Abstracts fra Bibliotek for Læger 3/2004

Oversigtsartikel: Kierkegaards »Pæl i kødet« – var magisteren maniodepressiv?

Per Vestergaard:

Søren Kierkegaard’s “Thorn in the flesh” – did he suffer from manic-depressive illness?

Bibl Læger 2004; 196: 192–201.

Søren Kierkegaard was a genius whether perceived as a great author, psychologist, philosopher or theologian. Søren Kierkegaard was extremely concerned about his health and the relationship between health and spiritual creativity. So are some of his biographers with their suggestions for circumscribed bodily or spiritual sufferings which supposedly were preconditions for his extraordinary writings. Popular suggestions are from the realm of psychiatry, neurology and sexual perversions with manic-depressive illness as one of the most thoroughly argued. However, perceptions of illness change over time. When the scholarly Danish psychiatrist Hjalmar Helweg in 1933 suggested that Kierkegaard suffered from manic-depressive illness Kierkegaard was considered to be “endogenous” with all the mystical connotation of this concept. Today, as we know Kierkegaard from his own writings and evidence from his peers, not much suggests that he would have satisfied modern definitional criteria for an affective disorder in the sense of DSM-IV or ICD-10. Some of Kierkegaard’s character traits could fit into a diagnosis of personality disorder e.g. narcissistic, but such a diagnostic labelling would unfairly limit the importance of the genius who also possessed an extremely high intelligence, an energetic productivity, a literary virtuosity, a profound honesty and a deeply humble religiosity. Kierkegaard certainly was an eccentric person, he probably died from an ascending polyradiculitis but through his productive life he was mostly well.

 

Oversigtsartikel: Mastoidectomiens historie. Om kirurgisk behandling af mellemørebetændelse og denne sygdoms komplikationer gennem tiderne.

Christian Brahe Pedersen & Frank Mirz:

The History of Mastoidectomy. On surgical treatment of middle ear infection and complications of this disease throughout times.

Bibl Læger 2004; 196: 202–25.

Mastoidectomy – or the surgical opening of the temporal bone behind the ear – is the basic surgical treatment of acute middle ear infection with complications and chronic middle ear infection. Symptoms of middle ear infection have been known since ancient times. A rational surgical treatment emerged in the 18th century. The first description of the surgical technique for such operation was written by Georg Heuermann, who was born in Holstein. He was educated as surgeon in Denmark and was practicing as a doctor in Copenhagen. Heuermann worked all his life in Denmark and was very productive. His textbooks in surgery and physiology were published in several editions and in the year 1760 he was given the title professor medicinae designatus at the University of Copenhagen. Due to changes in the indications of the operation, mastoidectomy fell into disrepute. The Danish king’s personal physician died after a mastoidectomy, and the operation was not used during the following 70–90 years. There was indeed a great need to be able to treat the not seldom fatal complications of middle ear infections. By presenting the results of a number of operations, Herman Schwartze was able to demonstrate the value of mastoidectomy, after which the treatment became widely used. Within a few years mastoidectomy became a daily peocedure in most ENT-departments. Also today this operation is frequently performed.

 

Original artikel: Indbildningskraftbegrebet i 1800-tallets medicin – Set i relation til litteraturen om placeboeffekt, indbildningskraft og det kontrollerede forsøg.

Lars Ole Andersen:

The concept of imagination in 19th century medicine – in relation to the literature on the placebo effect, imagination and the controlled trial

Bibl Læger 2004; 196: 226–68.

This article contributes to an understanding of the role of imagination in nineteenth-century medicine. Imagination is a concept which had been used in philosophy since antiquity, and which had been widely used in medicine from the Renaissance to the eighteenth century. In the article the discussions of imagination in nineteenth-century medicine are related to three histories: the history of the placebo effect, the history of imagination and the history of the controlled trial. The role of imagination in medicine in the nineteenth-century has been insufficiently studied, and is only briefly mentioned in much of the literature on the placebo effect and on the imagination in the history of ideas; or it is said that theories about the power of imagination belong to the eighteenth century or earlier. In the nineteenth century, however, imagination was discussed, for example, in relation to the mind’s influence upon the body, and in examinations of the results of the first blind and double-blind trials using intentionally non-effective treatments (placebos) in 1784, 1799 and 1835.

 

Forsidebillede: Tegning fra middelalderen af et kirurgisk indgreb bag øret.