Application characteristics of Qugu (CV 2) in ancient and modern literature / 中国针灸

To summarize and analyze the clinical application characteristics of Qugu (CV 2) in ancient and modern literature based on data mining technology. The Chinese Medical Code (the 5th edition) was taken as the retrieval source of ancient literature, while the CNKI, Wanfang, and VIP databases were taken as the retrieval source of modern literature. The indications of Qugu (CV 2) used alone or with compatible acupoints, compatible acupoints, acupuncture-moxibustion manipulation, etc., were systematically sorted out. As a result, a total of 140 articles of ancient literature were included. The common indications of Qugu (CV 2) used alone were urinary retention, profuse vaginal discharge and hernia. The common indications of Qugu (CV 2) used with compatible acupoints were profuse vaginal discharge, stranguria and hernia. Sixty-four acupoints were concurrently used with Qugu (CV 2), Qugu (CV 2) was mainly compatible with acupoints of conception vessel, bladder meridian and liver meridian, and the high-frequency acupoints included Zhongji (CV 3), Guanyuan (CV 4) and Sanyinjiao (SP 6); five-shu points were the most used special acupoints, and moxibustion therapy was often used. A total of 73 modern articles were included. The common indications of Qugu (CV 2) used alone were urinary retention, erectile dysfunction and chronic prostatitis; the common indications of Qugu (CV 2) used with compatible scupoints were urinary retention, erectile dysfunction and prostatic hyperplasia. Thirty-six acupoints were concurrently used with Qugu (CV 2), Qugu (CV 2) was mainly compatible with acupoints of conception vessel, kidney meridian and spleen meridian, and the high-frequency acupoints included Zhongji (CV 3), Guanyuan (CV 4) and Zusanli (ST 36); front-mu points were the most used special acupoints, and acupuncture therapy was often used. Qugu (CV 2) treats a wide range of diseases in ancient times, the distant treatment effectiveness of acupoints is emphasized; and it mainly treats local diseases in modern times, the nearby treatment effectiveness of acupoints is emphasized.

Bertie y Hamlet, dos príncipes en abismo / Two Princes in Abyss

El recurso de la narrativa literaria permite analizar el film "El discurso del Rey" desde una perspectiva diferente a las disponibles. Se trata de leerlo a partir del concepto de puesta en abismo (mis en abyme), encontrando una escena dentro de la escena, en la que la segunda ofrece las pistas para inteligir claves de la primera. Este recurso se aplica a dos pasajes clave del film, permitiendo así analizarlo como una ficción clínica y comprender mejor las vicisitudes psicológicas del personaje y sus posibles salidas

The resource of literary narrative allows us to analyze the film "The King's Speech" from a different perspective than those currently available. It is a matter of reading it from the concept of "mis en abyme", finding a scene within the scene, in which the second offers the clues to understand the keys of the first. This resource is applied to two key passages of the film, thus allowing it to be analyzed as a clinical fiction and to better understand the psychological vicissitudes of the character and the possible ways out of it

A review of clinical specifications of Scutellariae Radix pieces in ancient and modern literature / 中国中药杂志

Scutellariae Radix is a commonly used Chinese medicinal first recorded in the Shennong's Classic of Materia Medica. In the ancient books of traditional Chinese medicine(TCM), Scutellariae Radix is used in two specifications, solid one(Ziqin) and hollow one(Kuqin). In the current rules and regulations of Chinese medicine, Scutellariae Radix is used without the specific requirements for the specifications applied. To clarify the evolution of Scutellariae Radix specifications and analyze the current specifications of Scutellariae Radix pieces, the present study reviews the Scutellariae Radix from ancient literature, modern rules and regulations, and differences between Ziqin and Kuqin in composition, efficacy, and transformation mechanism. According to the research on ancient books, Kuqin is effective in clearing the fire of the upper energizer, and Ziqin in purging the heat of the lower energizer. Modern studies have revealed that Kuqin and Ziqin are significantly different in chemical components, and Ziqin and Kuqin target the colon and lung, respectively, which are consistent with the relevant records in ancient books. The review study suggests that the two specifications of Scutellariae Radix are reasonable since they can facilitate the precise treatment of Scutellariae Radix.

Memórias póstumas da loucura mulata: as apropriações de Machado de Assis sob o corte patológico / Posthumous memoirs of mulatto insanity: a pathological interpretation of Machado de Assis's appropriations

Resumo Estudos para identificar eventuais relações entre a criação artística e a psicopatologia - desde o século XIX, na Europa - influenciaram o pensamento brasileiro acerca desse tema. O objetivo deste artigo, sob a óptica da história das ciências da saúde, consistiu em analisar as perspectivas, ao longo do século XX, segundo as quais as doenças neurológicas e psiquiátricas de Machado de Assis foram determinantes na criação e no conteúdo de suas produções literárias. A partir de um referencial teórico e metodológico baseado em Bakhtin, verificou-se que muitos autores consideraram a epilepsia de Machado de Assis o principal elemento responsável por seu ato criador, o que permitiu revisar a apropriação de diferentes teorias psiquiátricas no Brasil, assim como diversos conceitos teóricos.

Abstract Studies to identify possible relations between artistic creation and psychopathology (starting in nineteenth-century Europe) have influenced Brazilian thought on this topic. The objective of this article, from the perspective of the history of health sciences, is to analyze viewpoints throughout the twentieth century which considered the neurological and psychiatric diseases of Machado de Assis as fundamental to the development and content of his literary work. A theoretical and methodological reading based on Bakhtin found that many authors considered Machado de Assis's epilepsy to be the main reason behind his creativity, which allowed a review of the appropriation of different psychiatric theories in Brazil, as well as various theoretical concepts.

Occupational Risks in Midwifery: From Bernardino Ramazzini to Modern Times

Occupational risks are often underestimated in midwifery. It is not commonly known that occupational risks were originally described by the Italian physician Bernardino Ramazzini (1633e1714) at the beginning of the 18th century. Our aim was to describe occupational risks in midwifery from Ramazzini to modern times. The original text by Bernardino Ramazzini was analyzed. A review of modern scientific articles on occupational risks in midwifery was conducted. Ramazzini identified two major occupational risks in midwifery: infections and awkward postures. Modern literature seems to agree with his considerations, focusing on infection, use of universal protection and personal protective equipment, and musculoskeletal problems. Modern studies also evidenced posttraumatic stress disorder that was probably postulated by Ramazzini himself. The poor number of articles in literature on midwives' occupational risks shows a lack of interest toward this issue. Prevention should therefore be emphasized in this field, so high-quality studies on occupational risks in midwifery are needed.

Enlaces y desenlaces de las psicosis: enseñanzas de Pizarnik / Bonds and outcomes of psychosis: lessons from Pizarnik

Este trabajo presenta algunos avances de una investigación sobre las psicosis y el lazo social. En esta ocasión presentaremos los hallazgos parciales del estudio del caso de la poeta Alejandra Pizarnik. El mismo estará construido a partir de fuentes publicadas en el que se han privilegiado datos convergentes y recurrentes, que presentaremos en los siguientes ejes: los enlaces con Bajarlía, su maestro, con Ostrov, su analista; el vínculo entre su escritura y la experiencia del sentimiento de la vida; y el desenlace. La orientación metodológica se sustenta en lo que Lacan formuló al proponer que el artista y el psicoanalista trabajan con el material de la condición humana, pero en esta tarea el artista precede al psicoanalista, para avanzar en la indagación sobre las formas en que un psicótico logra sostenerse en el lazo social, y en qué condiciones puede caer. Finalmente, cabe mencionar que nuestro estudio no se pretende exhaustivo sino que se propone presentar un esbozo de formalización de la experiencia subjetiva del lazo social en las psicosis desde una perspectiva no deficitaria, aún en construcción.

This paper presents some advances of a research on psychosis and the social bond. We will present the partial findings of the study of the case of the poet Alejandra Pizarnik. It will be constructed from published sources in which convergent and recurrent data have been privileged, which we will present in the following axes: the bonds with Bajarlía, her teacher, with Ostrov, his analyst; the link between his writing and the experience of the feeling of life; and the final outcome. The methodological orientation is based on what Lacan formulated when proposing that the artist and the psychoanalyst both work with the material of the human condition, but in this task the artist precedes the psychoanalyst, to advance in the investigation on the forms in which a psychotic manages to hold on to the social bond, and under what conditions he may fall. Finally, it is worth mentioning that our study is not intended to be exhaustive but rather to present an outline of formalization of the subjective experience of the social bond in psychoses from a non-deficit perspective, still under construction.

O presente e o futuro da Enfermagem no Admirável Mundo Novo / El presente y el futuro de la Enfermería en Un Mundo Feliz / The present and the future of Nursing in the Brave New World

RESUMO O "Admirável Mundo Novo" previa uma sociedade dominada por um progresso científico e tecnológico que chegava ao ponto de subjugar e desumanizar os seres humanos. O futuro previsto nessa obra não é distante do que estamos vivendo na atualidade. Assim, considerando que a Enfermagem é afetada e desafiada em meio a essas transformações tecnológicas, este artigo objetiva discutir o presente e o futuro da Enfermagem em uma sociedade em constante transformação tecnológica. Em meio a todo um aparato tecnológico, no qual os procedimentos fundamentais começam a ser realizados por máquinas, a Enfermagem precisa começar a refletir sobre qual seria sua melhor postura ou seu diferencial em um mundo com forte tendência ao domínio tecnológico. As transformações do futuro ainda são incertas, mas elas alterarão drasticamente a forma de os indivíduos relacionarem-se consigo mesmos, entre si e com os serviços de saúde. Todavia, mesmo em meio às incertezas advindas do avanço tecnológico e científico do presente e do futuro, a natureza da Enfermagem, essencialmente fundamentada nas interações humanas, pode garantir um lugar de destaque para essa profissão na sociedade.

RESUMEN Un mundo feliz preveía una sociedad dominada por un progreso científico y tecnológico que llegaba al punto de subyugar y deshumanizar a los seres humanos. El futuro previsto en esa obra no está tan lejano de lo que estamos viviendo en la actualidad. De esa forma, considerándose que la Enfermería se ve afectada y desafiada en medio de dichas transformaciones tecnológicas, este artículo tiene el fin de discutir el presente y el futuro de la Enfermería en una sociedad en constante transformación tecnológica. A la vista de todo ese aparato tecnológico, en el que las máquinas empiezan a realizar los procedimientos fundamentales, la Enfermería necesita empezar a reflejar acerca de cuál sería su mejor postura o su rasgo distintivo en un mundo con fuerte tendencia al dominio tecnológico. Los cambios del futuro todavía son inciertos, pero modificarán drásticamente la forma cómo los individuos se relacionan consigo mismos, entre sí y con los servicios sanitarios. Sin embargo, aun mediante las incertidumbres advenidas del avance tecnológico y científico del presente y del porvenir, la naturaleza de la Enfermería, esencialmente fundada en las interacciones humanas, puede asegurar un sitio de relieve a esa profesión en la sociedad.

ABSTRACT The "Brave New World" envisioned a society dominated by scientific and technological progress that went as far as to subjugate and dehumanize human beings. The future foreseen in this literary work is not far from what we are currently experiencing. Thus, considering that Nursing is affected and challenged in the midst of these technological transformations, this article aims to discuss the present and future of Nursing in a society that is undergoing constant technological transformations. In the midst of a whole technological apparatus in which fundamental procedures begin to be carried out by machines, Nursing needs to begin reflecting on what would be the best posture or its differential in a world with strong technological tendencies. Future transformations are still uncertain, nonetheless they will drastically change the way individuals relate to one another and to health services. Even in the midst of these uncertainties arising from present and future technological and scientific advances, the nature of Nursing which is essentially based on human interactions, can guarantee a place of prominence for this profession in society.

Os "Poemas da Negra", uma leitura a contrapelo da "poesia do senhor do engenho" / The "Poemas da Negra", a reading against the grain of the "poetry of the lord of the mill"

RESUMO O presente artigo dedica-se a uma leitura dos doze "Poemas da Negra" de Mário de Andrade, escritos em 1928 e publicados em 1930 na obra Remate de males. A análise e a interpretação do conjunto amoroso nascem dos estudos do manuscrito Preto no acervo do escritor (Grillo, 2010), salvaguardado no Instituto de Estudos Brasileiros (IEB-USP), e seguem indicações de Gilda de Melo e Souza (2005). A estudiosa aponta para que se faça uma leitura dos poemas a contrapelo do que ela denomina "poesia do senhor do engenho". De fato, em um dos mais belos versos amorosos de Mário de Andrade, o poeta desenvolve na poesia modernista uma nova dicção a respeito da negra, na medida em que o eu lírico a eleva a um plano cósmico, igualando o eu poético e a musa de azeviche.

ABSTRAR This article is dedicated to a reading of the twelve "Poemas da Negra" by Mário de Andrade, written in 1928 and published in 1930 in the book Remate de males. The analysis and interpretation of the love collection derive from studies of the manuscript Preto in the writer's collection (Grillo, 2010), safeguarded in the Institute of Brazilian Studies (IEB-USP), and follow indications of Gilda de Melo e Souza (2005). This scholar points out that the poems should be read against what she calls the "poetry of the plantation master". Indeed, in one of Mário de Andrade's most beautiful love verses, the poet develops a new Modernist diction about the black woman, insofar as the lyrical self elevates her to a cosmic plane, equating the poetic self and the black muse.

Mário de Andrade e Richard Wagner na aurora do modernismo paulista / Mário de Andrade and Richard Wagner at the dawn of modernism in São Paulo

RESUMO O início da carreira intelectual de Mário de Andrade é marcado por aproximações com o compositor alemão Richard Wagner de diversas maneiras. No presente artigo, apresento três modos pelos quais os autores se encontram: o primeiro é a leitura que Mário faz da obra de Wagner; o segundo, parte da importância do compositor e seu projeto estético na história da música; o terceiro traz o caso da apresentação realizada por Oswald de Andrade que utiliza termos da ópera Parsifal. A partir desses, propõe-se uma leitura do pensamento musical de Mário de Andrade que pode ser utilizada de amparo para a compreensão do seu pensamento estético.

ABSTRACT The beginning of Mário de Andrade's intellectual career is marked by his many approximations to the German composer Richard Wagner. In this article, I would like to present three excerpts that show how these two authors meet: the first is Mário's reading of Wagner's work; the second concerns the importance of this composer and his aesthetic project in the history of music; the third relays the case of a presentation by Oswald de Andrade that makes a comparison to the opera Parsifal. From these excerpts, I would like to propose a reading of Mário de Andrade's musical thought that may be used as a basis to understand his aesthetic thinking.

Georges Simenon, Inspector Maigret and his relevance to the practice of Neurology / Georges Simenon, Inspector Maigret e a sua relevância para a prática da Neurologia

ABSTRACT Georges Simenon’s work, including his famous ‘romans durs’ novels and the forensic investigations carried out by his artistic creation, Inspector Maigret, bear many similarities to some of the diagnostic methods of the founders of Neurology, particularly Jean-Martin Charcot.

RESUMO A obra de Georges Simenon, incluíndo os seus famosos “romances duros”, e as investigações criminais realizadas pela sua criação artística, o comissário Maigret, tem muitas similaridades com alguns métodos diagnósticos utilizados pelos fundadores da Neurologia, particularmente Jean-Martin Charcot.

Virginia Woolf, neuroprogression, and bipolar disorder

Family history and traumatic experiences are factors linked to bipolar disorder. It is known that the lifetime risk of bipolar disorder in relatives of a bipolar proband are 5-10% for first degree relatives and 40-70% for monozygotic co-twins. It is also known that patients with early childhood trauma present earlier onset of bipolar disorder, increased number of manic episodes, and more suicide attempts. We have recently reported that childhood trauma partly mediates the effect of family history on bipolar disorder diagnosis. In light of these findings from the scientific literature, we reviewed the work of British writer Virginia Woolf, who allegedly suffered from bipolar disorder. Her disorder was strongly related to her family background. Moreover, Virginia Woolf was sexually molested by her half siblings for nine years. Her bipolar disorder symptoms presented a pernicious course, associated with hospitalizations, suicidal behavioral, and functional impairment. The concept of neuroprogression has been used to explain the clinical deterioration that takes places in a subgroup of bipolar disorder patients. The examination of Virgina Woolf’s biography and art can provide clinicians with important insights about the course of bipolar disorder.

O dilema de Salieri: contraponto entre inveja e apreço / Salieri's dilemma: counterpoint between envy and appreciation

Tomando como ponto de partida os conceitos kleinianos de 1957, este artigo põe em destaque algumas características da inveja que ainda não foram levadas em consideração pela psicanálise. Klein descreve o conflito entre a inveja e a gratidão como algo inerente ao ser humano; ela sugere uma interessante conexão entre a inveja e a admiração, mas sua teoria nunca desenvolveu essa ideia. A hipótese que apresentamos neste trabalho é a existência de uma intolerância específica ­ relacionada à inveja ­ da capacidade de alguém de reconhecer os aspectos meritórios do objeto. Essa situação leva ao paradoxo de que a capacidade que permite ao paciente apreciar as qualidades boas do objeto é, ao mesmo tempo, fonte de dor insuportável. A capacidade de reconhecer os aspectos bons do objeto ­ percebidos ou atribuídos pela identificação projetiva ­ não pode ser aceita como um aspecto meritório do self e é considerada uma prova da falta de valor do self. Acreditamos que a descrição dessa intolerância em relação ao apreço admirativo introduz uma mudança no entendimento da idealização considerada como uma simples defesa contra a inveja, enriquecendo o conflito expresso no imediatismo da transferência ­ contratransferência(AU)

Taking as its starting point Klein's concepts of 1957, this paper stresses certain characteristics of envy that have not yet been taken into account in psychoanalysis. Klein described the conflict between envy and gratitude as inherent in the human being; she suggested an interesting link between envy and admiration, but never developed this idea in her theory. The hypothesis that we put forward in this paper is the existence of a particular intolerance ­ related to envy­ of one's own capacity to recognise the valuable aspects of the object. This situation leads to the paradox that the same faculty that allows the patient to appreciate the good qualities of the object is at the same time the source of unbearable pain. The capacity to recognise the good aspects of the object ­ whether they are perceived or attributed by projective identication ­ cannot be accepted as a valuable aspect of the self and is taken as a proof of the self's unworthiness. We think that the description of this intolerance towards admirative appreciation introduces a change in the understanding of idealisation simply as a defence against envy and enriches the conflict expressed in the immediacy of the transference countertransference(AU)

Tomando como punto de partida los conceptos kleinianos de 1957, en este artículo se resaltan algunas características de la envidia que el psicoanálisis aún no ha tenido en cuenta. Klein describe el conflicto entre la envidia y la gratitud como algo inherente al ser humano y sugiere una interesante conexión entre la envidia y la admiración, pero, en su teoría, nunca desarrolló esa última idea. La hipótesis que presentamos en este trabajo es la de la existencia de una intolerancia específica ­ relacionada a la envidia ­ de la capacidad de alguien de reconocer aspectos valiosos del objeto. Esta situación conduce a la paradoja de que la misma facultad que le permite al paciente apreciar las cualidades buenas del objeto es, al mismo tiempo, una fuente de dolor insoportable. La capacidad de reconocer los aspectos buenos del objeto -percibidos o atribuidos por identificación proyectiva ­ no se puede aceptar como un aspecto valioso del self y se considera una prueba de la falta de valor del self. Pensamos que la descripción de dicha intolerancia con respecto al aprecio admirativo introduce un cambio en el entendimiento de la idealización considerada simplemente como una defensa contra la envidia y enriquece el conflicto que se expresa en el inmediatismo de la transferencia-contratransferencia(AU)

O mentecapto de Itaguaí, história, loucura e saber psiquiátrico: diálogos historiográficos em torno de “O alienista” de Machado de Assis / The madman of Itaguaí, history, madness, and psychiatric knowledge: historiographic dialogues about “The Alienist,” by Machado de Assis

Resumo O artigo analisa a obra “O alienista”, de Machado de Assis, a partir de um diálogo com a historiografia (nem sempre escrita por historiadores) que, desde o final dos anos 1970 até períodos mais recentes, investiga tanto as práticas de intervenção psiquiátricas vigentes no Brasil da segunda metade do século XIX até o começo do XX quanto os aportes teóricos e as lógicas de poder e sociabilidades que davam sustentação a tais práticas. A perspectiva aqui assumida interpreta “O alienista” como um vigoroso “testemunho histórico”, num registro eminentemente crítico, dos momentos iniciais de implantação da medicina mental no Brasil e de seu correlato institucional, que é o hospício.

Abstract From the early 1970s until more recently, historiography (which is not always written by historians) has investigated the psychiatric intervention practices that prevailed in Brazil from the latter half of the nineteenth century through the early twentieth, along with their theoretical foundations and the underlying logics of power and sociability. The article analyzes the novella “The Alienist,” by Machado de Assis, by engaging in dialogue with this field. The book is interpreted as a robust and eminently critical “historical witness” of the early emergence of mental health medicine in Brazil and its institutional correlate, the asylum.

Historiografia brasileira e meio ambiente: as contribuições de Sérgio Buarque de Holanda e o debate contemporâneo da história ambiental / Brazilian historiography and the environment: contributions by Sérgio Buarque de Holanda and the contemporary environmental history debate

Resumo Ao longo da segunda metade do século XX, o debate historiográfico brasileiro foi profundamente marcado por Sérgio Buarque de Holanda. Na primeira década do século XXI, os problemas da identidade nacional, da ocupação do território, da organização social do Brasil e suas matrizes civilizacionais, dos limites e trocas culturais em terras interiores, das percepções e formas de apropriação da natureza, entre outros temas do autor, ainda ecoam nos estudos históricos contemporâneos. O artigo discute as contribuições das suas principais obras para a história ambiental, sobretudo as interpretações das interferências cruzadas entre sociedades humanas e o meio natural. O papel da natureza, suas metáforas, ideias ou imagens são os vestígios de uma história da historiografia brasileira.

Abstract Throughout the second half of the twentieth century, Brazilian historigraphical debate was profoundly marked by Sérgio Buarque de Holanda. The problems of national identity, the occupation of the land, the social organization of Brazil and its civilizatory roots, the cultural exchanges and boundaries in inland parts, the perceptions and forms of appropriation of nature, and other topics covered by the author still echo in contemporary historical research. This article discusses how his main works contribute to environmental history, especially his interpretations of how human societies and the natural environment have affected one another. The role of nature, its metaphors, ideas, or images are the evidence of a history of Brazilian historiography.

150 years of "Alice's Adventures in Wonderland": some considerations about the Cheshire cat and neuropsychiatric phenomena / 150 anos de "Alice no País das Maravilhas": algumas considerações sobre o gato de Cheshire e fenômenos neuropsiquiátricos

Alice's Adventures in Wonderland by Lewis Carroll, pseudonym of Charles Lutwidge Dodgson, is a psychedelic dream tale apparently made for amusement. But, many speculations may be raised about its characters and phenomena created by a devout, learned and imaginative mathematician/logistician. Some issues based on the Cheshire cat due to its vanishing apparitions and its clever arguments are considered. The interpretation of the visual perception may include the "binding problem" issue. Regarding the cat's thought about inquiry, fundamental for researchers, this represents similar reasoning to that of Claude Bernard. Secondarily, some neurological and psychopathological speculations are also focused.

As aventuras de Alice no País das Maravilhas por Lewis Carroll, pseudônimo de Charles Lutwidge Dodgson, é um conto de sonho psicodélico, aparentemente feito para diversão. Mas muitas especulações podem ser levantadas sobre seus personagens e fenômenos criados por um devoto, erudito e criativo matemático/especialista em logística. São feitas algumas considerações sobre o gato de Cheshire devido suas aparições evanescentes e seus argumentos inteligentes. A interpretação sobre a percepção visual pode incluir a questão do "binding problem". Em relação ao pensamento do gato sobre a investigação, fundamental para os pesquisadores, isso representa raciocínio similar ao de Claude Bernard. Secundariamente, algumas especulações neurológicas e psicopatológicas também são apresentadas.

Sábato, Winnicott e Grunberger: um encontro em El túnel / Sábato, Winnicott and Grunberger: a meeting in The tunnel

Dentre vários possíveis vínculos com referenciais psicanalíticos, o artigo busca fazer uma relação da novela El túnel1 (Sábato, 1948) com alguns entendimentos baseados em Donald Winnicott e Béla Grunberger. Com inspiração existencialista, o drama ilustra uma profunda imersão narcísica do protagonista, assim como uma busca de segurança frente ao caos de viver separado do objeto amoroso. Considerada uma narrativa que expõe a inevitável fragilidade da condição humana, o enredo penetra na intimidade última e na solidão essencial do homem. A aproximação com Winnicott refere-se às hipóteses de que a transicionalidade, no sentido primitivo, tenha deixado cicatrizes irreparáveis no personagem central de Sábato, com potentes angústias de separação. A ligação com os aportes de Grunberger incide nos seus entendimentos sobre o narcisismo, sobretudo na dualidade narcisismo/pulsões, na busca de constantes reparações da imagem fálica e, na analidade, com a insistente tendência de domínio e de controle sobre o objeto. Há indícios de que a honra narcísica do protagonista está sempre em perigo e este, então, em constante luta de resgate. Em El túnel, a dor da perda do objeto primário parece ter tomado dimensões acentuadas e esse colapso se reatualizar no vínculo amoroso atual do protagonista. Assim, com um forte investimento de representações ligadas à ferida narcísica (Grunberger), a novela de Sábato ilustra uma impossibilidade de separação, patologia da transicionalidade (Winnicott), em que as relações do sujeito são marcadas por temores catastróficos e, a cada ameaça de perda do objeto, pela emergência de sintomas de ciúme delirante(AU)

Among several possible connections with psychoanalytical references, this work aims at establishing a relationship between the novel The tunnel (Sábato, 1948) and some understandings based on Donald Winnicott and Béla Grunberger. With existentialist inspiration, the drama explores the deep narcissistic immersion of the main character, as well as his quest for security in order to cope with the chaos of living apart from his love object. Whilst the narrative is considered to expose the inevitable fragility of the human condition, the plot penetrates the ultimate intimacy and essential loneliness of man. The reference to Winnicott consists in the hypotheses that transitionality, in its primitive sense, has left irreparable scars on Sábato's main character, with deep anxieties of separation. The connection with Grunberger's contributions refers to his understanding of narcissism, especially to the duality narcissism/drives, to the search for constant reparations of the phallic image and to anality, with the insistent tendency of dominance and control over the object. There are indications that the main character's narcissistic honor is always in danger, with him being in constant struggle for rescue. In The tunnel, the pain for the loss of the primary object seems to have gained enormous proportions and this collapse to be renewed in the current love relationship of the main character. Therefore, with a strong structure of representations connected to the narcissistic injury (Grunberger), Sábato's novel shows the impossibility of separation, pathology of the transitionality (Winnicott), in which subject's relationships are characterized by catastrophic fears and, to each threat of object loss, by the emergence of delirious jealousy symptoms(AU)

Entre los varios posibles vínculos con referenciales psicoanalíticos el artículo busca plantear una relación entre el romance El túnel (Sábato) y algunos entendimientos basados en Donald Winnicott y Béla Grunberger. Con la inspiración existencialista, el drama ilustra una profunda inmersión narcisista del protagonista, bien como una búsqueda de seguridad frente al caos de vivir separado del objeto amoroso. Considerada una narrativa de la inevitable fragilidad de la condición humana, el enredo penetra en la intimidad última y en la soledad esencial del hombre. El acercamiento a Winnicott se refiere a las hipótesis que la transicionalidad, en el sentido primitivo, ha provocado cicatrices irreparables en el protagonista de Sábato, con fuertes angustias de separación. El vínculo con los aportes de Grunberger se relaciona con sus entendimientos sobre el narcisismo, sobretodo en la dualidad narcisismo/pulsiones en la búsqueda de constantes reparaciones de la imagen fálica y, en la analidad, con la insistente tendencia de dominio y controle sobre el objeto. Hay indicios que la honra narcisista del protagonista está siempre en peligro y ese, entonces, en constante lucha de rescate. En El túnel, el dolor de la pérdida del objeto primario parece haber tomado dimensiones acentuadas y ese colapso parece se reactualizar en el vínculo amoroso actual del protagonista. Así, con una fuerte inversión de representaciones vinculadas a la herida narcisista (Grunberger), el romance de Sábato ilustra una imposibilidad de separación, patología de la transicionalidad (Winnicott), donde las relaciones del sujeto son marcadas por miedos catastróficos y a cada amenaza de la pérdida del objeto surgen síntomas de celos delirantes(AU)

What is like to be a devoted doctor? An analysis of book reports on The Painted Veil / 한국의학교육

PURPOSE: The aim of this study is to see what medical students think about the role of spouse of a devoted medical doctor through the book reports of The Painted Veil (1925). METHODS: The 53 medical students were asked to read Maugham's The Painted Veil and to have a discussion. In their book reports, following questions were asked to be included: What it is like to be married a devoted medical doctor? Do you think that patients realize, value, and respect the importance of doctor's work? In the outbreak of highly infectious and fatal disease, can you carry out a heroic fight to control it? RESULTS: Among the 53 respondents, seven students (13%) answered that they would be happy if they marry a devoted doctor and scientist and 34 (64%) unhappy. The remaining 12 (23%) could not make a decision. The six students (11%) answered that doctor is valued and respected by patients while 46 (87%) answered doctor is neither valued nor respected. The remaining one (2%) could not decide. The 20 students (38%) answered that they would fight for the infectious disease and the remaining 30 (57%) answered that they would not. The remaining three (5%) could not determine their mind. CONCLUSION: The Painted Veil induced a virtue of "life of balance and harmony" and "attitude of doctor who give superiority to responsibility and duty over prestige and wealth" from the medical students. It could be a good teaching material for medical humanity.