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The historical origins of the vegetative state: Received wisdom and the utility of the text
Authors:Zoe M Adams  Joseph J Fins
Institution:1. Consortium for the Advanced Study of Brain Injury (CASBI), Department of Neurology and Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY, USA;2. Division of Medical Ethics, Weill Cornell Medical College, New York, NY, USA;3. The Rockefeller University, New York, NY, USA;4. Solomon Center for Health Law and Policy, Yale Law School, New Haven, CT, USA
Abstract:The persistent vegetative state (PVS) is one of the most iconic and misunderstood phrases in clinical neuroscience. Coined as a diagnostic category by Scottish neurosurgeon Bryan Jennett and American neurologist Fred Plum in 1972, the phrase “vegetative” first appeared in Aristotle’s treatise On the Soul (circa mid-fourth century BCE). Aristotle influenced neuroscientists of the nineteenth and early-twentieth centuries, Xavier Bichat and Walter Timme, and informed their conceptions of the vegetative nervous system. Plum credits Bichat and Timme in his use of the phrase, thus putting the ancient and modern in dialogue. In addition to exploring Aristotle’s definition of the “vegetative” in the original Greek, we put Aristotle in conversation with his contemporaries—Plato and the Hippocratics—to better apprehend theories of mind and consciousness in antiquity. Utilizing the discipline of reception studies in classics scholarship, we demonstrate the importance of etymology and historical origin when considering modern medical nosology.
Keywords:Antiquity  Aristotle  Hippocrates  minimally conscious state (MCS)  persistent vegetative state (PVS)  Plato  reception studies  traumatic brain injury (TBI)
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