Re: William Chester Minor born (22-6-1834)

 Ar an dara lá is fiche de mí Meitheamh, scríobh Stefan Ram:

 > Ross Clark <benlizro@ihug.co.nz> wrote or quoted:
 > >result of a campaign led by Murray, the Home Secretary (one Winston
 > >Churchill) had him released, and he was deported back to the USA. He
 > >spent some time in St. Elizabeth's Hospital, Washington (which later
 > >housed Ezra Pound) and was diagnosed with schizophrenia. (!) Died in 1920.
 >
 >   Back in 1918, the way doctors understood schizophrenia was shaped
 >   by early psychiatrists like Emil Kraepelin and Eugen Bleuler.
 >
 >   Kraepelin first called it "dementia praecox," focusing on its
 >   early onset and worsening over time. Later, Bleuler came up
 >   with the term "schizophrenia," highlighting the "splitting" of
 >   mental functions (rather than a split personality). At that time,
 >   the illness was mainly seen through its psychotic symptoms like
 >   hallucinations and delusions, but they also started to recognize
 >   its broader impact on cognitive and social functions.

In general there is no role for doctors in a given clinical picture absent a
current or future impact on cognitive functions, social functions, the
activities of daily living, or early death. The relevant thing about psychosis
(which is often but not always due to schizophrenia) is the auditory
hallucinations and delusions allow a better, more effective choice of
treatment. Lithium or SSRIs won’t be much help in schizophrenia.

Given Minor’s heavy use of prostitutes and the era, neurosyphilis was probably
the way to bet as to the underlying diagnosis, though I can’t comment on how
prevalent psychosis is as a presenting complaint of neurosyphilis. I thankfully
have very little clinical experience with syphilis of any sort.

(Every pregnant woman locally has a syphilis test done, since treating it is a
cheap and effective way of preventing major disability in the child and is of
benefit to the mother, and any positive test tends to be a false positive,
negative on repeat, so we are getting a representative sample of the sexually
active population and it’s not that we’re missing it. There’s just not a lot of
it about. Now, we don’t have huge numbers of men who have sex with men locally,
that would give a different epidemiological picture, cf the recent coverage of
syphilis in the NEJM.)

--
‘As I sat looking up at the Guinness ad, I could never figure out /
How your man stayed up on the surfboard after fourteen pints of stout’
(C. Moore)