, George Beard, Richard von Krafft-Ebing, Sigmund Freud, Alain Ehrenberg and Jonathan Crary use medical ideas about exhaustion as a starting point for more wideranging cultural critiques related to specific social and technological transformations. In these accounts, physical and psychological symptoms are associated with particular external developments, which are thus not just construed as pathology-generators but also pathologized. The essay challenges some of the persistently repeated claims about exhaustion and its unhappy relationship with modernity.