Anorexia nervosa in 19th century America

Article Abstract:

A history of the awareness of anorexia nervosa (a condition, more prevalent among younger women, in which appetite is lost and the patient suffers extreme weight loss) by the medical profession in Europe and the US is presented. Interest by American medical writers in ''sitophobia'' (as food aversion was then called) was considerably less than that displayed by their British colleagues until just before the year 1900; the term 'anorexia nervosa' was first conveyed to physicians in Sir William Osler's book Principles and Practice of Medicine. American medical opinion may have resisted confronting the problem because of the controversy over the ''fasting girls.'' One American physician, Silas Weir Mitchell, included in his description of the typical neurasthenic (weak) woman the fact that she ate little and was ''thin-blooded.'' Mitchell's treatment consisted, in part, of removing the patient from her environment. The diagnosis of neurasthenia overshadowed that of anorexia for several decades. Mitchell's methods formed the basis for treating neurasthenics and hysterics for many years in America and Europe, and ''parentectomy'' (getting the patient away from her parents) was an important component. James Hendrie Lloyd was an American physician who wrote in the late nineteenth century on the subject of anorexia nervosa without mentioning Osler, Mitchell, or any other American writer. Lloyd commented extensively on ''grave hysteria'' in one female patient, associated with appetite loss and vomiting; he also reported success when she was removed from her home. By the beginning of the twentieth century, interest in anorexia was awakening in Canada and the US; the disorder was beginning to be differentiated from neurasthenia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Works, Osler, William, Mitchell, Silas Weir, Lloyd, James Hendrie

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A description of eating disorders in 1932

Article Abstract:

Eating disorders are well recognized in the field of psychiatry today. Anorexia nervosa, the main characteristic of which is avoidance of food, has been traced to the Middle Ages. Bulimia, which is characterized by a binge and purge cycle, is thought to be a more modern disease. One current estimate is that almost 20 percent of college women practice this ritual. This article excerpts a paper entitled "An Interesting Oral Symptom Complex and Its Relationship to Addiction" that was presented by Dr. Moshe Wulff to the German Psychoanalytic Society in 1932. The cases Dr. Wulff presents, along with other references dating as far back as the 1700s, suggest that bulimia, also, is not new. Four cases are described of women who had a clinical syndrome that included binge eating followed by fasting and/or vomiting, excess sleep, apathetic depression, and disdain for their bodies. In three of the cases onset of this syndrome was during adolescence. All of the women only felt well if abstaining from food, and were swept in and out of this cycle by the perception of good or bad events in their lives. These cases are similar to modern cases of bulimia, and it may be underreporting rather than infrequency that explains its rarity in historical literature. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Eating disorders, Bulimia, Wulff, Moshe

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The concept and boundaries of personality disorders

Article Abstract:

The treatment of personality disorders may take a similar form for that of psychiatric cases except that the former requires a milder method and should be undertaken without the biases that have often plagued past psychiatric activities. Patients suffering from personality disorders have to be regarded as neither lunatic, antisocial and immoral. Melvin Sabshim, during his tenure with the American Psychiatric Assn., did much to advance knowledge on the area of personality disorders.

Analysis, Personality disorders

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