Habermas T
Institut für Medizinische Psychologie, Freien Universität Berlin.
Sudhoffs Arch. 1992;76(1):37-62.
German-language publications on anorexia nervosa and Simmonds' disease from between 1900 and 1945 are reviewed in order to trace factors inherent in medical thinking which have mostly hindered German-language medicine in understanding anorexia nervosa. It is demonstrated that a) the few German-language physicians who did describe central and possible characteristics of a.n. (weight-phobia, overactivity, bulimia, self-induced vomiting) were enabled to do so by valuing detailed clinical description, also of psychic characteristics, and an interest in the neuroses; b) the concept of anorexia nervosa was better known than previously assumed, though largely misunderstood; c) typical diagnostic misinterpretations led to typical biases in the description of the syndrome; d) in Germany more than in other countries a.n. was confounded with Simmonds' disease; and e) in addition to other factors, one reason for this lay in the 'holistic' ideal of psychosomatic medicine in the 1930s.
回顾了1900年至1945年间德语出版物中关于神经性厌食症和西蒙兹病的内容,以探寻医学思维中固有的、大多阻碍德语医学理解神经性厌食症的因素。结果表明:a)少数描述神经性厌食症核心及可能特征(体重恐惧、多动、暴食、自我催吐)的德语医生能够做到这一点,是因为他们重视详细的临床描述,包括心理特征,且对神经症感兴趣;b)神经性厌食症的概念比之前认为的更为人所知,尽管大多被误解;c)典型的诊断误解导致了对该综合征描述中的典型偏差;d)在德国,神经性厌食症比其他国家更常与西蒙兹病混淆;e)除其他因素外,这一现象的一个原因在于20世纪30年代身心医学的“整体”理想。