.: RESEARCH
Antikiteden 1950'lere Gelinene Dek "Depresyon" Kavramına, Etiyolojisine ve Tedavisine Dair Başlıca Eser ve Anlayışlar
Major Works and Theories Concerning the "Depression" Concept, Etiology, and Treatment from Antiquity to the 1950's
Turkiye Klinikleri J Med Ethics. 2019;27(3):256-68
doi: 10.5336/mdethic.2019-66772
Article Language: TR
Full Text
ÖZET
Bu çalışmada 1950'lerden bugüne depresyona karşı başvurulan birincil sağaltım biçimi olan antidepresif farmakoterapinin gelişiminden evvel tarihte depresyon tedavisinde ve etiyolojisinde ne gibi uygulama, tanımlama ve açıklamalara başvurulmuş olduğu, Osmanlı Anadolusu da dâhil olmak üzere her çağdan örnek mahiyetindeki başlıca yazılı eserler üzerinden ele alınmıştır. İncelenen metinlerden varılan sonuçlar özetlenecek olursa, geçen binlerce yılda depresif haletiruhiye; (i) terminolojik olarak "kalbin hiddeti," "melankoli," "nevrasteni," "hipokondri," "mâlihülyâ," "evham," "İngiliz illeti," "Amerikanit," "manik depresif psikoz" gibi çok çeşitli adlarla anılmıştır; (ii) "kanın kalpten taşması"ndan kötü yiyecek ve içeceklerin hazmedilememesine, "kara safra"nın baskınlık ve fazlalığından genel olarak vücuttaki "hıltlar" arasındaki dengesizliğe, çok çalışıp çok düşünmekten az çalışıp boş durmaya, kitle iletişim olanaklarının gelişmesinden kadınların entelektüel faaliyetlere katılmaya başlamasına, medeniyetin getirdiği suni ve müfrit yaşam tarzından dini liberalizme ve iklimlerin kasvetli yağmurlarına kadar, kimi absürt kimi görece makul çok çeşitli etiyolojik açıklamalarla izah edilmiştir; (iii) hılt dengelemek adına çeşitli maddelerle gastrointestinal boşaltıma yol açmak, elektrik akımına maruz bırakmak, kafatasını dağlamak, sıcak/soğuk suyla hidroterapi uygulamak gibi yararsız/zararlı olanlardan; bitkisel droglarla fitoterapi, ağır hayvani yiyeceklerden ve yüksek alkollü içkilerden kaçındırma, doğayla iç içe ve ölçülü bir hayata çağırma, elektrokonvülsif terapi, bilhassa psikanaliz olmak üzere psikoterapi, bedensel ve zihinsel meşguliyet ya da aksine istirahat gibi nispeten yararlı/zararsız sayılabilecek olanlara kadar, çok çeşitli terapötik yöntem ve modaliteler ile tedavi (edilmeye gayret) edilmiştir.
Anahtar Kelimeler: Amerikanit; depresyon; depresyon tarihi; hipokondri; malihulya; manik depresif psikoz; melankoli; nevrasteni
Bu çalışmada 1950'lerden bugüne depresyona karşı başvurulan birincil sağaltım biçimi olan antidepresif farmakoterapinin gelişiminden evvel tarihte depresyon tedavisinde ve etiyolojisinde ne gibi uygulama, tanımlama ve açıklamalara başvurulmuş olduğu, Osmanlı Anadolusu da dâhil olmak üzere her çağdan örnek mahiyetindeki başlıca yazılı eserler üzerinden ele alınmıştır. İncelenen metinlerden varılan sonuçlar özetlenecek olursa, geçen binlerce yılda depresif haletiruhiye; (i) terminolojik olarak "kalbin hiddeti," "melankoli," "nevrasteni," "hipokondri," "mâlihülyâ," "evham," "İngiliz illeti," "Amerikanit," "manik depresif psikoz" gibi çok çeşitli adlarla anılmıştır; (ii) "kanın kalpten taşması"ndan kötü yiyecek ve içeceklerin hazmedilememesine, "kara safra"nın baskınlık ve fazlalığından genel olarak vücuttaki "hıltlar" arasındaki dengesizliğe, çok çalışıp çok düşünmekten az çalışıp boş durmaya, kitle iletişim olanaklarının gelişmesinden kadınların entelektüel faaliyetlere katılmaya başlamasına, medeniyetin getirdiği suni ve müfrit yaşam tarzından dini liberalizme ve iklimlerin kasvetli yağmurlarına kadar, kimi absürt kimi görece makul çok çeşitli etiyolojik açıklamalarla izah edilmiştir; (iii) hılt dengelemek adına çeşitli maddelerle gastrointestinal boşaltıma yol açmak, elektrik akımına maruz bırakmak, kafatasını dağlamak, sıcak/soğuk suyla hidroterapi uygulamak gibi yararsız/zararlı olanlardan; bitkisel droglarla fitoterapi, ağır hayvani yiyeceklerden ve yüksek alkollü içkilerden kaçındırma, doğayla iç içe ve ölçülü bir hayata çağırma, elektrokonvülsif terapi, bilhassa psikanaliz olmak üzere psikoterapi, bedensel ve zihinsel meşguliyet ya da aksine istirahat gibi nispeten yararlı/zararsız sayılabilecek olanlara kadar, çok çeşitli terapötik yöntem ve modaliteler ile tedavi (edilmeye gayret) edilmiştir.
Anahtar Kelimeler: Amerikanit; depresyon; depresyon tarihi; hipokondri; malihulya; manik depresif psikoz; melankoli; nevrasteni
ABSTRACT
In reference to a set of main representative manuscripts from each era identified, including the Ottoman Anatolia, this study discusses the historical applications, definitions, and explanations elaborated in the treatment and etiology of depression prior to the development of antidepressive pharmacotherapy, the primary therapeutic modality in use against depression since the 1950s. The conclusions drawn from the texts examined can be abstracted as follows: During the past millennia depressive mood (i) was terminologically referred to by numerous names including "the anger of the heart," "melancholy," "neurasthenia," "hypochondria," "mâlihulyâ," "vapors," "the English malady," "Americanitis," and "manic depressive psychosis;" (ii) was etiologically explained sometimes absurdly and sometimes relatively plausibly by miscellaneous causes including "blood overflowing the heart," indigestion of bad foods and drinks, the particular predominance/ excess of the "black bile" or a general imbalance between the "humors" constituting the body, overworking and overthinking, underworking and idleness, development of the mass media, women's participation in intellectual activities, artificial and extravagant lifestyles brought about by civilization, religious liberalism, and rainy, gloomy climates; and (iii) was treated with multifarious therapeutic modalities ranging from futile/harmful practices such as gastrointestinal purgation with various substances for humoral counterbalancing, exposure to electric current, cauterization of the skull, and hydrotherapy with hot/cold water to relatively helpful/harmless methods including phytotherapy with herbal drugs, encouraging for abstaining from strong alcoholic drinks and heavy foods of animal origin and living a moderate life in touch with nature, electroconvulsive therapy, psychotherapy (particularly psychoanalysis), and physical and intellectual occupation or, contrarily, rest.
Keywords: Americanitis; depression; history of depression; hypochondria; mâlihulyâ; manic depressive psychosis; melancholy; neurasthenia
In reference to a set of main representative manuscripts from each era identified, including the Ottoman Anatolia, this study discusses the historical applications, definitions, and explanations elaborated in the treatment and etiology of depression prior to the development of antidepressive pharmacotherapy, the primary therapeutic modality in use against depression since the 1950s. The conclusions drawn from the texts examined can be abstracted as follows: During the past millennia depressive mood (i) was terminologically referred to by numerous names including "the anger of the heart," "melancholy," "neurasthenia," "hypochondria," "mâlihulyâ," "vapors," "the English malady," "Americanitis," and "manic depressive psychosis;" (ii) was etiologically explained sometimes absurdly and sometimes relatively plausibly by miscellaneous causes including "blood overflowing the heart," indigestion of bad foods and drinks, the particular predominance/ excess of the "black bile" or a general imbalance between the "humors" constituting the body, overworking and overthinking, underworking and idleness, development of the mass media, women's participation in intellectual activities, artificial and extravagant lifestyles brought about by civilization, religious liberalism, and rainy, gloomy climates; and (iii) was treated with multifarious therapeutic modalities ranging from futile/harmful practices such as gastrointestinal purgation with various substances for humoral counterbalancing, exposure to electric current, cauterization of the skull, and hydrotherapy with hot/cold water to relatively helpful/harmless methods including phytotherapy with herbal drugs, encouraging for abstaining from strong alcoholic drinks and heavy foods of animal origin and living a moderate life in touch with nature, electroconvulsive therapy, psychotherapy (particularly psychoanalysis), and physical and intellectual occupation or, contrarily, rest.
Keywords: Americanitis; depression; history of depression; hypochondria; mâlihulyâ; manic depressive psychosis; melancholy; neurasthenia
REFERENCES:
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Arlington, VA: American Psychiatric Publishing; 2013. p.991. [Crossref]
- Kearney CA, Trull TJ. Depressive and bipolar disorders and suicide. In: Abnormal Psychology and Life: A Dimensional Approach. 2nd ed. Stamford (CT/ABD): Cengage Learning; 2015. p.177-219.
- Temel MK. [The development of cytotoxic chemotherapeutics in the twentieth century]. Türk Onkoloji Dergisi. 2015;30(2):96-108. [Crossref]
- Bou Khalil R, Richa S. When affective disorders were considered to emanate from the heart: the Ebers papyrus. Am J Psychiatry. 2014;171(3):275. [Crossref] [PubMed]
- The heart and circulatory system. In: Bryan CP, İng. çev. The Papyrus Ebers. Londra: Geoffrey Bles; 1930. p.124-32.
- Shorter E. Before Prozac: the Troubled History of Mood Disorders in Psychiatry. 1st ed. Oxford: Oxford University Press; 2009. p.9-10, 13-18.
- Payk R. Treatment of depression. J Geriatr Psychiatry Neurol. 1994;7(Suppl 1):3-5. [Crossref]
- Stelmack RM, Stalikas A. Galen and the humour theory of temperament. Pers Individ Dif. 1991;12(3):255-63. [Crossref]
- Hipokrat. Hippocrates [Hipokrat külliyatı]. Cilt 4. (Loeb Klasikler Kütüphanesi tasnifi). İng. çev. Jones WHS, ed. Page TE ve ark. Cambridge (MA/ABD): Harvard University Press; 1959. p.127, 129, 131, 185.
- Porter R. Doctors. In: Blood and Guts: A Short History of Medicine. New York: W. W. Norton & Company; 2004. p.21-53.
- Puckrein GA. Humoralism and social development in Colonial America. JAMA. 1981;245(17):1755-7. [Crossref] [PubMed]
- Afkhami AA. Humoralism. Encyclopædia Iranica online (2012). www.iranicaonline.org/articles/humoralism-1.
- Nutton V. Galen of Pergamum. Encyclopædia Britannica online (15.11.2017). [Link]
- Bynum W. Tıp Tarihi. Gökçeoğlu N, Çeviri editör. Ankara: Dost Yayınevi; 2014. p.23.
- Pormann PE. Introduction. In: Rufus of Ephesus: on Melancholy. Pormann PE, ed. 1st ed. Tübingen: Mohr Siebeck; 2008. p.3-23.
- Galen. Fragments de Rufus d'Ephèse : extraits de Galien. In: ?uvres de Rufus d'Ephèse : texte collationné sur les manuscrits, traduit pour la première fois en français, avec une introduction. Publication commencée par le Dr. Ch. Daremberg, continuée et terminée par Ch. Émile Ruelle, bibliothécaire à la bibliothèque Sainte-Geneviève. Paris: L?Imprimerie nationale; 1879. p.291.
- Bujalkova M. Rufus of Ephesus and his contribution to the development of anatomical nomenclature. Acta Med Hist Adriat. 2011;9(1):89-100. [PubMed]
- Ertin H, Temel MK. Surgery and surgical sciences. In: Kalın İ, ed. The Oxford Encyclopedia of Philosophy, Science, and Technology in Islam. 1st ed. Vol. 2. New York: Oxford University Press; 2014. p.301-6.
- Temel MK, Ertin H. Surgical tools. In: Kalın İ, ed. The Oxford Encyclopedia of Philosophy, Science, and Technology in Islam. 1st ed. Vol. 2. New York: Oxford University Press; 2014. p.306-8.
- Omrani A, Holtzman NS, Akiskal HS, Ghaemi SN. Ibn Imran's 10th century treatise on melancholy. J Affect Disord. 2012;141(2-3):116-9. [Crossref] [PubMed]
- Karlığa HB. Konstantin, Afrikalı (Constantinus Africanus). Türkiye Diyanet Vakfı İslam Ansiklopedisi. Cilt 26. Ankara: Türkiye Diyanet Vakfı; 2002. p.180.
- Şahin H, Cihan AK, İshak b. İmran. Türkiye Diyanet Vakfı İslam Ansiklopedisi. Cilt 22 (İhvan-ı Safa-İskit). Ankara: Türkiye Diyanet Vakfı; 2000. p.535.
- Koetschet P. Experiencing madness: mental patients in medieval Arabo-Islamic medicine. In: Petridou G, Thumiger C, eds. Homo Patiens: Approaches to the Patient in the Ancient World. 1st ed. Leiden: Brill; 2015. p.230-2. [Crossref] [PubMed]
- Sezgin F. İslam?da Bilim ve Teknik. 1. Cilt. 2. Baskı. İstanbul: İstanbul Büyükşehir Belediyesi Kültür A.Ş. Yayınları; 2008. p. 93.
- Ricordel J. [Innovations in Arabic medicine from the 9th to the 13th centuries]. Rev Hist Pharm (Paris). 2011;59(370):235-45. [Crossref] [PubMed]
- Dols MW. Galen ve akıl hastalığı. In: Mecnun: Orta Çağ İslam Toplumunda Deli. Dinç DG, çev. 1. baskı. İstanbul: Pinhan; 2013. p.35- 60.
- Sezgin F. İslam?da Bilim ve Teknik. 4. Cilt. 2. Baskı. İstanbul: İstanbul Büyükşehir Belediyesi Kültür A.Ş. Yayınları; 2008. p.29, 182, 207.
- Demirhan Erdemir A. Ahlat-ı Erbaa. Türkiye Diyanet Vakfı İslam Ansiklopedisi. Cilt 2. Ankara: Türkiye Diyanet Vakfı; 1989. p.24.
- Kahya E. el-Kânûn fi?t-Tıb. In: Türkiye Diyanet Vakfı İslam Ansiklopedisi. Cilt 24. Ankara: Türkiye Diyanet Vakfı; 2001. p.331-2.
- Karlığa HB. Anâsir-i Erbaa. In: Türkiye Diyanet Vakfı İslam Ansiklopedisi. Cilt 3. Ankara: Türkiye Diyanet Vakfı; 1991. p.149-51.
- İbn-i Sina. [On black bile and melancholy]. In: Radden J, ed. The Nature of Melancholy: from Aristotle to Kristeva. 1st ed. Oxford: Oxford University Press; 2000. p.78.
- İbn-i Sina. The Canon of Medicine of Avicenna [el-Kânûn fi?t-Tıb]. 1st ed. New York: AMS Press; 1973. p.187, 194, 206, 446.
- Haque A. Psychology from Islamic perspective: contributions of early Muslim scholars and challenges to contemporary Muslim psychologists. J Relig Health. 2004;43(4):357-77. [Crossref]
- Khodaei MA, Noorbala AA, Parsian Z, Targhi ST, Emadi F, Alijaniha F, et al. Avicenna (980-1032 CE): the pioneer in treatment of depression. Transylv Rev. 2017;25:4377-89.
- Abdel-Halim RE. The role of Ibn Sina (Avicenna)'s medical poem in the transmission of medical knowledge to medieval Europe. Urol Ann. 2014;6(1):1-12. [Crossref] [PubMed] [PMC]
- Albucasis on Surgery and Instruments: A Definitive Edition of the Arabic Text with English Translation and Commentary. In: ez-Zehrâvî, ed. Spink MS, Lewis GL, İngilizce çeviri editörleri. 1st ed. Londra: The Wellcome Institute of the History of Medicine; 1973. p.7- 15.
- Sabuncuoğlu Ş. Cerrâḥiyyetü?l-Ḫâniyye. Tıpkı basım. Uzel İ. Ankara: Atatürk Kültür, Dil ve Tarih Yüksek Kurumu, Türk Tarih Kurumu Yayınları; 1992. p.154.
- Uzel İ. Yeni bulunan bir at-Tasrif tercümesi: ?Zahravi? ve ?İlm-i Cerrah.? Belleten. 1988;52: 445-9.
- Democritus Junior. The Anatomy of Melancholy, What it is. With all the Kindes, Causes, Symptomes, Prognostickes, and severall Cures of it. In Three Maine Partitions, with their severall Sections, Members, and Subsections. Philosophically, Medicinally, Historically, Opened and Cut Up. Oxford: John Lichfield & James Short; 1621.
- Burton R. The Anatomy of Melancholy. In: Shilleto AR, ed. Vol. 1. Londra: George Bell and Sons; 1903. p.XII, 16-8, 88.
- Nicol WD. Robert Burton's anatomy of melancholy. Postgrad Med J. 1948;24(270):199-206. [Crossref] [PubMed] [PMC]
- Dunea G. Medical classics: The Anatomy of Melancholy. BMJ. 2007;335(7615):351-52. [Crossref] [PMC]
- Lawlor C. From Melancholia to Prozac: A History of Depression. 1st ed. Oxford: Oxford University Press; 2012. p.265.
- Cheyne G. The English Malady: or, a Treatise of Nervous Diseases of All Kinds, as Spleen, Vapours, Lowness of Spirits, Hypochondriacal, and Hysterical Distempers, etc. Londra: G. Strahan; 1733. p.I-II, 49-50, 162-3, 172, 273, 284.
- Beard G. Neurasthenia, or nervous exhaustion. Boston Med Surg J. 1869;8:217-21. [Crossref]
- Dunglison R. Medical Lexicon: A Dictionary of Medical Science, Containing a Concise Account of the Various Subjects and Terms, with the French and Other Synonymes, Notices of Climate, and of Celebrated Mineral Waters, Formulae for Various Officinal and Empirical Preparations, etc. 6th ed. Philadelphia: Blanchard and Lea; 1846. p.229.
- Neurasthenia and neuratrophia. JAMA. 1887;8(10):270. [Crossref]
- Beard G. Other symptoms of neurasthenia (nervous exhaustion). J Nerv Ment Dis. 1879;6:246-61. [Crossref]
- Beard G. A Practical Treatise on Nervous Exhaustion (Neurasthenia): Its Symptoms, Nature, Sequences, Treatment. 2nd ed. New York: William Wood & Company; 1880. p.262.
- Beard G. Preface. In: American Nervousness: Its Causes and Consequences: A Supplement to Nervous Exhaustion (Neurasthenia). New York: G. P. Putnam's Sons; 1881. p.III-XVIII.
- Presley JW. Neurasthenia and the cure of literature: Robert Graves, Siegfried Sassoon, Andy Collins. JAC. 2010;30(1-2):269-313.
- Blocq P. Neurasthenia. Brain. 1891;14:306-34. [Crossref]
- Engstorm EJ, Weber MM. Making Kraepelin history: a great instauration? Hist Psychiatry. 2007;18(3):268-73. [Crossref]
- Altınbaş K, Tunç S, Yazar MS, Özçetinkaya S, Gülöksüz S, Oral ET. [If Kraepelin was still alive would dichotomy still survive?]. Düşünen Adam Psikiyatri ve Nörolojik Bilimler Derg. 2011;24:321-30. [Crossref]
- de Young M. The Encyclopedia of Asylum Therapeutics, 1750-1950s. 1st ed. Jefferson (NC/ABD): McFarland; 2015. p.376.
- Tan SY, Yip A. António Egas Moniz (1874-1955): lobotomy pioneer and Nobel laureate. Singapore Med J. 2014;55(4):175-6. [Crossref] [PubMed]
- The Nobel Prize in Physiology or Medicine 1949. The Nobel Prizes online (2018). [Link]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington DC: American Psychiatric Association; 1980. p.494.
- Dowrick C, Frances A. Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit. BMJ. 2013;347:f7140. [Crossref] [PubMed]
- Khan A, Brown WA. Antidepressants versus placebo in major depression: an overview. World Psychiatry. 2015;14(3):294-300. [Crossref] [PubMed] [PMC]
- Temel MK. [The 1950s and antidepressive psychopharmacotherapy: classification and history of clinical antidepressants from their prototypes to today]. Turkiye Klinikleri J Med Ethics. 2019;27(2):89-102. [Crossref]
.: Process List