Høyersten Jon Geir
Centre for Research and Education in Forensic Psychiatry, Regional Secure Unit, Haukeland University Hospital, Sandviken, Bergen, Norway.
Nord J Psychiatry. 2007;61(5):324-31. doi: 10.1080/08039480701643258.
The principal sources on illness in historic periods can be divided into "intrinsic" medical practice, further ideas and conceptions about disease. Legal texts, in the form of laws and verdicts, represent interesting cues. Popular and folklore traditions comprise important and challenging sources, and not least, fictional literature from Homer to the present day gives us important information about the practice, ideas and social implications of psychiatric disorders. In the Viking Age (800-1030 a.d.) and the Middle Ages (1030-1500 a.d.) in Northern Europe, the main available information stems from fictional literature - more precisely the sagas, written predominantly in Iceland during the 13th century: Above all, the Kings' sagas of Snorri Sturlusson and the Icelandic family sagas give short remarks and anecdotes as well as more extensive and perspicuous narratives. On the whole, these "reports" reveal an almost "clinical" descriptive and rationalistic ideal, giving insight into attitudes and reactions to psychiatric illness. Considered according to present day's categorization, the described psychopathological spectrum covers three main areas: 1) affective disorders caused by loss and mourning (sometimes with psychotic symptoms); 2) acute ("reactive") psychoses; 3) dissociative disorders (berserkr). Oligophrenia (or pervasive developmental disorders) as well as bipolar syndromes might be suspected from a few accounts. Some vague notions on aetiology of psychiatric ills are reflected in these texts, for example on the role of heredity. Some kind of basic understanding of the importance of psychological loss prevails in the frequent descriptions of depressive reactions. Overall, the accounts seem largely non-theoretical, uninfluenced by contemporary medical theories.
历史时期疾病的主要来源可分为“内在”医学实践、关于疾病的进一步观点和概念。法律文本,以法律和裁决的形式,提供了有趣的线索。大众和民俗传统是重要且具有挑战性的来源,而从荷马时代至今的虚构文学,也为我们提供了关于精神疾病的实践、观点及社会影响的重要信息。在北欧的维京时代(公元800 - 1030年)和中世纪(公元1030 - 1500年),主要的可用信息来自虚构文学——更确切地说是传奇故事,主要是13世纪在冰岛写成的:最重要的是,斯诺里·斯图鲁松的《诸王传》和冰岛家族传奇故事既有简短的评论和轶事,也有更广泛、更清晰的叙述。总体而言,这些“报告”揭示了一种几乎“临床”的描述性和理性主义理想,让我们得以洞察对精神疾病的态度和反应。按照当今的分类来看,所描述的精神病理学范围涵盖三个主要领域:1)由丧失和哀悼引起的情感障碍(有时伴有精神病症状);2)急性(“反应性”)精神病;3)解离性障碍(狂战士)。从一些记载中可能会怀疑存在智力发育迟缓(或广泛性发育障碍)以及双相综合征。这些文本反映了一些关于精神疾病病因的模糊概念,例如遗传的作用。在对抑郁反应的频繁描述中,某种对心理丧失重要性的基本理解普遍存在。总体而言,这些记载似乎在很大程度上是非理论性的,不受当代医学理论的影响。