Eponyms and epilepsy (history of Eastern civilizations)
Janković, S.M.; Sokić, D.V.; Lević, Z.M.; Susić, V.; Drulović, J.; Stojsavljević, N.; Veskov, R.; Ivanus, J.
Srpski Arhiv Za Celokupno Lekarstvo 124(7-8): 217-221
1996
ISSN/ISBN: 0370-8179 PMID: 9102852 Document Number: 6715
The hystory of eponyms for epilepsy in the lands of the Eastern globe present the portrait of the attitudes of both the laymen and skilled people towards the disease and patient, as well as to the Nature itself. As opposed to the West which during the Middle ages changed its concepts of epilepsy as the organic brain disease for the sublime 'alchemic' position, the people of the East were more prone to consider from the beginning of their civilization till the XIX century that epilepsy is the consequence of the evanescent spiritual and extracorporal forces which by themselves were out of their reach. As compared to the western civilization, the historical resources are, often as a consequence of a linguistic barriers, more scarce as consequently is the number of eponyms, but are neverhtless picturesque. The medical science from Babylonian period presumed that epileptic manifestations are the consequence of the demonic or ill spiritual actions. There existed an attitude that at the beginning of an epileptic attack the patient was possessed by a demon (the Akkadic, i.e., Babylonian verb "sibtu" denoting epilepsy, had the meaning "to seize" or "to be obsessed"); at the end of the clonic phase the demon departed from the body. Different demons were responsible for different forms of epilepsy such as nocturnal and children epilepsy, absence epilepsy and pure convulsions, simple and complex automatisms, and gelastic epilepsy. Thus, the doctors from the period of Babylon aside from making primordial classification of epilepsies, knew about their clinical picture (prodromal symptoms and aura, Jackson's epilepsy, Todd's paralysis), postictal phenomena and intericatl emotional instability; provocative factors were also known (sleep deprivation, emotions, as well as alcohol, albeit in a negative sense as a cure for epilepsy). There is no doubt than in the period of Babylon the clinical picture of serial fits and its progress to status epilepticus were clearly recognized and considered as life threatening events. Persian history of epilepsy, except from the 6th century Zoroastrian "Avesta" document, lacks the written or spoken medical heritage untill the 7th century A.O. and the Arabic conquest of the entire Moslem world. On the other hand, Islamic medicine should be freed from the simple prejudice that the Moslem authors were only the translators of Greek medicine; contrary to such a view, their work contains a high degree of individuality. Although Mohammed introduced a lot of novelty into medicine, Khoran and the Sayings do not explicitly refer to epilepsy. Of importance is to notice that Moslem medicine did not have demons in the "repertoire" of direct causes of epilepsy. The causes and the cures of epilepsy were more magicmystical and occult in nature, which is reminiscent of the European, as well as Serbian Middle age attitudes. Avicenna recognized difference between children and adult epilepsy. He considered insomnia and afternoon siesta as well as intensive sounds and light to be a provocative factors, whereby we see that at least empirically he knew of sleep (deprivation), startle and reflex epilepsy. The XIII century invasion of Mongols brought about the recession in Moslem Medicine; it recovered only in the XVIII century under the strong influence of European medicine handed over to us through Jewish doctors of various nationalities. The story of the China history of epilepsy has its debut approximately in the 8th century B. C. Medical texts from this period name epilepsy "Dian" and "Xian" which meant "the falling sickness" and "convulsions", respectively. Chinese medical terminology often interchangeably used the words "mania", "madness" and "psychosis" for "epilepsy" which, aside from a prominent language barrier, brings additional confusion. Although Chinese documents gave the first description of the grand rnal epileptic attack already in the 8th century B. C., the descriptions that followed, albeit richer in details but also similar with the first one, hardly brought anything newer in delineation between different epileptic attacks. Only in the 15th century there is a description possibly referring to the complex partial attacks. One meets no description of absence epilepsy and it could be that they were classified as psychiatric entities, or simply were not recognized at all. However, as from the 7th century Chinese documents make difference between attacks starting prior to and after the 10th year of age. The names for epilepsy were based either on the a) presumed causes and clinical picture (five major types), b) "voices" that patient emitted during the attack, and c) names of visceral organ supposed to represent the cause of epilepsy (see table). Characteristic of the Chinese history of epilepsy is that there is no mention of the brain dysfunc tion as a possible cause of epilepsy; above classifications were based on the Chinese philosophy of medicine; lastly, Chinese traditional medicine classifications do not make difference between partial and generalized attacks until the beginning of this century. This lapidary portrayal covering the views of the Old Babylon that epilepsy comes from Heaven, over the sublime Persian concepts influenced by the works of the Old Greeks, up to the elementary Chinese views, shows that there exists a clear intellectual gradient ceaselessly biased with its rationality towards the Western, and its imaginativeness towards the Eastern civilization. Albeit basically hermeneutic, it gives an overview of the basic tenets of the Eastern esotericism in the field of epilepsy and should be of particular interest to younger readers.
Document emailed within 1 workday
