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Providing an overview of health, medicine and medical practitioners in France at the time of Molière, this chapter shows that, unsurprisingly, medical treatment and access to trained practitioners depended on social status and geographical location, although life expectancy for adults was not as uneven as we might expect. While humoral medicine continued to dominate, key advances were accepted over time, and the publication of medical works in the vernacular disseminated knowledge among literate lay persons. The challenge is to recognise what Molière’s audiences would have found credible or risible. His depiction of illness and medicine belongs to the traditions of farce, comedy-ballet and extravagant entertainments, and should not be read as a reflection on his own health or treatment by doctors. Two farces (Le Médecin volant, Le Médecin malgré lui) and a farcical scene in Dom Juan derive broad humour from a character grotesquely impersonating a physician. In contrast, three comedy-ballets (L’Amour médecin, Monsieur de Pourceaugnac, Le Malade imaginaire) feature genuine physicians treating patients whom they seek to exploit for financial gain if they are delusional and gullible. Yet music, dance and entertainment are also artfully contrived to restore health, at least in the world of the theatre.
Chapter 13 examines Hegel's understanding of animal and mental illness and extrapolates from them an account of social pathology. Social pathologies should be understood not only in terms of impaired functioning or as imbalances among functional spheres but also as ways in which society fails to enable its members to relate to life in the mode of freedom, including: social practices becoming indistinguishable from processes of mere life; social impediments to realizing practical selfhood, such as inadequate sources of recognition or the generation of infinite, unsatisfiable desires; and ideology that involves a mismatch between what social members do and what they take themselves to be doing in their practices. The form of immanent critique found in Hegel's account of bondsman and lord is presented as a promising solution to the problem of providing an ethical justification of social norms that avoids reducing the morality to mere functionality for social reproduction.
Panic attacks are frightening experiences. During a panic, you experience strong physical sensations that feel very serious and threatening at the time. This can leave you fearful of having further panic attacks. This chapter outlines how to understand and beat panic attacks at this time. Pregnancy is a time of lots of physical change and lots of focus on those changes, which can be difficult if you have become worried about physical sensations. It can be difficult managing panic attacks if you are caring for young children. We guide you through the cognitive understanding of panic attacks, that they are driven by understandable but incorrect interpretations of physical sensations. We will help you to apply this theory to your individual situation, to recognise which sensations are particularly frightening, and outline experiments to target behaviours such as avoidance, focus on sensations and other factors that keep the fear going.
Drawing on the ideas of ancient Greek scientists, people in early modern Europe thought of their bodies as containing fluids that influenced health. To them, illness was caused by an imbalance in these fluids, for which bloodletting was the most common treatment. Food was more important than medicine in keeping the body healthy, and what people ate was determined by social class and religious teachings. Many children died young, and those who survived began their training for adulthood at an early age. As young people reached adolescence, the experiences of boys and girls grew more distinct from one another. Authorities tried to restrict sexual behavior, but courts were successful in imposing rules only when these fitted with community norms. Most people married, earlier in eastern and southern Europe than in northern and western Europe, and remarried after the death of a spouse. Widows were more common than widowers, and older women were poorer than older men. Death came at all stages of life, and the living cared for the dying and memorialized the dead with a variety of rituals. Families, guilds, and religious organizations provided people with a sense of community.
Tefo’s voice came in a sudden and surprised cry from behind the closed door, followed by steady sobbing. From the broad slapping sound that punctuated his wailing, I gathered that his mother Kelebogile had taken a pata-pata, or flip-flop, to him. As she beat him she challenged him with scarcely controlled fury: ‘Why do you like to go up and down so much, eh? Why don’t you listen?’
Just as illness and difficulties punctuate our lives, so do times of healing and achievement. As an experience of recovery and renewal, healing through self-expression is a creative process and a triumph of the creative trance. It can bring the possibility of a new self, new work, and new aspects of existence. Illness influenced Itchiku Kubota to expand his designs of Japanese textiles and kimonos. Addressing both emotional and physical pain, healing with creativity can occur through the creative arts therapies and in individuals. By using her creativity in hopes of healing the world, Greta Thunberg healed her difficulties with speaking. Paradoxically, impairments may augment the creative trance by becoming a transforming illness, as in Ludwig van Beethoven’s increasing deafness that imparted greater power to his music. Even when a condition is terminal, and there is no cure, there can still be healing with an altered, yet profound form of creative trance.
Little is known about the effects of informal care-giving on employees' absenteeism due to illness. This paper therefore provides a longitudinal analysis of the consequences of taking on informal care-giving for men's and women's working hours and workplace absenteeism due to illness. Data were taken from the Dutch Labour Supply Panel (waves 2004–2018); 495 of the 6,452 male observations in this panel and 696 of the 5,961 female observations had taken on informal care-giving. It was tested whether respondents who became (intensive) informal carers were more likely than respondents who remained non-care-givers to reduce their work hours or stop working between waves t and t1, or to be absent from work due to illness in wave t1. (Multinomial) logistic regression analyses showed that taking on informal care reduced women's working hours when the care they provided was intensive, but not men's. The predicted probability of women reducing their work hours was 12 per cent if they had remained non-care-givers between waves t and t1, 15 per cent if they had started giving non-intensive care and 19 per cent if they had begun providing intensive help. In addition, starting to provide (non-intensive) informal care increased the risk of workplace absenteeism among both women and men. The study highlights the need for workplace policies that prevent female carers from reducing their work hours, and enable male and female carers to continue working in a healthy way.
Histories of dissolving high/low culture divides inform Katalin Orbán’s discussion of contemporary graphic fiction, as she posits the critical and popular emergence of long-form, verbal-visual works that push narrative conventions in new directions, such as spatial-temporal experiments (e.g., by Chris Ware and Richard McGuire), the use of visual metaphors and other conventionally linguistic literary devices, and genre blurring distinctive to the drawn medium.
This chapter accepts that biomedicine is the dominant influence on our ideas about health and disease but considers what qualifications need to be introduced to do justice first to the more complicated issues to do with mental health and then to the very diverse conceptions that have been entertained in this area in non-Western societies, ancient and modern. Drawing on Hacking’s work on natural kinds and Luhrmann’s analysis of the uncertainties of modern psychiatry, it suggests further respects in which we need to exercise caution in assessing competing claims for expertise in this area.
Early grief is a concept about which there is little literature. This generates difficulties in order to perform a differential diagnosis, as it poses complications to determine if the symptoms that the patient suffers are relative to the mourning or if they appear as part of a comorbid disorder.
To assess the difficulty in discriminating when accompaniment is necessary and when the patient can benefit from pharmacological, psychotherapeutic or combined treatment.
Patients’ data is obtained from their medical history as well as psychological interviews carried out during the process.
32-year-old woman, with a previous history of depression. The patient was living abroad when her father was diagnosed with a terminal illness, so she decided to return home, making a radical change in her life. She is currently facing the functional deterioration of her father, who is rapidly getting worse. The patient shows symptoms of anxiety, tendency to cry and apathy. 34-year-old woman, with no history in Mental Health. As a result of her father’s illness, the patient develops a clinical manifestation of anxiety and low spirits. After one year, the clinic is maintained according to the variations in the health of her father. She also reports problems concentrating, fatigue, ruminative thoughts and structured autolithic ideas. Finally, she is referred to begin a psychotherapeutic follow-up.
Bearing in mind that we are facing an increase in diagnoses of terminal illnesses, I consider it is necessary to reflect on this concept in order to provide a better response to patients.
Narrative medicine, a discipline largely built upon literary studies in confluence with healthcare, bridges cultural divides between sufferers and healers and offers a framework for reading and writing illness, person to person and person to text. This chapter discusses Roth's work within this framework, highlighting how his stories of the body – in health, in illness, in pain, in dying – demonstrate radical empathy and humanism.
‘Dr. Google’ has become the go-to resource when our wellbeing is threatened and we initiate the process of self-medication – due to expediency, necessity, or frugality. Yet, the Internet was not always available to help us minister to the illnesses and injuries we endure. Understanding the origins of modern medicine inevitably turns to its history. Possibly the earliest practitioner of medicine was the Egyptian polymath Imhotep, believed to have diagnosed and treated some 200 diseases. Even more speculation revolves around the prehistory of medicine, when our ancestors could neither read nor write; prehistoric medicine may have used the familiar process of trial-and-error learning to identify medicinal herbs and plant substances. This process has now been documented in many living animals by the emerging science of animal self-medication – zoopharmacognosy. Self-medication may thus have a long evolutionary history, which embraces human evolution, as well as the evolution of most living animals.
Chapter 6 explores US survivors’ activism in the last three decades of the twentieth century through the lens of health, illness, and medicine. Radiation illness – physical and psychosocial – continued to concern US survivors. Women were frequently primary caretakers in Asia and Asian America, spurring female survivors to consider radiation illness from both patients’ and caregivers’ perspectives. This dual challenge became a driving force for US survivors to form trans-Pacific coalitions with Japanese and Korean survivors. US survivors’ understanding of illness that placed psychosocial factors at its center drew attention from the broader Asian American community, also plagued by the lack of resources for culturally aware medical and social services. Unlike the earlier medical exams conducted on US survivors by the Atomic Bomb Casualty Commission, US survivors’ grassroots activism proved capable of producing a solution fitting their needs. One distinct accomplishment of their activism was the creation of biannual health checkups conducted in America by Japanese physicians familiar with radiation illness, funded by the Japanese government and supported by the Asian American community.
After providing an overview of modernist disability studies, this essay uses three prone modernist bodies to explore some of the ways weakness, illness, madness, and disability suggest a revisitation of what Paul Saint-Amour has called “the politics of force or strength.” The prone and potent bodies of Joseph Conrad’s Kurtz and Elizabeth Bowen’s Madame Fisher and Josephine Mather blur the distinction between active and passive, their strength inseparable from their weakness. Disability in these texts is able to infect the self of the “normate,” replacing the oppositions of self and other, normate and abject, with characteristically modernist instability. By highlighting the ways the prone bodies of these characters collapse such distinctions, this essay sheds light on the ambivalence folded within modernism’s embrace of the active and the fit.
This chapter begins with a discussion of concepts related to health and illness in West-Central African societies. It then focuses on the plurality of African healing specialists in the region. Some of the African healers treated everyday occurrences of illness with natural remedies and could be referred to as herbalists. Other healer-diviners focused on treating social ills or so-called diseases of men. Besides offering herbal remedies, their methods often included religious rituals and ceremonial practices. Such activities were often scrutinised and investigated by the Inquisitional commissioners in Luanda. The activities of herbalists, on the contrary, rarely led to denunciations to the Portuguese religious or secular authorities. In West-Central Africa, African herbalists, healers and diviners were the primary source of healing knowledge and power. The imagined powers of individual healers were made manifold by their mobility. Mobile healers offered the possibility of new cures, both spiritual and medicinal.
Chapter 1 functions as introduction that sets the stage for the study as a whole. In this chapter, I discuss cases of royal illness in the Bible, cuneiform writings and early Jewish literature. I also lay out my methodological framework. The introduction of the book scrutinizes the categories of disease, illness, and disability and then reviews how they have been treated in academic discussions of physical disorders. This chapter also involves a short review of the different theoretical frameworks that have been applied to the study of illness in the ancient world which is followed by the introduction of my own approach of illness as frame or the framing of illness. Finally, I outline the organization of the book by giving an overview of the key passages that will be examined in the course of the study
This chapter examines children's daily life in monasteries, examining rules and narrative accounts to reconstruct the social history of these children. Despite the gaps and limitations of our sources, we can map some of the difficult terrain minor children navigated. On the one hand, monasteries offered a fairly stable home with food, healthcare, and educational opportunities for a lifetime. (Though even children could be expelled from the monastery.) On the other hand, children were regarded as a challenge, even a danger, to adult monks, who often prioritized adults’ needs and power over children’s well-being. This chapter looks at these complexities with respect to sexuality, food, labor, health, illness, disability, and even death.
La compétence culturelle telle qu’elle est développée au centre Françoise-Minkowska a ceci de particulier dans le fait qu’elle tient compte non seulement de la dynamique entre le thérapeute et le patient mais également du système de soins dans lequel fonctionne cette offre thérapeutique. Il s’agit essentiellement de mettre le thérapeute dans les conditions optimales pour élaborer un diagnostic ou une indication thérapeutique. La dimension linguistique bien entendu n’est jamais négligée, le travail se fait essentiellement sur la reconnaissance de la dynamique engagée par la confrontation des modèles explicatoires. Cela permet au patient d’exprimer sa souffrance avec ses propres termes et ses références culturelles (illness) et au thérapeute de formuler au plus juste la nosographie psychiatrique éventuelle (disease), tout en tenant compte des déterminants sociaux et de leur impact soit précarisant, soit déstructurant. Cette approche est celle de l’anthropologie médicale clinique.
Health care and health care systems should be seen and understood in their socio-cultural context. Modern urbanized societies are likely to exhibit health care pluralism, and different therapeutic approaches are available side-by-side. The various models may take their origin in different cultural traditions, but in most societies one type of care is at a given time considered “above” the others. However health care activities in all societies show a degree of interrelation, reflecting societal changes in which normative practices, value systems and structures change over time. In the current Western health systems evidence-based biomedical care is the prevailing system taught to all professionals.
The present paper outlines the prevailing health paradigms, and the advantages and shortcomings of the various approaches and their relation to modern care will be discussed. With increased multicultural backgrounds of patients there is a need for mental health professionals to recognize the existence of traditional approaches and be aware of the parallel systems of care. Competent treatment of such patients requires that mental health professionals are aware of this and exhibit a willingness and ability to bridge between the more traditional and the Western approaches to treatment. The delineations and various aspects of the concept cultural competence and its dimensions will be discussed from a clinical perspective.
Comparative studies of the various Western and the traditional approaches respectively will be reviewed.
L’enseignement dans le cadre d’un diplôme universitaire à Paris-Descartes de l’anthropologie médicale clinique permet aux professionnels de la santé mentale et du social d’accéder à une approche théorique qui leur facilite le travail thérapeutique et l’accompagnement social. Les notions d’illness, sickness et disease autorisent un travail de décentrage et de confrontation de représentations culturelles de la souffrance psychique. Il est important que cette approche soit intégrée dans la formation des professionnels de la santé qui reçoivent des personnes migrantes et réfugiées.