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唤醒失眠:19 世纪的医学文献中的失眠症

Awaking insomnia: sleeplessness in the 19th century through medical literature.

机构信息

Institut Ethique Histoire Humanités, Université de Genève, Genève, Switzerland

Service de médecine de premier recours, Hôpitaux Universitaires de Genève, Genève, Switzerland.

出版信息

Med Humanit. 2020 Sep;46(3):340-347. doi: 10.1136/medhum-2019-011683. Epub 2019 Nov 1.

Abstract

Sleep disorders have received growing public and scientific attention in the last decades. Scientific research and publications on sleeplessness are ongoing and considerable progress has been made on the medical understanding of sleep. And yet, insomnia affects an ever-growing number of people around the globe and remains both a difficult and common complaint general practitioners have to deal with on a daily basis. Sleeplessness is not new, although its transformation from a state of accepted wake to that of exasperating insomnia is a relatively recent transition in which, this article argues, Western medicine took an active part. In the 19th century, the theorisation of different nervous disorders and later of neurasthenia shaped the transformation of insomnia from a constituent of everyday life into a pathology. Based on research in French medical journals published in the second half of the 19th century, this article retraces a succession of medical paradigms for sleeplessness, including 'symptomatic insomnia', 'nervous insomnia' and interestingly, 'insomnia' as a key element in neurasthenia theories. The analysis of medical discourse in all successive theories reveals the decisive influence of physicians in the medicalisation of insomnia, their sociocultural representations echoing patient's complaints as well as professional imperatives.

摘要

在过去的几十年里,睡眠障碍受到了越来越多的公众和科学界的关注。关于失眠的科学研究和出版物一直在进行,医学对睡眠的理解也取得了相当大的进展。然而,失眠症影响着全球越来越多的人,而且它仍然是一个常见且难以解决的问题,这是普通医生每天都必须面对的。失眠并不是什么新鲜事,尽管它从一种被接受的清醒状态转变为令人苦恼的失眠状态是一个相对较新的转变,但本文认为,在这个转变中,西方医学发挥了积极的作用。在 19 世纪,不同神经紊乱的理论化以及后来的神经衰弱理论,塑造了失眠从日常生活的一部分转变为一种病理学的过程。基于对 19 世纪后半叶法国医学期刊上发表的研究,本文追溯了一系列关于失眠的医学范式,包括“症状性失眠”、“神经性失眠”,以及有趣的是,作为神经衰弱理论关键要素的“失眠”。对所有连续理论中的医学话语的分析揭示了医生在失眠症的医学化过程中的决定性影响,他们的社会文化表现反映了患者的抱怨以及专业要求。

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