[Expert assessment of peripheral nerve damage--evaluation of pain syndromes].
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Biomedical subjects
Publications and source records attributed to F Kohl.
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UNLABELLED: In the last 20 years the fibromyalgia syndrome and the somatoform pain disorder became more and more important in clinical medicine and in legal affairs. The consultant meets progressive more specific questions, which are not sufficient mentioned in the medico-legal recommendations and at least national "guide-lines" of medical societies. METHODS: By an casuistic approach we try to show the implications of the often seen comorbidity of these two common disorders (i.e. the fibromyalgia syndrome and the somatoform pain disorder) both in legal and in medical perspectives. RESULTS: At the moment the medico-legal recommendations and the national "guide-lines" of medical societies are often not sufficient to decide many of the the legal implications and consultant questions that result from the comorbidity ot these often seen "modern disorders". Therefore we try to develop in an single case the solution principles of appropriate judgement for the functional effects of comorbidity with fibromyalgia syndrome and the somatoform pain disorder. CONCLUSIONS: Because of the wide spectrum of comorbid symptoms between these both disorders one must analyse any specific case very exactly and prove the individual functional implications of the comorbidity in correlation to the degree of impairement. We try to show in an casuistic presentation the possibilities of judgement according the appointments of german law.
We discuss the history of "agoraphobia" and related descriptions as the "Platzangst" from M. Benedikt and the artile of E. Cordes, who used the same title "agoraphobia" as Westphals original paper. It is remarkable that Westphal and Cordes recognized the psychological character of the phenomenon, whereas Benedikt in 1870 suspected a neuroophthalmological origin for his "Platzschwindel". Regarding the details of these first three descriptions one can show that the primary authorities set up a discussion, which is still going on: The relation between agoraphobia, dizziness, fear and panic is until now object of many controversies, as shown in the final chapter.
This article describes the historic roots of acetylsalicylic acid (ASA) from the first experiments at 1800 until the introduction into the pharmaceutical market in 1899. In 1869, Hermann Kolbe enlightened the chemical structure of salicylic acid, which was used at that time as an analgetic and antipyretic drug. Because of the side effects, for example the irritation of the stomach, analytical chemists and pharmacologists searched for chemical modifications. In August 1897 Felix Hoffmann (1868-1946) was successful in acetylizing the salicylic acid to acetylsalicylic acid (ASA). Between 1897 and 1899 Kurt Witthauer (1865-1911) collected clinical data and experiences on the efficiency of ASA as an analgetic and antipyretic drug. In 1899 ASA was introduced into the pharmaceutical market as Aspirin and became soon one of the most successful drugs of its time. The indication exceeds analgesia in the mean time and to prophylaxis of myocardial ischaemia or cerebral stroke, among others.
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Emil Kraepelin's (1856-1926) famous lecture "Zur Diagnose und Prognose der Dementia praecox" was held in Heidelberg 100 years ago on 27. November 1889. In this lecture Kraepelin suggested for the first time his famous "nosological dichotomy" between the group of "manisch-depressives Irresein" and the so-called "Dementia-praecox-Gruppe". This dichotomy became world famous since the publication of his "Lehrbuch der Psychiatrie", 6th edition 1899. Kraepelin founded his psychiatric system on outcome observations and the nosological principles of Kahlbaum. His nosology is very influential to the present day. The revision of American psychiatry in the 1970's and 1980's is unthinkable without Kraepelin's concept. Therefore the name "Neo-Kraepelinianism" was created.
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Since the introduction of the modern psychiatric diagnosis systems anxiety disorders have been intensively discussed. As clinical subtypes in panic disorder the cardial type and the vestibular type are widely accepted. We describe in a case report another of these subtypes, the pharyngeal type; it is characterised by symptoms that are related to the pharynx such as feeling a lump in the throat, swallow disturbance or pain in the pharynx region. It may therefore be called "throat-anxiety syndrome" or "phagophobia". Nosological implications are also discussed.
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The great importance of the "illenau", the so-called "first model asylum of the Germans" (letter) has been increasingly appreciated in recent years. This article describes the "illenau" especially as place of education for young psychiatrists. It seems legitimate to speak of the "illenau psychiatric school" in respect of its function for the practical education of young psychiatrists, but not as a special academic mode of teaching or research.
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Part I of this article has described Pinels carrier upto the 1790ies. This second part concentrates of the actual events and the general historical backgrounds of the so-called "chain liberation." This--in our opinion--cannot be regarded as one singular act, but as symbol for a complex and multistage process. The very common conception of a selective act of "chain liberation" is very simplified and influenced by the "myth of Pinel, " built by the 19th century psychiatrists and historians. Nevertheless: a scientifically sophisticated biography founded on archives material is yet expected.