["Transforming poetry into reality"--figures in the legends of antiquity in modern medicine].
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Burghard Breitner, born on June 10, 1884 in Mattsee (Salzburg state) went to school in Salzburg. From autumn 1901 he studied medicine in Graz and Vienna, where he graduated on 1 (st) of June 1908. In the time of his studies he worked on literature and poetry. But finally he decided to become a surgeon. In World War I Breitner was a prisoner of war (POW) of Russia. During this period he used his medical expertise to help wounded soldiers and the local people. For this honourable gesture he was popularly known as "The Angel of Siberia". From 1932 he was Professor of Surgery in Innsbruck. Mainly he worked on the therapy of goiter. Breitner restructured the department of surgery because of scientific development. In 1951 he was a presidential candidate in Austria in an election, which he did not win. In autumn 1952 he became the Rector magnificus of the University of Innsbruck. Breitner died on 28 (th) of March 1956 in Innsbruck.
The confrontation of a poet with himself and his world may be obvious in his creations. When a breakdown like a schizophrenic illness occurs in his life he will fight with creative efforts against his injury. As fragment of this struggle poetic expressions result which allow us to understand the inner life of a psychotic disturbed person better. The poems of two Austrian authors of our time can help us as introduction in this field.
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Suicide is widely understood as a failed solution of a crisis triggered by actual stress in a psychologically predisposed person. This description of the biography of the Italian author Cesare Pavese (1908-1950), who committed suicide at the peak of his career, emphasizes that chronic suicidal tendencies may be a feature of certain life-styles. A diary published posthumously shows that he had been reflecting on suicide for many years. A psychodynamic interpretation of his chronic suicidal tendencies stresses the importance of developmental goals in adolescence and early adulthood. Pavese did not establish a firm ego-identity. He remained through-out his life in a state of ambivalence between intimacy and autonomy, typical of adolescence. He increasingly experienced his writing as a surrogate for real life. His suicide was the paradoxical attempt to experience himself as a person acting in reality.
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As a young physician the poet Gottfried Benn (1886-1956) gave up a promising career in psychiatry after short period in practice. A psychodynamic analysis of this failure stresses the importance of the relationship of father and son in adolescence for the maturing of ego identity and ego ideal. At the beginning of this century psychiatry was a medical field with strong materialistic and biologistic positions. Benn embraced this position and tried to distance himself from his father, who was a charismatic priest with psychotherapeutic ambition. Benn experienced difficulty in competing with his father and this can be attributed to disturbances in his relationship to his mother in early childhood. The consequence was e.g. a narcissistic vulnerability in adulthood. The contrast of the splendid success in brain research with its inapplicability in routine therapy was characteristic of the state of psychiatry at the time of Benn's failure.
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In the past, physicians interested in the great poetess Annette von Droste-Hülshoff argued as to whether she suffered from chronic tuberculosis or Graves' disease. We can now explain her physical appearance without any difficulty, thanks to our knowledge of the oculopathy of prematurity. Annette von Droste-Hülshoff was a premature infant delivered in the seventh or eighth month, and there is no doubt that she suffered from severe myopia and myopic exophthalmos. Moreover, she had a divergent pseudosquint, as can be seen in some portraits of her; this was very probably caused by a dragged disc or dragged retina (i.e., displacement of the macula). The increasing number of outstanding talents seen among premature infants, who now grow up thanks to the incubator, reminds us that Annette von Droste-Hülshoff's vast knowledge and her poetic genius were an expression of her prematurity, which is documented in biographies and by cryptic autobiographical evidence.
Ophthalmic diseases reported in the age of Goethe are difficult to identify today because the nomenclature used at that time is now antiquated. However, it is not difficult to establish from available documents that Goethe's left eye was seriously affected by an erysipelas (tenonitis? orbital phlegmon?), though it was not permanently damaged. With regard to differential diagnosis, an ophthalmic zoster may also be considered, but this is most unlikely considering the documentary evidence and the absence of lasting ocular damage.
The nose is the prominent part of our face. Its look often determines a good part of its owner's image. Rhinophyma is a malformation of the nose of unknown etiology that is often mistakenly associated with drinking alcohol. This rare but definitely eye-catching nasal deformation has found interest not only among doctors but among poets and artists throughout the ages. We attempt to follow this disease from the old Maya culture up to the present century, using known pieces of art, as well as literary quotations.
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