Area postrema syndrome: A short history of a pearl in demyelinating diseases.

In this topical review, we discuss the history of the area postrema syndrome, with special attention given to early studies aimed at identifying the area postrema and its function, possible early cases of the syndrome and its current relevance in neuroimmunology and demyelinating diseases. In 1896, Retzius named a structure in the posterior medulla oblongata as the area postrema. The work of Borison in the middle of the 20th century led to the elucidation of its function as a "vomiting center." The historical medical literature is filled with excellent examples that could be described as "area postrema syndrome." While severe and bilateral optic neuritis and transverse myelitis still constitute the classic components of neuromyelitis optica spectrum disorder (NMOSD), intractable vomiting and hiccups due to area postrema involvement is now recognized as essentially pathognomonic, indeed a shiny pearl in neuroimmunology and demyelinating diseases.

Charles Darwin and the Dentists.

Charles Darwin suffered relapsing, debilitating illness for most of his adult life with many symptoms. His most prominent complaints were episodic nausea, retching and vomiting. As is common in patients with repeated vomiting he developed dental problems, problems that may be dated back to his voyage on the Beagle and his vomiting due to persistent seasickness. Dental problems continued after the voyage and he was one of the first patients to have extractions under chloroform. Watching a dental procedure caused Darwin great distress, much as surgical and obstetric procedures had previously caused him distress with onset of symptoms. Darwin's dental experiences are consistent with the proposed diagnosis of his lifetime illness- patients with similar illnesses today have much the same dental problems. Dentists also helped Darwin with his researches and collection of specimens. In Darwin's day, dentists, like country clergymen, had time to follow other interests. Dentists contributed to Darwin's dental health, to the dental health of his family and to Darwin's work and biological studies. Dentists, in their own right, were also prominent in developing our biological understanding.

Historical perspective on the progress of chemotherapy-induced nausea and vomiting treatment in oncology nursing forum.

Chemotherapy-induced nausea and vomiting (CINV) has been a priority symptom in the management of patients with cancer since the inception of chemotherapy. In the mid-1970s, the most effective agents available were the standard antiemetics used for gastrointestinal illnesses, postoperative nausea, and morning sickness. The Oncology Nursing Forum has documented the study of this symptom­causes, pathophysiology, and manifestations­in the past four decades as well as emerging treatment therapies. To date, CINV is fairly well controlled, but work still needs to be done, particularly in delayed and refractory management.

Charles Darwin's impressions of New Zealand and Australia, and insights into his illness and his developing ideas on evolution.

Charles Darwin visited New Zealand in December 1835, and Australia from January until March 1836, on the return portion of his voyage around the world in HMS Beagle. Despite the shortness of these visits, he retained an interest in these countries throughout his life, maintaining correspondence and receiving many biological specimens. His experiences in these places influenced his thinking on evolution, particularly on the evolution of man. Aspects of his health recorded during this part of the voyage support a new hypothesis for the diagnosis of the illness that Darwin endured for most of his life.

Was late-nineteenth-century nervous vomiting an early variant of bulimia nervosa?

We studied a wide variety of medical publications to find out whether late-nineteenth-century nervous or hysterial vomiting was clinically consistent with modern bulima nervosa. Since modern diagnostic criteria of bulimia nervosa my be time- and culture-bound, we made use of adapted criteria, focusing on the more overt, physical and behavioural features of the syndrome. In retrospect, it became obvious that only some of these specific diagnostic requirements were met. Indeed, late-nineteenth-century nervous or hysterical vomiters most likely have been non-organically-ill neurotics. However, their disorder was more closely associated with food abstinence in general and anorexia nervosa in particular than with overeating. Only in a few cases doctors made mention of recurrent episodes of binge eating, but there was no convincing evidence of any concern for body shape and weight. Obviously, late-nineteenth-century nervous or hysterial vomiting was still located at the crossing between classic hysteria, the 'new' clinical entity of anorexia nervosa, and forms of psychogenic vomiting.

Merycism or rumination disorder. A historical investigation and current assessment.

BACKGROUND: In the 'fashionable' field of eating disorders, there has been a notable gap in the historiography of rumination, allowing considerable scope for constructing a comprehensive historical profile of this disorder. METHOD: A wide-ranging examination of printed material, both etymological and medical, backed by a Medline computer search, uncovered extensive sources, some of considerable rarity, including case reports from the early 17th century onwards. Extracted data focused on incidence, sex distribution, age range, outcome and causation, and the findings are discussed in relation to diagnostic criteria in DSM-III-R and ICD-10. RESULTS: While confirming the frequency of rumination in infants and the mentally retarded, the study demonstrated, particularly, the need to recognise its occurrence in normal adults, occasionally as a collateral behaviour in anorexia and bulimia nervosa, and suggested that its prevalence, distorted by secrecy, exceeded estimated levels. CONCLUSIONS: In future reviews of classification, existing anomalies and inadequacies in the status and description of rumination would benefit from integrating some of the historical conclusions.

Regurgitation erosion as a possible cause of tooth wear in ancient British populations.

Clinically, in modern populations, tooth wear can be differentiated into three main types--attrition, abrasion and erosion, acting either separately or together. Anthropologists generally have not recognized erosion as a factor affecting the teeth of past populations. This study compares the patterns of wear known to be associated with erosion in present-day dental patients with those found in some British, pre-Conquest, skeletons. It is concluded that erosion may have been a major factor causing the extensive tooth wear in some 20 of 151 individuals.