[History of chlorosis]. / Storia di una malattia scomparsa, la clorosi, dal morbus virgineus all'anemia (XVI-XX secolo).

The once-prevalent disease known as chlorosis, that for centuries has been considered as typical of young unmarried women, is--in the history of Medicine--one of the few for which the abundant medical literature allow to assign the exact date of beginning in the sixteenth century--and its disappearance in early twentieth century. Origin and history of chlorosis--along four centuries--are an intriguing example of how sickness is not only related to the history of medical science, but it is also deeply rooted to the history of the imaginary, mentalities, culture and social trends. But that's not all. In general, through the history of chlorosis it is possible to focus some important issues: the transformation of puberty and adolescence in medical problems; the growing medicalization of the society that is reflected in the gradual inclusion into the scientific medical discourse of social and cultural issues (the status, the emancipation of women, etc...). Using a range of medical writings and treatises, supplemented with statistical data, this article focuses on the spread of the chlorosis--the incidence of which apparently increased at that time--and explores the interpretations of the disease in Nineteenth Century Italy. A "golden age" of medical debate and speculations about the disease, that even after the developments of haematology and its diagnostic identification as hypochromic anaemia, will continue for a long time to carry the weight of the nervous and emotional factors that had accompanied the chlorosis for centuries.

[On chlorosis and anaemic girls in the end of the 19th century]. / Om klorose og blodfattige jenter på slutten av 1800-tallet.

Towards the end of the 1800 s, chlorosis was a frequently used diagnosis, in Norway as well as in America and the rest of Europe. The physiological basis for the disease was assumed to be decreased levels of haemoglobin and/or red blood cells. Chlorosis was not synonymous with anaemia, but rather a subcategory with a vague symptom-based picture associated with female puberty. The different opinions on causes of the disease can be divided into three main groups: environmental, moral and biological-constitutional. At the time, it was well known that iron was an effective treatment. In a cultural critical perspective the disease was seen both as a phenomenon of degeneration and as a reaction to modern life with its stress and demands. During the first decades of the 1900 s, the chlorotic girl disappeared from medical textbooks and articles. The article points at medical, biological and dietary improvements as explanations for why chlorosis disappeared as a diagnosis, but also considers historical aspects such as new cultural norms for femininity, changed laws and an increasing political understanding of health's role in society.

Early modern green sickness and pre-Freudian hysteria.

In early modern medicine, both green sickness (or chlorosis) and hysteria were understood to be gendered diseases, diseases of women. Green sickness, a disease of young women, was considered so serious that John Graunt, the father of English statistics, thought that in his time dozens of women died of it in London every year. One of the symptoms of hysteria was that women fell unconscious. The force of etymology and medical tradition was so strong that in one instance the gender of the patient seems to have been changed by the recorder to make the case fit medical theory.

Pubertal process and green-sickness in Renaissance drama: a form fruste of anorexia nervosa?

OBJECTIVE: The aim of this paper is to investigate the relationship between puberty and the onset of green-sickness in early modern popular culture with findings on puberty and the onset of anorexia nervosa. METHOD: Four plays from the late 16th and early 17th centuries dealing with 14-15-year-old girls were analysed for information on puberty and for precipitating factors for the onset of green-sickness. These were then contrasted with the literature on anorexia nervosa where puberty has been proposed as a potential risk factor for the development of the disorder. RESULTS: These four plays endorse a common understanding in early modern popular culture that puberty presents a major developmental challenge for young women. Four common precipitating factors for the development of green-sickness were identified: socio-economic status; age at onset; nutrition and sexual development. These have a striking resemblance to our current understanding of the development of anorexia nervosa in adolescence. CONCLUSION: Green-sickness shares certain similarities with anorexia nervosa. It is a post menarcheal condition arising out of the body's ripeness for reproduction at around the age of 14. Affluence and improved nutrition were recognized as contributory factors. The development of both green-sickness and anorexia nervosa appear to share a common theme in the context of puberty.

Categorías diagnósticas y género: los ejmplos de la clorosis y la neurastenia en la medicina española contemporánea (1877-1936) / Diagnostic categories and gender: two examples in contemporary spanish medicine, chlorosis and neurasthenia (1877-1936)

La Clorosis y la Neurastenia representan dos ejemplos históricos de disociaciones patológicas y de las dificultades que conlleva abordar su diagnóstico con los criterios de la mentalidad científiconatural. En el contexto de aquellas dificultades, el trabajo profundiza en la visión androcéntrica y el discurso ideológico con el que observaba la medicina española contemporánea a la naturaleza femenina y a las patologías de mujeres. Así mismo, a partir de las similitudes mostradas con los actuales síndromes del dolor y la fatiga, la investigación plantea la necesidad de revisar el abordaje clínico de éstas dolencias al intentar superar las limitaciones que ofrece el modelo biomédico

Chlorosis and Neurasthenia are two classical examples of pathological dissociations and the difficulties involved in approaching their diagnosis using scientific-naturalistic criteria. In the realm of those difficulties, the study examines the androcentric viewpoint and the ideological perspective of Contemporary Spanish Medicine when addressing the feminine nature and women’s pathologies. Moreover, based on the similarities with present-day pain and fatigue syndromes, the study underlines the need to review the clinical approach to these illnesses by attempting to overcome the existing biomedical limitations

[Diagnostic categories and gender: two examples in contemporary Spanish medicine, chlorosis and neurasthenia (1877-1936)]. / Categorías diagnósticas y género: los ejemplos de la clorosis y la neurastenia en la medicina española contemporánea (1877-1936).

Chlorosis and Neurasthenia are two classical examples of pathological dissociations and the difficulties involved in approaching their diagnosis using scientific-naturalistic criteria. In the realm of those difficulties, the study examines the androcentric viewpoint and the ideological perspective of Contemporary Spanish Medicine when addressing the feminine nature and women's pathologies. Moreover, based on the similarities with present-day pain and fatigue syndromes, the study underlines the need to review the clinical approach to these illnesses by attempting to overcome the existing biomedical limitations.

[Chlorosis, the lost disease of languid young women]. / Chlorose, een verdwenen ziekte van kwijnende jonge meisjes.

Chlorosis or 'green sickness' was frequently seen in languid girls and young women in the 19th century but disappeared completely in the first part of the 20th century. The clinical picture comprised menstrual disorders such as ameonrrhoea, pallor and many vague symptoms including apathy and hypochondria. At a later stage anaemia and iron deficiency became prominent characteristics. The skin was reported to take on a greenish hue, but this is disputable. Related diseases were hysteria and anorexia. In the middle of the 19th century hydrotherapy was treatment of choice, and later on iron therapy came to the fore. In 1898 Catharine van Tussenbroek, the first female Dutch gynaecologist, pointed to the social factors at the root of the disease: the lack of perspective for young girls in society at that time. The disappearance of the disease can be partially attributed to improved diagnostics but more so to changes in the social position of women around the turn of the century.

Chlorosis: the rise and disappearance of a nutritional disease.

Chlorosis was the first described by Lange in the 16th century as an anemia often found in adolescent girls and young women. Despite the recommendation by Sydenham in the 17th century that the condition be treated with iron supplements, chlorosis was classified among the hysterical diseases. By the end of the 19th century, the incidence of chlorosis apparently increased. It became an important subject of medical literature, but the true nature of the disease remained unknown. Many physicians believed that it was a result of a nervous disorder affecting various organ systems including the blood-forming organs. Iron medication became popular because of its therapeutic value, but its mode of action was controversial. Stockman in 1895 proposed that chlorosis was the result of a nutritional iron deficiency, but his view was largely ignored for decades. After World War I the incidence of chlorosis declined, and the disease ceased to be reported in the 1930s.

Developmental, diachronic, and demographic analysis of cribra orbitalia in the medieval Christian populations of Kulubnarti.

Previous analysis of cribra orbitalia in the medieval populations of Kulubnarti focused only on the presence or absence of the lesion relative to age, sex, and cultural period. Demographic consideration of the lesion was limited to a gross comparison of lesion frequencies and probabilities of dying by age group. The scope of the earlier work has been expanded in the present research to include the consideration of cribra orbitalia from a developmental, demographic, and diachronic perspective. The sample consisted of the same 334 crania analyzed by Van Gerven et al. ([1981] J. Hum. Evol. 10:395-408). All skulls showing the lesion were dichotomized as active or healing, and separate life tables were constructed for those with lesions and those without. The results demonstrate that active lesions are confined entirely to infancy and childhood with formation beginning as early as six months and ending by the twelfth year. This childhood pattern is consistent with the iron deficiency anemia hypothesis proposed by Carlson et al. ([1974] J. Hum. Evol. 3:405-410). Among young adults (16-40), healing lesions occur more frequently in males than females. In the older age categories, however, females exhibit a higher frequency of partially healed lesions than males. A life table comparison of those with and those without cribra orbitalia reveals a dramatic reduction in mean life expectancy for those with the lesion across the formative childhood years (birth-16). This reduction peaks at age 5 where 78% of the children exhibit lesions and where they, as a group, have a mean life expectancy 15.5 years below those without the lesion.

Pica: symptom or eating disorder? A historical assessment.

In DSM-III-R, pica, with anorexia nervosa, bulimia nervosa and rumination disorder of infancy, is accorded the status of a separate eating disorder. However, in the Draft of ICD-10, only anorexia nervosa and bulimia nervosa are listed under eating disorders. Pica in children, and feeding disorder in infancy and childhood, are incorporated with enuresis, encopresis, and feeding, movement and speech disorders in a separate "heterogeneous group of disorders". Extensive research on the history and terminology of eating disorders from the 16th to the 20th century suggests that, historically, pica was regarded as a symptom of other disorders rather than a separate entity. This paper aimed to locate and assess chronologically significant definitions and accounts of pica, to provide a fuller clinical description of a condition which, despite its current relevance, has received little detailed historical examination, and to give some consideration to the multiple aetiological theories which have been put forward. The historical findings are related to the descriptive criteria for pica in DSM-III-R and Draft ICD-10.