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    The Concept of Schizofrenia Historical Perspectives

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    Cazan Stelian

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    The Concept of Schizophrenia: Historical Perspectives Edited by John G. Howells, M.D. Washington, DC London, England Tecpel by a G Howe — tk SN ae ak pop ‘Schaophesty Howl, Joe 6 CON. Ball They cpio. WW 184 ‘Beth Library Casloguing in Pabation Date Contents Contributors lnaroduction 2 3 Jol G. Howe, M.D. CClasieal Concepts of Schizophrenia ‘Gnsppe Roca, M.D. Schizopheens inthe Medieval Period ‘Jobe G- Howell, SD. Concepts of Schizophrenia: 1600-1860 Mark J. Seer, MD. “The German Clascal Concept of Schizophrenia “sper’s View on Schizophrenia “Jobe Horie, MD. ERCP, PRC Pryh, PREP IC) ‘Concepts of Schizophrenia Afer Kracpelin and Bleuler ‘Charles P. Peer, M.D, ” ” %s 7 The Historical Background of the Concept of Childhood Schizophrenia 109 Taw Border, M.D. 8 The Psychodynamics of Schizophrenia I: Introduction and Psyehounalyie re Miche! H. Stone, AD. 9 ‘The Paychodynamics of Schizophrenia I: Other Contributors and Discussion 153, Micka! H. Stone, M.D. 10. Family Psychopathology and Schizophrenia 173 in G. Howell, M.D. 11 Paychocherapy of Schizophrenia: 1900-1920 ra ors B. Nagel, ALD, Index ans Contributors Laurerra BENDER, M.D. Formerly Clinical Professor of Psychiatry. University of Maryland School @f Medicine, Bakimore, Maryland Jous Hore, MD. Professor of Pychisty, Clarke Iniate of Prychitry, Univesity of| Toronto, Toronto, Onsario, Cans Jon G. Hows, MD. Formerly Directo, Institute of Farly Psychiatry, Ipowich, United Kingdom Doms B. Naot, M.D. Cina Assistant Professor of Paychity, History of Peychistry Section, [New York Hospital-Corel Medial Centr, lacs, New York (CHARLES P. PETERS, MD, ERCP. ERC.Pych, FRCPC) ‘Chit of Serie, Personality DaorderTrestment Progra, Sheppard and Enoch Prat Hosp, Balimore, Maryland U. HL Pers, M.D, Direcor, Universitas Nervenklinik, University of Cologne, Cologne West Germany GlustrPE RoceATAGLIATA, M.D. Assouite Professor of Psychiatry, University of Genoa School of ‘Median, Genes, lly Mank J. Septsa, M.D. Department of Prychaty and Behavioral Sciences, State Unversity of Now York at Stony Brook, Stony Brook, New York andthe Section fon the History of Psychiatry, Cornel University Medical College Ithaca, New York Mcrae H. Srowe, M.D. Profesor of Cinieal Psychiatry, Corel University Medical College Ikkaca, New York, and Uni Chief, The New York Hospitl- Westchester Divison, White Pins, New York Introduction Jol G. Howells, a1.D. The statesman, Winston Churchill had 4 vivid sayings “The farther back you lok, the father forward you cans" Thi phate comin the mais Justia for listoncl research pat knowledge canbe of vac o preset practice, The subject af th volume, the concept of chcophrcma trough Pst history. prime example ofthis oii at work. From te efor. {oF an international group of baton teseurchers—talan, Getmane Co fad, American, and Beth we ae able draw conclusions of fas ‘Gimenal npotance to contemporary psych, hth cc and pace ‘A reward of sah + magnitude was unexpected The volumes divided to wo ae of rssh, lth st, the concept ‘of schizphnenia i teseed Irom the chai period up tthe presets 9 bational elated chaperdexeribr te history of the concept of chido Schizophrenia. We wish to know whether te ction we term hie hve oay existed in Former mes We settee in any views held ln tilogy, nosology, symptomatology and rests. Of peal erst 2c any cli or eacarchsnsght highlighted bys comida fine Span of approximately ie years In the second are, the history ofthe paychody amis of scizophynia ‘5 explored 9 tos pombe cilogy i adlt oe fimly psychopathology a bet chapter ao conser the stomps t psychotherapy a csophems by 2 distinguished group of carly psyshotherapts, We are concerned to know wheter therts prychodynamis of schizophrenia whet nahi. Spring fom this ld of mnguiry istocal research on stiophrena will mst he same methodological problems as in different types of research (.g., biochemical, epidemiologic Fistologc) 26 well problems particlr to historical tecarch. Before 3 discussion of methodalogicl problems, atentiontnust be addressed fo 1s Schizophrenia of Recent Origin? Some would argue that1o sare the centuries for schizophreniasa wakes task because schizophrenia of recent origin, Torey (1) sated tht shit Divena is associated with modem iiliztion and s possibly of vel ogi He asserted that there are no descriptions of schirphvenia 2 we know it before the erly 19h century, when Halim (2) in England and Panel) in France gave clear descrptons. Hare (6 4b) supported Toney’s view point He pointed to dhe sudden incre inthe mental hospital population nthe second half ofthe 19th cencury and agucd that much of this wet duc to an epidemic of schizophiena, suggesting again vil hypothe tology Jablensky (5), however, reported that only 9.1% of the men and 7.3% ‘ofthe women ist admit to the Unieraty Psychiatrie Cine at Mach in 1908 were diagnose as slfering from dementia praccox, and this w=, a the ime ofthe expansion of ment hospitals in Europe, Hae (@n.#) ‘conceded that there may be sociological fate t work to expan the sudden Increase inthe hospital population. We know thatthe deren in Set times not due to reduction in identifi cscs of schizophrena, ot speci treatment. Wis de to an increase in the peychitric work the ‘Suipationt departments of general hoxptale andthe planed program fo ‘moving paints rom the hospi o community resmures, The same eX Blosion inthe provision forthe phy il ssn acetate odo he Th century. Others have argued strongly sn the upp direction, bing cea accounts of schizophrenia through history. Wilson 0) sad thatthe are verbatim ucterances of schizophrenic patents n Babylonian due ‘of the second mien s.c- and gives ieances (Thre would be tore ‘oavicion i alicinations were not svarably ofthe vial kind.) Most (7 quote the Satie of Horace (65-08 Wc), hich ae suid totem with {terms referable co mental illbess. He wrote of + man of Argos in Tore, Epises 22, who was ceuly deluded. Mose ao pointed to descrip spven by Caclis Aurclana inthe fifth century a:b. and Alexander of ‘Tales (a. 525-05) In addition go the cases quoted by Wilson and Mos. Jeste eal. also quoted descripions ftom ancient Indian medicine fom 2 Gar hack asthe 14th centory Bc. and that of Hetodots (80-425 8) ‘with bis description ofthe mad king Cleomencs, king of Sparta Jet ct al. quoted fiom Celss ©) (25 BAD. 50), who noted thre types of Insanity. The fist two were phen nd melancholia The rd type of inanity was desenbed 2 follows: [There i 2 third kind of madness, the kingest ofall so that it docs aot injure Meet and which scat ete sce fang oy Bo ee ate fo hn af this for some ate decved by fb agen, at ssgment sachs prt pot he vng Ano Ore fo hve peered Some ate donde sr judge ip. 22) Jats eta. 8 io mensioned some of the material on the mesieval period covered emer (Howells, Chaper 2 ths val) Dictel (1) maintained that Felix Ptr (183-14) presented “lor observations of schizophrenic lls” but under the teem mine, He seo ‘quoted André Du Laurens (IS8°-10), who gives account of vivid dee sons ner the term mantis, ‘este ct ah (also quoted wo cass ofthe 17h century. The fis ese is of an English miniter,Gcorge Tosi, plguel by audcry halla tions However, Hare (1) convincingly showed tht the minister es sa {ang from alcoholic allucinoss. The Second ese was thet of dary kept ‘by a patient Chitoph Haizman, which as ler publised (12), Elsa (19) analyzed 2039 mentlydkordered putes os country gen- eral practice in England beeen 1997 and 634 (37 year). stems that ‘ere one earcevt description of schizophrenia ovr posible ees, and 2 numberof suggestive cases. Ellard coneluded if what we are necking [schizophrenia] enstedinG:K. Naper'sumeicwas probably nots common slsordr”(p_ 906). Warner (14) estimated hat Nap saw ho more thn + orem patie yarn the category of mad," "Tuna," “Astscted, "oF “mop (he nor neces schiophrenc). The prevaknce of schizo pronase tat lowin encal practi, which des with representative ample of peopl, a indisted by John Hall nthe aly 17th century (= ‘med by Howland Osborn (15) and by Kev (6 nthe 2h cenry Tn he Ih comary alo cxme Thomas Wilr's (21-1673) novons on fools.” whit appear to rxemble descriptions of simple shi phreni led (13) considered olection of caer eported by Pett, the keeper lof prvate madhoue, The cacy, drawn fom the se quarer of the Tih feotary, consid of mts of 3 private madhouse Of the 108 recorded (dues, fay appronimnts schizophrenia. Tha docs not sugges that private ‘ental Hospi then were full a schizophrenic pooces, ‘Aer the Ich century cme decripoons by Haslem (2) and others of| ‘eto reviewed nosologctopcs and found he cul ot ge a te id ‘wa infloenced by black il nly. Rather, he believed that in many inst it was inluneed by the strong power of wrath, fexs or pam he fs deine the natre of emotions (aceon) she Saxon misey ofthe th cennry found the folowing coupe, which din the se Odo we bur in rage [And become tf we rere ma “This ps he station very clay —"s if" The composer Verdi aio made this ea iferemation, He sent hs ie» pesrtion for the p= senahty of Arana in I roar, He te, “Dott me Aru a Exhausted wth fie. th sorrow een and ak of lacs som to speak rationally. Hex senses te overought, but she wot mad” He saw clearly tha state of emotion ies (euros) ae qusttssely di fret from madness an insanity (peyhons). Frere al he above ‘quoted thors sw har emotion donde 3 severe Jnaet Parkin (9) sad the development of ers on memos and Sho pri from the 1h cemuryonmard. He poet the woes of Gres Sogo (UNI7=1808), Kab (IACIBD Hecker and Kren "eae ne nd schon a andmelydc Ths ey Ws quali differen. He quoted heen the eppte poit ‘ew, ich sy neurns and setups having som with one being ale enor st ft hehe tose wl eed this inca Conolly (174-1. Feuer hea), Mwy (O885-198), Myer (1867190), and Mapother (ABC 1D. Ts ty saw only» quanaive difeenc. To tar ay be added lel, hes emp © matty physiologic and paychologil concepts was pasa norma Ayer Libsed the neuen the mon pene es ing the confision, Parkin pointed to the aston nna of eh co £85 38 cay schizopheei, nonprychonc scapes, prpsychose schuophten, nerosrtte sehicophens, ncpene scope bulatoryschizaphrein pscado-nearoescheophtenaypreadosciv ron sesh tend adiopen, ed ehcp et ehzophten, atypical schzophrn moyated schizophrenia, borden shear rr scope adr trope No eh isogansstion would be sccple the agnoss of any tet med Condon, A dsode xis dor non nn 14 Neurosis (cosonal disorder) major diode in ems ofthe nom ‘of people suffering from it; a collective estimate o emotignal disorder in teal practice pu the Bure an 0% of ating patents (I). The se fimattn of schizophrenia im ener prac sn ha snl ar tat fF 1%5 thas emotional donde 13M tes more onan evan. Emotional disorder is mar dordr tres the every ne symp toms these ar, a expremed in prychowomti cio, ene cat ‘hing. Schizophr snot common chu of moray. ‘Confasion may be snerened by many fates. The te condisons cn coca fone of the population ae nara then by chene lone ‘numberof there wil lo sir frm schirphrona fn he early stages of Schizophrenia, there may be some emotional action a» schiophrene becomes wate of his oF ber fling mental powers Some symptoms te ‘m common with chizophrenis; fr example withdrawal in aaron Sa Picton in ansety Sats. spor i reactive depression, and manne ih eurosis: Drogsadminsced in emsionalstacs may lead toa tow ro econ, with sympeoms simulating schizophrens. Neuro acohoic may in severe ses, pats to skoholichlluinoss, which may be confit ‘ith shiophrena. Neurotic dug adits may sur hllacioss ad again come confused with schizophrenics. Psyehtest tained im emotions) lsonder may not rely identify python equally, cinicans ened in psychosis may not rely dent emotion disorder A severe neurotic onion may be equated with schizophrenia because the seventy of new otic sates i ofen underestimated. Fly, a emotional tate of advanced Akgre. asi panic states, cam prodace + hormonal snd brocherieal sate that temporal simulates schzopheena "Neurosis emosonal disorder) and schizophrenia ate qualitatively de ‘ot Schizophrenia would scem to be 3 form of organic dementia, The forganic native of schizophrenia 2 thea running throughs story — fom hormonal physiology, to Krai and hi adherens 1 con porary teseach, This areas the subjet ofa massive research fo today Ris outie the range ofthis volume Tefliows from the mata of ths volume tac he diniion of schizo- phrenia must be narrowed to the pot whrecincns with gst cic Experience of schizophrenia worlwide can find an accopable definiton Consistent with thir immedate knowledge ofthe disease That the DSM Mmoealgi system vecring back wo more nchniv, procs, descr ot echizophrena ito be welcomed and encoraged We mnt a fe onrales Tom th monn of te scirophny 1) 4 pcuderachiophrens band on 4 misconceenn of secre cra wats {nd 2} 4 ear mace, pron, core schizophrenia ly the seca ah and a achisoprer, Creat cave un be xerched ncn. ube in scach any penn whe cannot be» proven schiropbrent accopebl Intemational expert apmon. I snst be demonstrated tat tere has Boch 2 cael excision of any rated organi stat tha could smite chio~ Pires, rman ao be demonataed tha there hos been sn exclauon of ‘those severe emotional states that can simulate schizophrenia. A case history ‘wih dats om se presenting sympromatlogy, the course of the dionder 2d the esl of mental examination must be publahed. his information iSessential in any eeseach protocol on schizophrenia Chrty willbe helped by 2 more operationally eactve ter to cove the condition. The Harlem: Pine! syndrome snot tobe advocated bec tel nothing of the condition. A resrn to demon pra 3 possi ‘We need to describe a form of achizphrenis tat occurs inthe young ba that doesnot lead to comple, but ner, incapacity. Poe wed in Rr pelin’s meaning to denote “occurence in youth,” would be apposite, bot Mot in Morel's meaning of "rapid deterioration.” Should an organic bss Sted inthe bran be accept, then the sri empha could be employes 2 supposed brain pathology wold be etalshe inthe term. The mal ‘ffet of pathology disorganization, sntal sonfusion, mental isonet ‘or dysfunction ofthe mental apparatus (m Kracptin’s sents). Tiss covered by he term ataxia, which is defined ae "want of order, egy, physiology of + chld and that of am aged person, “This implies that the ndvidaal makes no progess, but eather sere lacking 2 hot and dry soul, which would sapport an adequate ligt snd energetic vital emotions. capable of tao the dificlies of le Fr ‘he philsophers of nacre. the fie of the soul represents gcral ft fof intelligence, andi dhe tone ofthis ie that sustains full emotions and affective lie suitable for objective relationships, The psychopathology of dementia pracox hae is origin in 2 pinay proces affecting the fre of the soul the symptoms ate but an eppbene menon thereof. According to this naturalistic paradigm, ll pycholopl mechanisms derive directly from an undesying thermodynamic ical metabolism thachas been “corrupted bythe action of humoral toe The material and_primary factor ofthe soul the ule of cso psychopathology. This scence defines the sympeoms tat reflet an ate {toon in the oral encngetic source (14-16), Hellenic naturalism is based on + synopsis justified, from 2 pathologic point of view, by the fet chat the term pitas both a physical meaning indicating» watery. dense, and mucous hunoe) ands pape one (ing 1 Slow and idle personality). "This way of seeing the prychopathologc world 2 the direct expres ‘of the action of a certain physi ofthe soul determined by patolon= factor, and not dichotomously. 33 disharmony between the pysal ad the peychologial worlds, bs eypiesl of cli hough leis therefore the natre ofthe sul that gives the prychic word shape. whether ithe normal or pathologic. The configuration of he symbole sychopathologc form, the mode f being ofthe "Yooh" peychote dete from an impoverishment ofthe wal tone of the soul the sign is metly {he expression of the chil mutation tat has aken place eadogensly In he piss ofthe soul. The psychotic manifestation is «sign ofthe nature ofthe sou, which presides over the payee Ife Hest, fie st vital physi energy Gor the “per thot contains the cosmic of) become contaminated by westery Substance thats the eune of ew physiochemical esenee tantorting ‘he organism. According to che naturals paradigm. sh subtatally oe endogenous, somatic medication that deermins the onset of + opecic psychosis Ie therefore posible. because of an innate excess of pita, have prychotc disturbances im which + dcioushalluceatory spomptone ology prevails, accompanied by “Yooh laughter" and, above al, by apathetic indalncs." Ths happens because the pits ars the bess ‘otras and aba consequence brings about "mental scnation (W During this historical phase, the scent presuppostions wee la ow forthe creation of chal psychiatry tha ne etary later wast Brak ‘every te with elgion and myth, thanks tothe work of Flippocttes A physician, Hippocratcs combine the conturies-olt poychiatrc experience DF the mtialeuccrl cy of the Aswan tmp wih he at Sse ineeprtve el Cll poy ses he tle he In ts til, emotion. and amine fet eyultl by mo) mechanisms Beaune st adopts the angie heal apa a th Phlosophers of mare (2-2) “Theta is considered a organ thats th ag of sve pathogen factors, among wine the humors ae the mont inv It ool a htempeis cerebe"—that sy he alteration ofthe physical and homie constants of he brain (ue to the acon of pathogenic ato) —tha the buss of psychopathology. A humoral imbslane or the denaturation af {ert belemente cane» “corupio cre" an 36. consequence. poy thon symptomatology. Phrenic an mana orgie fom an exeaely ry and hot" bran sve through the acon of fever and yelow Ble Melancholy sic ttm the ation of lick i, which rasfor the py ial state of dhe rain Int 2 "eld and dry" one. The sympeomstelogy of = stanly autonomous, The sul sen av an ey compared ore” oF 2 Thaks thought "Wo the energy ofa magnet” (15. 22.28) The work oh philosopher of nate, betcoh the 7h nd gh ence bc invesgaed arth" Th od to» cries sae toward the sacred tnd mythological conception of mental diese. The “physiology” 38 {ey were called by Ansel, wd primar, Fandamental matter, supe posed fo consti theatre” ofthe soul eich they considered #0 be felted to sce and pave metabolic process, both stable and exe bob, of "generation and "omoption "Psychopathology rlted tothe Strate ofthe soul and to the variations ha seundergoes thr pathos logi proceses of “rasmattion The iterprtive mo! for paychons, cle “of clement and gushes and chaborsted by the physcnn and phienophce Empedocen of Apres tm, wa ned on th hyp of able eur oe bomen 2 the hiss of mental smty Only brokers! dnequiboum of the amoral mctabsim cool bing sot x substantial aeration of he phy stochemicl bale ofthe brain. This phenomenon woul then be he aus (3 “tansmutatecrcbn” physically homologous seh he physical ehat= seserancs of the humor o., eiph ay ake the Patuita}, the humor selected by the pituitary glint Ge. epipyi he au ofthe cerca eal, fine Wate crise os pls chistes, tt or soon ce the body sumed 2 relevant vale nthe coop dynes Sctiophnenia. Beco he ih and th ems. the physi thle hal parcly Alemacon of Croton, Philly of Crono and Paste o Loe ll fllowes ofthe Pythotean tend) ~ed sendy socal ‘enntyng inthis simple element eh cto cor othe Papen ol Fisteodo." te was physically "cold and mois therefore, had bing fnson on the psychic acts causing slowing domed Yrakening ofthe cerebral chemism. I the quinty of pcos de Sruinencedd cern ve would onepowe thee hare ss 2 homologous modiicton of the bra, whish onl tee Sco Gelder and mover than normal This low, viscous, iid, cold, and watery humor woud be imi by the ecb ste, easing sore precios, It ft {he same huror that io previled nol age an avg A pot Fetion affected by ths biochemical anomaly instead having s etd Sy" brain apd ad strong bloga factor woul oer come Siar co that oa old person. Pn snd haben were thro lea 4 the physi characteristics of the amor cortspunded alleen the psychotic symptomatology The physilocly semend ecb {asc was subject to an “intrpers (ncs ts cngeWoeegy sho {he pla. ecings. motions, feos, and seme sa elect ghettos ww al ied by dpa ode the opel tration will by that mor. Therefor, hebphney repre render" of psychic othe darters te poo Ms ee ‘i. car ond “penis atone A yun psn a hy het wait, Pris, Vole unt for and sly-all quae tos ceneponel 40 the characteris ofthe tts Gol, water apd, weal el At SEESHY mot bat was erte a te bof bee. Th he eprom psychosis acconding to this wii approche wit go 2 "acetal weakness of the nerves and pnt" The hue ose aoathev, able and lacking mwalty Thus the Lato debe se orn" fhom “sors” meaning "without hear” ecg foe estat, and courage since the here wos comer sh sep se ot asi boli impale ofeach nde The sul the seat of metalic proces of «physi and chen! Datu, which ate reflected n+ pias ype ofenitnal steed pryhologica ie. The substance of whic he sols eke ere et tinuous nna activity, though proseues oreo contensneh seoling, heating, and so forth, When the mracaon of ce meee ‘oslo homeo qulibmam dato abnnny sce he Se health. When there i a disequilibrium duc to the excess of one factor, there isa psychic dco. The ater i always the expres of the action oe factor that predominates over the ath. augmenting ie “paneer tad, Lublahing a"monarchy." The power of one single phys cemeonspea # corel and homologous sat ofthe woul 2.3), ‘The Vitalis of Heraclitus of Ephesus (520-460 w.c:) The thinker who stressed the ve ofthis biophysical mode ofthe soul and who used tr interpret the prychoputhology of “Tools fly” sae he reat Heraclius of Epes, who lad the foustions for the mc ot ‘both normal an pathologic mental if which was to ead othe fornaion ‘ofa scene pychopathology. Herat st the limits of complet ange ‘of reciprocal relations between the orginal matter and payee Me, wing tn tum depen onthe mutations ofthe sbstanc hat conten the toa fre, an lemenc hats By nature ist, active hot nd dey, Dire Ectors may ater the physical sate ofthe original mater ofthe soul apecly water, the clement that involves diminution, an extingushing of he wa hea (i makes the soul "moist and col), “According to Heraclitus, in fc, the “fol paychoss is beowghe bout by a soul which has Become 29 moist, happens inthe tke sallow much wine.” A"hot and dey" sul we, whereas mos id cold one nies “Yoolshnes." The folh,supercal, and waned bchavioe chat occurs inthis morbid state comparable otat of" young boy who as nt yet developed. so that he staggers and dows mot Know which divecon hei going” Therefore, according to Heralus ssl witha metabolism that ha lowed down Because of moisteving scion the cus ofan extinguishing of emotions and the loss oft unifie! payee Iie (12.13, 16, 22. 37-33, Hippocrates of Cor (460-377 nc) Inthe year 400. when Herts of Epos de, Hippocrates was bom on the land of Cou, He was a member of he cl of Acraps. and the firs person inhstory o give cnc psyatry x ologl ba,Hippectae thinking as an atempe to esublsh + relsnon bexwecn the sympeom, the Imotbid proces, and the phyiopsthology af he humors by nek the mode of she phylogs) Hippocrates tho ct up 4 toni poche dscns ners of biohumal copathogete ne Hippocrates vase cnc experience enabled him to st the bs ofthe Imanestaton of melancholy that would sei cern nds lows tng a motivated sorrow.” Such an event would ply + deve fle he had een in many easer-patclay that of +g thom Thorny af the particule typeof characte now called “chion," was ako pest Inc, the deprive symptomatology appeared tobe atypical dc tothe tas Oy Gl oa gy Cols pe a Se etn na ana an ane omy Meo as pre me ie i ahaa chara ge The “humoral secretion.” which takes place i halaneed “eareui” wo provkie an guilt berwces he warn humans puts a caren ‘quantity OF pata ito virco. Thin happson an pal sates fs {use of the nluence of gence ciate aa marina fetrs ano "Bors connected with age" The pti "ul and mons homer, tee in wimer, in people approzcng ok age, adm young peopl with 2 predisposition." Asan icra of Blick ble induces melancholy an that of yellow ble induces man, so an excess of pts bring about the folsh eythonis, characterised by “inability arian, aothflass inebtence Sf ychic Ii, sometimes exes ingnuty or dificult snd hose temperament ippocats’s biochemist hypothesis on peychoss is based om elie dt thac he sw a the expression of an undrying sme proce. Ts “esipientae” with “gays and ugh” were ned by yellow til, whereas those with “nessa pecosupaton” were induced by back ble: The ban according to Hippocrates was land secret ha ‘mors.” above allpita thetnind aca only eh the cee "ase is "perturbed by a mei dysfunction (11, 17, 18, 36-39). Hip pocrc's great achcvement was fo unite payer semlogy wh the |humoral concep of prycons soo clte certan cline itr to 1 Spee endogenous dyamcabol, Another of Fippocttes’ merits sin the fc that he establish «otelation becen the ps choc symptomatology nd the physic chaee $etestes ofthe humors: the ptt, so and mest hormone, thas hes {mn inhbtory accion both on de intelectual facalcs and on the emotona ‘ones. "Sapa" therefore an epipenomenon of phys modern ‘ofthe bra duct the ation ofthe pituitary humor (11.39) Hippocrates dsnguished the “veal” endogenous pavehores ofthe kind ‘of “sient spi” from sone forms that preset a-analogoas yp ‘omatology:n thir ease, however. the symptoms arse 3 consequence of internal and neurologic disease, Which he elled"s moda” (ees SSP romati Hippocrates ako provided a description of dementia pracox in which he stressed the sapct of payhicdvactoon, the theme a dels, the hal Iuciatory phenomena, an he anwioue-dpresive septs: andsometins sha Jes phen ah eh owe he ftake atime motes og whch be obey an fc ‘some momar may borne abn 1 es ippociates’contbuton relating to the moval dase led “heb tudo" wor considered chy wl sined and neti cnet the work of Mord the ah comry Thi dese nats om _an Inversion of the physiologic ratio inside the brain; of the balance of thr ‘0 components ofthe so ofthat bislogisl energy thet suppor et ropsychologca activities andthe affective, natincve-emetion ne ‘imental spheres The water content of the brain, due tn augmenting ofthe pitta of the cerebrospinal liquid, the typical humor of» deficent ment) il becomes higher han chat of he "re" (of the substance thats ener active, and wal) Because it fst Thus a slow and retarded cerebral te tuboliso prevail, bringing about an otlectal def, called “stl by Hippocrates, People flected by thie snomtly are no insane, bt athe they ate oligophrenis. idiots, with “slow sensory pereeptive process” They ate individuals wiose brain "canalcal re hated by soul hati slow because itis watery. They ate neapabl of grasping sensual percep data They ate slow in providing verbal sd paychomotor answers Tet soul of “ntligene” individual, to the cnteey has higher fe cote. Their mental proceses af ative, energie and with reese ms They are, Hippocrates sircsed, “active and constant in elation.” The “substantial dficuly in grasping realy” tha pertains to stolid nv. does ot yet make them ino insane persons. They ate merely examples of human variety, characterized by a bicogieal fron, to be conde = incapable persons Tea higher quantity of water is smbibed i the cerebral sue, de 0 # farther exces of pitta, the cognitive capacity will be farther reed 8 real signs of mental disco will appear (mainly. "the meapacty of gra tality) Inthisease, wrote Hippocrates, “a specific hin of sent se which is called “desipcnti’ by tome, atony by thers and spit BY Yet others." Ifstolidty indicated «foals indv il the three ters ed for rea sanity designated a severe accemuation ofthe symptomtel for insane, the appearance as We have sc, of teo-verl incre ‘of emotions blaming. and of vague delnous ideas, Howes. th 6 "he niles of che mental disease characterized by afolsh and emt¥ aga folly, behavioral attitudes marked by stupor, absent mindedness fois nes: ftwousness, and emotional inadequacy. "The mdvidal appears mi, slow in comprehending, stupid Hippocrates, n short, dered ih lini picture err be defined by Morel, Kricpelin and Bleler = st of dementia praccon. n ts vant: simplex ad eben. However, Hippoctaes ako isolated cases of personality acrations Sa he considered “onthe border” with rei insanity and that he denominated ith the terms simple and zg, cs designating individuals who wee ingenuows prudent, cedulous,spathticindlene, an ary. inl. a borderie with heberde he ako considered the so-called subirions (ie individuals the lint with mental disease who, do “emotons exces ‘incatallowing or fever may become ina’), Physiologic normality consists in 3 dynamic stability, thanks to which the vanous metabolic processes are equivalent, so thatthe physical 208 ‘chermical characteristics ofthe soul remain constant. akan tis perspective Lppcrates wrote: "hoeate of tet ol the fief th soo 5 fortes Because ay aecannultn of pts ae th beam, “sia ats «the patito onan set (72 4, 8). Hi Pichon, which Hippocrates illo “het Foca pyle Prologic Festures ad boat ofthe fc tht arkes myth, Breet out by 2 dyametabois of the ptt a natant symptoms oF Feet, such a the spericaty a cometonal eaton (which appest ‘xremely weak) the rowncs of Behavior and thc meherence of thou deal epphenoriens of weak and Ins vital tone, Thsinay be obser, Hippocrates thought. by checking the quality of the arena puke the ‘expression of the biologi force of" ial” ne whose elbow artery pobster strongly able ands manic; wheses one whose elbow ary ‘sweak and cangr be seon pubting "sll from hebotde" ‘According ro Hippoctats an excessive quantity of pts Or water mide the rain brings about a change nthe deetion of cold and damp, 0 that the “oul” (hes the gener fetor oF mcgence, physlogally hot std Ary") loses tone and vigor. Thus, 4 brobumora condion would sri which was necessary to induce the appearance of “denies” (re hea state characterized by senseesnes) However, pays enc ly when the bra i exremely imbibed with tie, ao tht i uch aes, togethot ‘eth desipcne here slo sap. mans by slow, obs, clams and “supeied behavior According to Hippocrates, the snes Fring from hebstade specially 4 °stape despcet”(17-39, There an incongruity an Hippocrates work concern the set of the lesion, which varied according to whether the stom seat ofthe solves onsidred to be the brat ofthe hee Ins demas ao 0), Hippocestes Indie the bain sth anatomic seat ofall the soul's funtion, fom the neurologic othe psychological and emsional ones. In his work de conde {@t}-on the ther hand he wrote tat the scat ofthe soul win the “left fear vente" However according to Hippocrates, thre was ne doubt About the seat of the copathogenic mechanism involv in deme pace ox. The heare was the source of dhe pute Wi tne, wheres the bras ozted the strate designed tansonn these ene nt Formal ‘peratons, In this connection, the heaters dma, cation d= ment praccor, was acucy analyzed by 7tscct phsieun. an “Maric, is crrcation of dene pra so By Fi oct The lan sear wrote ‘The male sperm, according tothe pre-Socrtc theory of elements and ‘qualities, had the same characteristics as water and therefore as the piruita, Moreover, it was 2 sore of “corrupt” puta andi could bring dat hebephrenie paychosis if twas not emis, Hippocetes wa thee ‘Mlamanton his subject: "coitus morbi ex pitta sommodas™ (1.390, Plato (428-47 nc) Hippocrates humoral approach war ls accepted by Athenian pilsoph- ical cles connected 0 Plato's academy, which had, sn any case ways 2ssnmlted the bological teachings on mental dscave of the medi schol ‘of Magna Grecia. The most severe prychic daturbance as comieted © be “sali.” loin the opinion of Plato, who wes influrced im tis his contemporary Diocles of Cryeus (384-322 bc). Ths morbi form had always been striking because of ie obvious synthe oft compe. nents: foolishness and extvagan oly Tre “fool inapersn who i lin hi other soul, deco certain obviows sstrbanees affecting humors. These, eapeculy put, become corre ‘they decay and aes, ths forming certain serial substances aed “vapor” 23 Diccles of Carystor armed, which intoxiate the mind. In “Tosh ess” in the see given tothe word by Heraclitus, and ao in ito ‘view. the sou, whose sea isthe brain, Becomes "watery ducts exe ot corre pits” (2) ‘The Vitalism of Aristotle (384-322 nc) os pupil the philosopher and biologie Aristo, ever he “neo roccrtie” hypothesis concring the sol he consiefed seat to eth bear and he vascular system. The sul nance forces sens wt pet to the hoy,“ he whch eee s pe pon” Body and soul coexist a "form and mater Tso coin to Arntle," the act ofa natral organic body. the body code homologous to the ee the soa is the "wal ncn Th snl tof Het regula vial acai: senive, mute, append Uncle. The sous ot an abstract ety, but ther “reer shh ‘xpress itseln own physi tempersinent" Blood the cement at

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