Making Distinctions: The Contribution of Hector Landouzy to Differential Diagnosis in Relation to Hysteria and Epilepsy

Hector Landouzy (1818-1864) is known for his Traité Complet de l'Hystérie (1846), which was crowned by the Académie de Médecine, but this work is not given much importance in historical accounts. It deserves more attention because it was more than an orthodox statement about the nature of hysteria. In the context of the diagnostic confusion between epilepsy and hysteria, it introduced a method of presenting criteria to facilitate diagnosis. An examination of French authors on epilepsy and hysteria in the second half of the nineteenth century suggests that this method probably set the example which was to be followed by later clinicians, including Charcot at the Salpêtrière.     

Jean-Martin Charcot and the epilepsy/hysteria relationship

Research from many perspectives has been made on the work of the French neurologist, J.-M. Charcot (1825-1893) with particular reference to his fame for his studies and "construction" of hysteria. What has not been demonstrated so far is the extent to which Charcot's construction can be explained by the perceived relationship between hysteria and epilepsy and Charcot's access to epileptic patients at La Salpêtrière. From the confusion that reigned concerning hysteria and epilepsy, both separately and in relation to each other, Charcot claimed to have isolated hysteria as a distinctive and universal pathology. This claim was partly based on the "grande attaque", representing the most intense degree of hysteria. A comparison with Gowers, the contemporary English neurologist suggests that diagnosis was the function of the practitioners' preferences; and a linguistic analysis pinpoints Charcot's problems in describing an isolated pathology in terms of its relation to its neighbour, epilepsy.     

Metastatic carcinoma: palaeopathology and differential diagnosis

A 62 year‐old contemporary white female diagnosed with metastatic carcinoma of the breast was examined after skeletonisation. She never received chemical, hormonal or radiation therapy. Because of the confirmed clinical diagnosis, lack of medicinal intervention, and quality of bone preservation, this specimen provides a comparative standard for metastatic carcinoma and differential diagnosis of idiopathic dry bone pathology. We detail gross and radiographic bone response to this disease and differentially diagnose the skeleton against Langerhans cell histiocytosis and multiple myeloma, conditions capable of modifying bone in characteristic patterns that may mimic metastatic carcinoma. Copyright © 2006 John Wiley & Sons, Ltd.     

Neolithic case of metastasizing carcinoma: Multiple approaches to differential diagnosis

The remains of the fragmented skeleton of a mature male individual from a Neolithic mass burial (ca. 5000 years BP) are presented. The lesions consist of osteoblastic proliferation and replacement of previously normal haematopoietic tissue. The most affected area seems to have been the iliac blade. So-called ‘seeding’ of tumour tissue has been found in different loci in the femoral neck, sacrum, L4 and scapula. Differential diagnosis points to metastatic carcinoma, most likely from the prostrate gland. In order to support the observations, radiological and histological analyses have been performed. Trace element analyses of tumour and control samples have shown the limited contribution of these data to ascertain the aetiology of secondary neoplasias in buried material.     

Intervertebral chondrocalcinosis: an exercise in differential diagnosis in palaeopathology

Intervertebral chondrocalcinosis (calcification of intervertebral discs and associated structures) may arise from a variety of causes. This work presents a discussion of intervertebral chondrocalcinosis and the identification of its most probable cause in skeletal remains, using as a case study a skeleton of an elderly male from medieval Ipswich, UK. The skeleton is examined using gross observation and radiography, and the intervertebral calcifications are subject to chemical analysis. In addition to intervertebral chondrocalcinosis (which has resulted in ankylosis of lumbo‐sacral segments), lesions identified include chondrocalcinosis at some synovial joints, various soft tissue calcified bodies, and severe osteoarthritis particularly at the gleno‐humeral joints. Interpretation of the results of the chemical analysis of the calcified deposits is complicated by diagenesis, but they are most consistent with apatite and/or whitlockite. Arriving at a most probable cause of the lesions in this case is difficult, but it is tentatively suggested that ochronosis may be the best diagnostic option. Copyright © 2008 John Wiley & Sons, Ltd.     

Historical perspective: The British contribution to the understanding of neurocysticercosis

Neurocysticercosis, or brain infestation with the larval stage of Taenia solium, is the most common risk factor for epilepsy in many endemic regions of the world. Hardly any cases are seen in Western developed countries, including Britain. However, a sizeable number (n = 450) was seen among British soldiers returning from deputation to India, then a British colony, first reported by Col. MacArthur at the Queen Alexandria Military Hospital in 1931. Here, we review the influence of the perceptive observations of British Army medics on the understanding of the parasitic disorder. The majority of these people presented with epilepsy. Among the contributions of the army medics were establishing the diagnosis, initially by histological examination of subcutaneous and muscular infestation, and later by radiography, clarifying the prognosis and the role of medical and surgical treatments and uncovering the close relationship between the larval (cysticercosis) and adult (intestinal tapeworm) stages of T. solium.     

Fiction and the small town in the United States: a contribution to the study of urbanisation

In recent years human geographers have turned to creative writing as a source of insights, and it is suggested that data can be derived to shed light on Facts, Experiences and Meanings. A large group of United States novels reveals two shifts in opinion of the small town compared with the city. Up to 1880 the small town was seen favourably, but from 1880 to about 1935 it was seen as vicious and repellent. A return to a favourable image then took place and continues. Using the approach of Raymond Williams to literature as ‘production’, these novels can be seen as a signifying system reinforcing public opinion as an integral part of the process of urbanisation.     

The many ways of caring: Anthropology's contribution to the nursing profession

Madeleine Leininger. Transcultural Nursing. New York: Masson Publishing U.S.A., Inc., 1979. 742 pp.     

Kinned to be Norwegian: transnational adoptees' positioning in relation to whiteness and the negotiation of nationhood

Embedded in ongoing discussions on everyday nationhood in the context of migration‐related diversity, this article explores how Norwegian transnational adoptees, as border subjects, negotiate their national belonging and identities by positioning themselves in relation to whiteness. By doing so, it further explores the relationship between race and nation. The analysis demonstrates that transnational adoptees position themselves as white when encountering the norm of whiteness, which the author argues in favour of understanding as continued process of doing race. While phenotypic differences trigger a process of racialisation through which transnational adoptees can easily be placed in a minoritised position, adoption provides them with unique access to whiteness, mostly along the negotiable and intertwined dimensions of kinship and the notion of ‘origin’, referred to as the place where they grew up. The article argues that individuals' positioning along majoritisation/minoritisation processes is another important dimension to understand one's multiple and fluid national identity and belonging in migration‐related diversity. The analysis also furthers the discussions on hierarchy of belonging by highlighting the relevance of kinship in intersection with race.     

Making Tuba in the Torres Strait Islands:

There is relatively scant evidence of the Indigenous production and consumption of intoxicating drinks on the Australian mainland prior to the arrival of outsiders. Although Australian Aboriginal peoples had mastered fermentation in some regions, the Indigenous manufacture of much stronger drinks by distillation was unknown on the Australian mainland. However, following contact with Pacific Island and Southeast Asian peoples in the 19th century, Islanders in the Torres Strait adopted techniques for fermenting and distilling what became a quasi-indigenous alcoholic drink known as tuba. This paper discusses the historical process of the diffusion of this substance as a result of labour migration and internationalisation in the Strait, and provides present-day accounts of tuba production from Torres Strait Islanders.