BIND_2_(s. 411-892)_Marius Gudmand-Høyer.pdf - OpenArchive ...

vendelse om sådanne tilstande hvor de vrange forestillinger angående den syges
egen person, anliggender og forretninger samt almene tilstand var emner
for vedkommendes bekymring (»are the subjects of his distress«), hvorimod
den anden neologisme skulle forbeholdes de tilfælde hvor de vrange forestillinger
gennemgående var forbundet med glæde og fornøjelse, eller ved fraværet af
bekymring (»being generally attended with pleasure, or the absence of distress«).
1 At der blev tale om en betydningsmæssig begivenhed i melankoliens
historie havde derimod snarere sin grund i det forhold at det var fra og med
Esquirols arbejde at den bredt kolporteredes i den internationale psykiatri i
hvis sammenhæng hans autoritet regnedes som uomtvistelig — dels i kraft af
positionen som Pinels umiddelbare arvtager, dels for så vidt som Esquirol var
1 Cf. B. Rush: Medical Inquiries and Observations upon The Diseases of the Mind (1812) hvori den
betydningsmæssige opsplitning introduceres i forbindelse med en diskussion af de ligheder og forskelle
som de naturhistoriske nosologer, især Cullen, havde fremhævdet imellem melankolien og hypokondrien.
I “Chapter III: Of Partial Intellectual Derangement and particularly of Hypochondriasis” skrev han
således: »Partial derangement consists in error in opinion, and conduct, upon some one subject only,
with soundness of mind upon all, or nearly all other subjects. The error in this case is two-fold. It is
directly contrary to truth, or it is disproportioned in its effects, or expected consequences, to the causes
which induce them. It has been divided by the nosologists according to its objects. When it relates to
the persons, affairs, or condition of the patient only, and is attended with distress, it has been called
hypochondriasis. When it extends to objects external to the patient, and is attended with pleasure, or
the absence of distress, it has been called melancholia. They are different grades only, of the same morbid
actions in the brain, and they now and then blend their symptoms with each other. […] I wish I
could substitute a better term than hypochondriasis, for the lowest grade of derangement. It is true the
hypochondriac region is diseased in it; so it is after autumnal fevers, and yet we do not designate the
obstructions induced by those fevers by that name. It would be equally proper to call every other form
of madness hypochondriasm, for they are all attended with more or less disease or disorder in the liver,
spleen, stomach and bowels, from which the name of hypochondriasm is derived. But I have another
objection to that name, and that is, it has unfortunately been supposed to imply an imaginary disease
only, and when given to the disease in question is always offensive to patients who are affected with it.
It is true, it is seated in the mind; but it is as much the effect of corporeal causes as a pleurisy, or a bilious
fever. Perhaps the term TRISTIMANIA might be used to express this form of madness when erroneous
opinions respecting a man’s person, affairs, or condition, are the subjects of his distress. […] I object
likewise to the term melancholia, when used, as it is by Dr. Cullen, to express partial madness from
external causes. […] 1. Because it is sometimes induced by causes that are not external to the patient,
but connected with his person, affairs, or condition in life; and, […] 2. Because it conveys an idea of its
being seated in the liver, and derived from vitiated or obstructed bile. Now the seat of the disease, from
facts formerly mentioned, appears to be in the brain, and morbid or obstructed bile is evidently an accidental
symptom of it. Perhaps it would be more proper to call it AMENOMANIA, from the errors that
constitute it, being generally attended with pleasure, or the absence of distress« (pp. 74-76).
615