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The Decadence of Medical Science
Published in Arturo Castiglioni, A History of Medicine, 2019
Alexander was a physician of wide experience, but he possessed scanty anatomical and physiological knowledge. He studied the diseases of the nervous system with great care. Phrenitis was regarded as a cerebral disease to be treated with narcotics, bleeding, warm baths, wine, and so on. Melancholia could change into mania, and represented an advanced stage of dementia. He devotes special attention to the treatment of diseases of the eye. Diseases of the respiratory tract are described clearly; for hemoptysis he prescribes absolute rest, potions of diluted vinegar, cold compresses on the chest, and strict diet, hot or cold soups, and, finally, bleeding for patients of a plethoric habit. For consumptives he strongly recommends change of air, sea voyages, easily digested food, and a milk cure, especially asses’ milk.
The history of psychiatry
Published in Ben Green, Problem-based Psychiatry, 2018
Soranus of Ephesus (ad 100) described a condition called ‘phrenitis’ in which thinking was predominantly affected. He distinguished it from mania and melancholia. Other features of phrenitis that he described, beyond affected thinking, were acute fever, foolish gesticulations and a small, full pulse. It may be that he was perhaps describing an acute confusional state or condition similar to lethal catatonia. Soranus was also interesting in terms of his philosophy in that he thought that the process of thinking was localised to the head where others favoured the heart. He also described delusions in mania, that people saw themselves as perhaps sparrows, cockerels, gods, orators, actors or the centre of the universe. He also wrote about a form of cognitive therapy and with manic patients he would adopt a ‘serious demeanour’ and with depressives he would adopt a ‘cheerful demeanour’ to try to alter their mood. He would also try to ‘strengthen their reasoning powers by asking them questions or getting them to read and criticise text which contained false statements’.
A Conceptual History of Anxiety and Depression
Published in Siegfried Kasper, Johan A. den Boer, J. M. Ad Sitsen, Handbook of Depression and Anxiety, 2003
In fact, mania and melancholia together encompass virtually the entire field of prolonged psychopathology, that is, chronic diseases not associated with fever. The third form of mental illness, phrenitis, is both acute and associated with fever. The obvious comparison here is with delirious visions and acute psychoses. Epilepsy had a place all its own. Viewed by the Greco-Roman world as a “sacred disease”, it includes forms that are transitional between classic epilepsy and melancholia.
The pharmacotherapeutic management of postoperative delirium: an expert update
Published in Expert Opinion on Pharmacotherapy, 2020
Delirium as a neurocognitive syndrome has long been recognized in medical history from ancient times by Hippocrates whose original term phrenitis described changes in mentation caused by fever and head trauma, but the term delirium itself is credited to the first century encyclopedist Celsus in his medical textbook De Medicina [1]. In relation to surgery specifically, which is the focus of this review, delirium was identified by Dupuytren in 1819 who reported ‘postoperative psychosis’ in a patient with delirium tremens in the context of an operative procedure [2]. Over time, the diagnostic criteria for delirium have been refined with the most recent version in the Diagnostic and Statistical Manual 5 (DSM-5) emphasizing that there is a change in one’s baseline ability to direct, focus, sustain, or shift attention as well as a disturbance in awareness marked by reduced orientation to one’s environment; this develops acutely over hours to days with fluctuation in severity over the day and can be caused by medical conditions or substance intoxication/withdrawal. Furthermore, cognitive deficits are components of the syndrome and can include changes in memory, language, visuospatial abilities, or perception [3]. Clinical presentations of delirium can be subcategorized by type: hyperactive where patients are restless, combative and agitated, hypoactive where lethargy, diminished alertness, and reduced motoric activity are prevalent, and mixed with combined features which can wax and wane, with the latter two types being most common [4,5].
Delirium in hospitalized older adults
Published in Hospital Practice, 2020
Katie M Rieck, Sandeep Pagali, Donna M Miller
Delirium derives from the Latin word ‘de-lira’ which means to ‘deviate from track’ or ‘out of the furrow’ [1]. Celsus first used the term delirium in first-century AD, when it was used to describe mental disorders during fever or head trauma [1]. A variety of terms has been used to describe a similar clinical symptom or syndrome, including phrenitis (as early as 500 BC by Hippocrates), and more recently with terms such as encephalopathy, altered mental status, acute confusion, or sun-downing [1]. The inclusion of delirium in early writings is indicative of its long-standing prevalence.