This document summarizes the life and illness of Vincent van Gogh based on previous studies. It describes his unstable moods and recurrent psychotic episodes in the last two years of his life. Van Gogh experienced two distinct episodes of depression earlier in life, followed by periods of high energy. While in Arles, France, his illness evolved and reached a psychotic dimension by the end of 1888, involving mood shifts, anxiety, and exhaustion. He was hospitalized after cutting off part of his earlobe and attacking his friend Paul Gauguin. His illness involved recurrent psychotic episodes, often precipitated by absinthe use, and he was ultimately diagnosed with epilepsy. He lived out his final year in an asylum at Saint
Anne Frank's diary chronicles her life from ages 13 to 15 while hiding from the Nazis in an attic in Amsterdam. She receives the diary as a gift on her 13th birthday and begins writing about her daily life, hopes, and struggles living in such close quarters with seven other people. As time passes, Anne matures and develops feelings for Peter Van Daan. However, the Secret Annex is eventually discovered and its occupants arrested. Anne's diary ends abruptly, and she dies in a concentration camp at age 15, though her diary is published after the war as a testament to her experience during the Holocaust.
The Diary of a Young Girl / The Diary of Anne FrankTechnoBoy5
Anne Frank's diary chronicles her life from ages 13 to 15 while hiding from the Nazis in an attic in Amsterdam. She receives the diary as a gift on her 13th birthday and begins writing about her daily life, hopes, and struggles living in such close quarters with seven other people. As time passes, Anne matures and develops feelings for Peter Van Daan. However, the Secret Annex is eventually discovered and its occupants arrested. Anne's diary ends abruptly, and she dies in a concentration camp at age 15, though her diary is published after the war as a testament to her experience during the Holocaust.
- Anne feels depressed and oppressed living in hiding in the Secret Annex. She has conflicts with her mother and feels her parents favor her sister Margot.
- The group living in hiding argue frequently about money, food, and safety. Mrs. van Daan is stubborn about selling her possessions for money.
- Anne finds some comfort in her budding friendship with Peter van Daan, as they discuss topics like sex and anatomy. However, she still dreams of her childhood friend Peter Schiff.
Irena Sendler was a Polish social worker who rescued 2,500 Jewish children from the Warsaw Ghetto during World War II. As a member of Zegota, a Polish underground organization, she used methods like coffins and ambulances to smuggle children out of the ghetto and placed them with Christian families and orphanages. Sendler was captured by Nazis in 1943, tortured, and sentenced to death but escaped. After the war, she was recognized for her heroism with awards from Israel, Poland, and others for saving children's lives at great personal risk during the Holocaust.
Jane Eyre is a novel by Charlotte Bronte published in 1847 under the pen name Currer Bell. It follows Jane Eyre, an intelligent but plain young girl who faces oppression and hardship. She meets Edward Rochester, her employer and master of Thornfield Hall, who is passionate but has a dark secret. Jane also encounters St. John Rivers and his sisters after fleeing Thornfield, who take her in but St. John is cold and ambitious. The mystery woman Bertha creates suspense and obstacles for Jane's happiness, representing fears of other cultures and the typical restricted Victorian wife.
This document provides an overview of the key characters in Anne Frank's diary. It describes Anne Frank, who wrote the diary from 1942 to 1944 while hiding from the Nazis in Amsterdam. It also describes her family members and the seven other people hiding with her, including the van Daans and Albert Dussel. Finally, it briefly mentions some of Anne's friends and acquaintances that she writes about. The document concisely introduces each character along with key biographical details and Anne's impressions of them from the diary.
Charlotte Brontë was born in Yorkshire, England in 1816. After being mistreated by her aunt as a child, she was sent to a harsh boarding school where her sisters died of tuberculosis. She later became a governess but disliked the work. She and her sisters published a book of poems under male pseudonyms which received little attention. Charlotte then wrote Jane Eyre, a Bildungsroman about the maturation and experiences of the title character. The plot follows Jane's development through various stages of her life, incorporating Gothic elements. The novel was highly successful and established Charlotte as a prominent author.
Anne Frank's diary chronicles her life from ages 13 to 15 while hiding from the Nazis in an attic in Amsterdam. She receives the diary as a gift on her 13th birthday and begins writing about her daily life, hopes, and struggles living in such close quarters with seven other people. As time passes, Anne matures and develops feelings for Peter Van Daan. However, the Secret Annex is eventually discovered and its occupants arrested. Anne's diary ends abruptly, and she dies in a concentration camp at age 15, though her diary is published after the war as a testament to her experience during the Holocaust.
The Diary of a Young Girl / The Diary of Anne FrankTechnoBoy5
Anne Frank's diary chronicles her life from ages 13 to 15 while hiding from the Nazis in an attic in Amsterdam. She receives the diary as a gift on her 13th birthday and begins writing about her daily life, hopes, and struggles living in such close quarters with seven other people. As time passes, Anne matures and develops feelings for Peter Van Daan. However, the Secret Annex is eventually discovered and its occupants arrested. Anne's diary ends abruptly, and she dies in a concentration camp at age 15, though her diary is published after the war as a testament to her experience during the Holocaust.
- Anne feels depressed and oppressed living in hiding in the Secret Annex. She has conflicts with her mother and feels her parents favor her sister Margot.
- The group living in hiding argue frequently about money, food, and safety. Mrs. van Daan is stubborn about selling her possessions for money.
- Anne finds some comfort in her budding friendship with Peter van Daan, as they discuss topics like sex and anatomy. However, she still dreams of her childhood friend Peter Schiff.
Irena Sendler was a Polish social worker who rescued 2,500 Jewish children from the Warsaw Ghetto during World War II. As a member of Zegota, a Polish underground organization, she used methods like coffins and ambulances to smuggle children out of the ghetto and placed them with Christian families and orphanages. Sendler was captured by Nazis in 1943, tortured, and sentenced to death but escaped. After the war, she was recognized for her heroism with awards from Israel, Poland, and others for saving children's lives at great personal risk during the Holocaust.
Jane Eyre is a novel by Charlotte Bronte published in 1847 under the pen name Currer Bell. It follows Jane Eyre, an intelligent but plain young girl who faces oppression and hardship. She meets Edward Rochester, her employer and master of Thornfield Hall, who is passionate but has a dark secret. Jane also encounters St. John Rivers and his sisters after fleeing Thornfield, who take her in but St. John is cold and ambitious. The mystery woman Bertha creates suspense and obstacles for Jane's happiness, representing fears of other cultures and the typical restricted Victorian wife.
This document provides an overview of the key characters in Anne Frank's diary. It describes Anne Frank, who wrote the diary from 1942 to 1944 while hiding from the Nazis in Amsterdam. It also describes her family members and the seven other people hiding with her, including the van Daans and Albert Dussel. Finally, it briefly mentions some of Anne's friends and acquaintances that she writes about. The document concisely introduces each character along with key biographical details and Anne's impressions of them from the diary.
Charlotte Brontë was born in Yorkshire, England in 1816. After being mistreated by her aunt as a child, she was sent to a harsh boarding school where her sisters died of tuberculosis. She later became a governess but disliked the work. She and her sisters published a book of poems under male pseudonyms which received little attention. Charlotte then wrote Jane Eyre, a Bildungsroman about the maturation and experiences of the title character. The plot follows Jane's development through various stages of her life, incorporating Gothic elements. The novel was highly successful and established Charlotte as a prominent author.
Charlotte Brontë was a 19th century English novelist best known for her novel Jane Eyre. She lost her mother at a young age and two of her sisters died from an illness contracted at their harsh boarding school. Brontë published Jane Eyre in 1847 under the gender-neutral pseudonym "Currer Bell" since women faced dismissal as writers at the time. Jane Eyre combines elements of a Gothic novel, romance, and Bildungsroman story about a woman's journey to independence. It was an immediate success and brought Brontë recognition in London literary circles. After losing all of her siblings, Brontë married a clergyman but died at the age of 38 after the birth of her first child
Sylvia Plath was a renowned American poet who struggled with depression for much of her life. She had a promising early academic career but began experiencing mental health issues in her 20s. Plath attempted suicide once and wrote about her experiences in her autobiographical novel The Bell Jar. She married fellow poet Ted Hughes but their relationship was turbulent and he eventually left her, which sent Plath into a deeper depression. In 1963, at age 30, Plath took her own life by placing her head in a gas oven, leaving behind a young family and a legacy as one of the most influential confessional poets of the 20th century.
Charlotte Bronte was born in 1816 in England. She studied at various schools as a child and later became a governess and teacher. She opened a school with her sister. Bronte published her famous novel Jane Eyre in 1847 under a male pseudonym, as female authors were not widely respected at the time. The novel reflects Bronte's experiences and the social injustices of the Victorian era in England, including the poor conditions of many schools. It tells the story of the orphan Jane Eyre and her relationship with Mr. Rochester, and was a great success. Unfortunately Bronte's personal life was marked by loss as many of her siblings died and her brief marriage ended with her early death in 1855.
1) Anne Frank was a German-Jewish teenager who was forced into hiding from the Nazis in Amsterdam during World War 2 along with her family and four others.
2) They lived in secret rooms above her father's office for over two years until they were discovered and deported to concentration camps.
3) Anne documented their time in hiding through her diary, which was published after her death in the Bergen-Belsen concentration camp at age 15 and has become one of the most widely read books in the world.
Maurice Sendak, artist and humanist, an expanded versionDave Shafer
A highly visual slideshow about the life and work of Maurice Sendak, with an emphasis on the roots of his art in the personality of his deeply unhappy man
Anne Frank was a young Jewish girl who lived in Germany and Amsterdam before going into hiding from the Nazis during World War II. She received a diary for her 13th birthday, where she documented her experiences living secretly with her family for over two years. Though Anne and her family were eventually discovered and died in concentration camps, her diary was published after the war and has inspired millions with her hopeful spirit and insights into life under Nazi occupation. Her diary is one of the most widely read books in the world and has helped shape understanding of the Holocaust.
Nora Ephron was a screenwriter, director, and author who came from a family of screenwriters, with both of her parents being successful Hollywood screenwriters in the 1940s-1950s. She grew up in an unconventional household for the time, with her mother Phoebe not adhering to traditional gender roles and focusing on her career over housework, which influenced Ephron to also pursue a career in writing and filmmaking. Throughout her life and career, Ephron drew inspiration from her family experiences and relationships, often turning personal material into her films, novels, and essays.
The document provides background information on Jane Eyre by Charlotte Bronte. It discusses how the novel is considered highly autobiographical and influenced by Bronte's own life experiences. Key elements of the Gothic novel are also examined, such as the haunted settings and supernatural occurrences. Symbols and themes in the novel like feminism, social class, religion, and search for identity and family are then outlined in more detail.
This document provides an autobiographical summary of Dr. Mark Vonnegut's lifelong experience with mental illness and his journey to becoming a physician. It describes his three psychotic breaks in early adulthood, treatment, and focus on writing which helped his recovery. It outlines his acceptance to medical school later in life, another breakdown, and realization that willpower alone does not determine recovery. Through treating patients and his own experiences, he now advocates for greater understanding and prevention of mental illness.
1. This document provides biographical information about the artist Vincent van Gogh, including details about his life, artistic development, and mental health struggles.
2. It describes how van Gogh grew up in a religious family in the Netherlands and worked as an art dealer before deciding to become an artist. He was influenced by the French Impressionists after moving to Paris in 1886.
3. The document highlights van Gogh's prolific yet short painting career from the 1880s until his death by suicide in 1890 at age 37. It provides context for some of his most famous paintings through summaries of where he was living and working at different points in his life.
Sylvia Plath wrote the poem "Daddy" shortly before her death by suicide in 1963. The poem uses the metaphor of a train journey to represent Plath working through her complex feelings about her father, who died when she was young, as well as her estranged husband, Ted Hughes. Through vivid, surreal imagery and references to death and World War 2, Plath conveys her deep-seated anger and desire to break free of the men who dominated her life. The intensely personal work is considered a prime example of confessional poetry and gives insight into Plath's inner psychological state near the end of her life.
Vincent van Gogh struggled with mental illness for many years, with theories that it was caused by conditions like schizophrenia, bipolar disorder, syphilis or epilepsy. He cut off his own ear lobe during an episode in 1888, though some believe it was an accident during a fight with fellow artist Paul Gauguin. Over his brief career he sold only one painting, but produced his finest work in the last three years of his life using expressive brushstrokes and symbolic colors in paintings like "The Potato Eaters". He died by suicide in 1890 at only 37 years old.
This document provides biographical information about Vincent Van Gogh and his development as an artist. It discusses that [1] Van Gogh was self-taught and experimented with black and white drawings before using color, [2] after moving to Paris in 1886 he was influenced by Impressionism and adopted brighter colors and looser techniques, and [3] in 1888 he suffered from mental illness which caused him to mutilate his ear and later commit himself to an asylum where he painted many works including Starry Night.
Friedrich Wilhelm Nietzsche was a German philosopher, writer, and philologist in the late 19th century whose work has profoundly influenced modern thought. He began his career as a classical philologist at a young age before turning to philosophy. His writing explored philosophical concepts like the Ubermensch and eternal return and critiqued religion, morality, and the "death of God." However, in 1889 at age 44, Nietzsche suffered a mental breakdown and lived his remaining years in an unsound mental state until his death in 1900.
Friedrich Wilhelm Nietzsche was a German philosopher, writer, and philologist in the late 19th century whose work has profoundly influenced modern thought. He began his career as a classical philologist at a young age before turning to philosophy. His writing explored philosophical concepts like the Ubermensch and eternal return and critiqued religion, morality, and the "death of God." Nietzsche suffered mental breakdown in 1889 at age 44 and lived his remaining years in an unsound mental state until his death in 1900. His work addressed cultural and philosophical issues through aphorisms and was influential though also controversial.
Friedrich Wilhelm Nietzsche was a German philosopher, writer, and philologist in the late 19th century whose work has profoundly influenced modern thought. He began his career as a classical philologist at a young age before turning to philosophy. His writing explored philosophical concepts like the Ubermensch and eternal return and critiqued religion, morality, and the "death of God." However, in 1889 at age 44, Nietzsche suffered a mental breakdown and lived his remaining years in an unsound mental state until his death in 1900.
Vincent Van Gogh was a post-Impressionist painter known for works like Starry Night. He painted from 1879 until his death in 1890 at age 37, producing over 2,000 works. Van Gogh struggled with mental illness throughout his life, which led to a botched suicide attempt and his eventual death. Despite selling only one painting during his lifetime, Van Gogh is now considered one of the most influential artists in modern art history.
Vincent Van Gogh was a Dutch post-impressionist painter born in 1853 who produced some of the most famous and influential artworks in Western culture. He struggled with mental illness and poverty throughout his life. As a young man he worked briefly as an art dealer but found his calling in painting in the 1880s. His vivid use of color and emotional depictions of rural life came to define his signature style. He had a close relationship with his brother Theo, who financially supported him. Though unsuccessful in his lifetime, Van Gogh is now regarded as one of history's greatest artists, known for paintings like The Starry Night and Sunflowers. He died by suicide in 1890 at the young age of 37.
The case of "Ellen West," reported by Ludwig Binswanger as the foundational case of "Daseinanalyse" or existential analysis, is revisited and shown to be a mirror of 20th century psychiatry’s core dilemmas
This document provides a summary of Ernest Hemingway's life and works, and how his physical and mental health issues impacted both. It discusses how Hemingway struggled with alcoholism, liver damage, head injuries from plane crashes, depression and possible bipolar disorder. His physical and mental health declined in his later years, which reduced his creative writing. The document also explores how Hemingway's family had a history of mental illness and suicide, and how reflecting on his own wounds and illnesses through fiction may have been a coping mechanism for Hemingway.
Charlotte Brontë was a 19th century English novelist best known for her novel Jane Eyre. She lost her mother at a young age and two of her sisters died from an illness contracted at their harsh boarding school. Brontë published Jane Eyre in 1847 under the gender-neutral pseudonym "Currer Bell" since women faced dismissal as writers at the time. Jane Eyre combines elements of a Gothic novel, romance, and Bildungsroman story about a woman's journey to independence. It was an immediate success and brought Brontë recognition in London literary circles. After losing all of her siblings, Brontë married a clergyman but died at the age of 38 after the birth of her first child
Sylvia Plath was a renowned American poet who struggled with depression for much of her life. She had a promising early academic career but began experiencing mental health issues in her 20s. Plath attempted suicide once and wrote about her experiences in her autobiographical novel The Bell Jar. She married fellow poet Ted Hughes but their relationship was turbulent and he eventually left her, which sent Plath into a deeper depression. In 1963, at age 30, Plath took her own life by placing her head in a gas oven, leaving behind a young family and a legacy as one of the most influential confessional poets of the 20th century.
Charlotte Bronte was born in 1816 in England. She studied at various schools as a child and later became a governess and teacher. She opened a school with her sister. Bronte published her famous novel Jane Eyre in 1847 under a male pseudonym, as female authors were not widely respected at the time. The novel reflects Bronte's experiences and the social injustices of the Victorian era in England, including the poor conditions of many schools. It tells the story of the orphan Jane Eyre and her relationship with Mr. Rochester, and was a great success. Unfortunately Bronte's personal life was marked by loss as many of her siblings died and her brief marriage ended with her early death in 1855.
1) Anne Frank was a German-Jewish teenager who was forced into hiding from the Nazis in Amsterdam during World War 2 along with her family and four others.
2) They lived in secret rooms above her father's office for over two years until they were discovered and deported to concentration camps.
3) Anne documented their time in hiding through her diary, which was published after her death in the Bergen-Belsen concentration camp at age 15 and has become one of the most widely read books in the world.
Maurice Sendak, artist and humanist, an expanded versionDave Shafer
A highly visual slideshow about the life and work of Maurice Sendak, with an emphasis on the roots of his art in the personality of his deeply unhappy man
Anne Frank was a young Jewish girl who lived in Germany and Amsterdam before going into hiding from the Nazis during World War II. She received a diary for her 13th birthday, where she documented her experiences living secretly with her family for over two years. Though Anne and her family were eventually discovered and died in concentration camps, her diary was published after the war and has inspired millions with her hopeful spirit and insights into life under Nazi occupation. Her diary is one of the most widely read books in the world and has helped shape understanding of the Holocaust.
Nora Ephron was a screenwriter, director, and author who came from a family of screenwriters, with both of her parents being successful Hollywood screenwriters in the 1940s-1950s. She grew up in an unconventional household for the time, with her mother Phoebe not adhering to traditional gender roles and focusing on her career over housework, which influenced Ephron to also pursue a career in writing and filmmaking. Throughout her life and career, Ephron drew inspiration from her family experiences and relationships, often turning personal material into her films, novels, and essays.
The document provides background information on Jane Eyre by Charlotte Bronte. It discusses how the novel is considered highly autobiographical and influenced by Bronte's own life experiences. Key elements of the Gothic novel are also examined, such as the haunted settings and supernatural occurrences. Symbols and themes in the novel like feminism, social class, religion, and search for identity and family are then outlined in more detail.
This document provides an autobiographical summary of Dr. Mark Vonnegut's lifelong experience with mental illness and his journey to becoming a physician. It describes his three psychotic breaks in early adulthood, treatment, and focus on writing which helped his recovery. It outlines his acceptance to medical school later in life, another breakdown, and realization that willpower alone does not determine recovery. Through treating patients and his own experiences, he now advocates for greater understanding and prevention of mental illness.
1. This document provides biographical information about the artist Vincent van Gogh, including details about his life, artistic development, and mental health struggles.
2. It describes how van Gogh grew up in a religious family in the Netherlands and worked as an art dealer before deciding to become an artist. He was influenced by the French Impressionists after moving to Paris in 1886.
3. The document highlights van Gogh's prolific yet short painting career from the 1880s until his death by suicide in 1890 at age 37. It provides context for some of his most famous paintings through summaries of where he was living and working at different points in his life.
Sylvia Plath wrote the poem "Daddy" shortly before her death by suicide in 1963. The poem uses the metaphor of a train journey to represent Plath working through her complex feelings about her father, who died when she was young, as well as her estranged husband, Ted Hughes. Through vivid, surreal imagery and references to death and World War 2, Plath conveys her deep-seated anger and desire to break free of the men who dominated her life. The intensely personal work is considered a prime example of confessional poetry and gives insight into Plath's inner psychological state near the end of her life.
Vincent van Gogh struggled with mental illness for many years, with theories that it was caused by conditions like schizophrenia, bipolar disorder, syphilis or epilepsy. He cut off his own ear lobe during an episode in 1888, though some believe it was an accident during a fight with fellow artist Paul Gauguin. Over his brief career he sold only one painting, but produced his finest work in the last three years of his life using expressive brushstrokes and symbolic colors in paintings like "The Potato Eaters". He died by suicide in 1890 at only 37 years old.
This document provides biographical information about Vincent Van Gogh and his development as an artist. It discusses that [1] Van Gogh was self-taught and experimented with black and white drawings before using color, [2] after moving to Paris in 1886 he was influenced by Impressionism and adopted brighter colors and looser techniques, and [3] in 1888 he suffered from mental illness which caused him to mutilate his ear and later commit himself to an asylum where he painted many works including Starry Night.
Friedrich Wilhelm Nietzsche was a German philosopher, writer, and philologist in the late 19th century whose work has profoundly influenced modern thought. He began his career as a classical philologist at a young age before turning to philosophy. His writing explored philosophical concepts like the Ubermensch and eternal return and critiqued religion, morality, and the "death of God." However, in 1889 at age 44, Nietzsche suffered a mental breakdown and lived his remaining years in an unsound mental state until his death in 1900.
Friedrich Wilhelm Nietzsche was a German philosopher, writer, and philologist in the late 19th century whose work has profoundly influenced modern thought. He began his career as a classical philologist at a young age before turning to philosophy. His writing explored philosophical concepts like the Ubermensch and eternal return and critiqued religion, morality, and the "death of God." Nietzsche suffered mental breakdown in 1889 at age 44 and lived his remaining years in an unsound mental state until his death in 1900. His work addressed cultural and philosophical issues through aphorisms and was influential though also controversial.
Friedrich Wilhelm Nietzsche was a German philosopher, writer, and philologist in the late 19th century whose work has profoundly influenced modern thought. He began his career as a classical philologist at a young age before turning to philosophy. His writing explored philosophical concepts like the Ubermensch and eternal return and critiqued religion, morality, and the "death of God." However, in 1889 at age 44, Nietzsche suffered a mental breakdown and lived his remaining years in an unsound mental state until his death in 1900.
Vincent Van Gogh was a post-Impressionist painter known for works like Starry Night. He painted from 1879 until his death in 1890 at age 37, producing over 2,000 works. Van Gogh struggled with mental illness throughout his life, which led to a botched suicide attempt and his eventual death. Despite selling only one painting during his lifetime, Van Gogh is now considered one of the most influential artists in modern art history.
Vincent Van Gogh was a Dutch post-impressionist painter born in 1853 who produced some of the most famous and influential artworks in Western culture. He struggled with mental illness and poverty throughout his life. As a young man he worked briefly as an art dealer but found his calling in painting in the 1880s. His vivid use of color and emotional depictions of rural life came to define his signature style. He had a close relationship with his brother Theo, who financially supported him. Though unsuccessful in his lifetime, Van Gogh is now regarded as one of history's greatest artists, known for paintings like The Starry Night and Sunflowers. He died by suicide in 1890 at the young age of 37.
The case of "Ellen West," reported by Ludwig Binswanger as the foundational case of "Daseinanalyse" or existential analysis, is revisited and shown to be a mirror of 20th century psychiatry’s core dilemmas
This document provides a summary of Ernest Hemingway's life and works, and how his physical and mental health issues impacted both. It discusses how Hemingway struggled with alcoholism, liver damage, head injuries from plane crashes, depression and possible bipolar disorder. His physical and mental health declined in his later years, which reduced his creative writing. The document also explores how Hemingway's family had a history of mental illness and suicide, and how reflecting on his own wounds and illnesses through fiction may have been a coping mechanism for Hemingway.
1) Arthur Schopenhauer was born in 1788 in Danzig and died in 1860 in Frankfurt am Main. He studied business and later philosophy.
2) In 1818, he published his major work The World as Will and Representation, which was not very successful. He later worked as a private tutor in Berlin but had few students.
3) Schopenhauer believed that the world is representation and phenomenon, but underneath is a constant will and desire that leads to suffering. His philosophy was therefore profoundly pessimistic about life and the world.
Este documento presenta los principios generales del diagnóstico dermatológico. Describe las características de la historia clínica dermatológica, incluyendo la anamnesis y el examen físico. También describe las diferentes lesiones elementales primarias y secundarias que se pueden observar, como máculas, pápulas, nódulos, vesículas, úlceras y escamas. Finalmente, menciona algunas pruebas complementarias útiles para el diagnóstico dermatológico como bi
El documento describe la historia y uso de la espirometría para evaluar patologías pulmonares como EPOC y asma. Explica cómo la espirometría mide el volumen espiratorio forzado en el primer segundo (FEV1) y la relación FEV1/FVC para diagnosticar obstrucción bronquial. También describe los patrones obstructivos, restrictivos y mixtos y cómo cuantificar la gravedad de cada patología. Finalmente presenta tres casos clínicos y sus conclusiones basadas en los resultados espirométricos.
Este documento describe varios síndromes neurológicos, incluyendo el síndrome de acroparestesias, el síndrome de Adie-Critchley, y el síndrome adverso. Describe los síntomas clínicos, la etiología y la patogénesis de cada uno. También incluye información sobre el síndrome de afasia de Broca, el síndrome de afasia de Wernicke y otros síndromes como el síndrome de agenesia del cuerpo calloso y el síndrome de Alexander.
La pandemia de COVID-19 ha tenido un impacto significativo en la economía mundial y las vidas de millones de personas. Muchos países han impuesto medidas de confinamiento que han cerrado negocios y escuelas. Aunque estas medidas han ayudado a reducir la propagación del virus, también han causado un aumento en el desempleo y la pobreza. Se necesitan esfuerzos globales coordinados para desarrollar tratamientos y vacunas contra el virus, y para reconstruir las economías a medida que la pandemia disminuya.
Gastrointestinal bleeding emerg med clin n am 2016cesar gaytan
This document discusses gastrointestinal bleeding (GIB), which leads to nearly 1 million hospitalizations annually in the US. It covers the epidemiology, risk factors, risk stratification, diagnostic modalities, and management of GIB. Upper GIB and lower GIB have different etiologies and treatments. Risk stratification is important to determine if patients require aggressive resuscitation or can be safely discharged. Comorbidities are a strong determinant of prognosis, as most GIB-related deaths are due to end-organ injury rather than blood loss.
This document provides a critical evaluation of laboratory tests used in the diagnosis and assessment of acute pancreatitis. It discusses the advantages and limitations of commonly used tests like serum amylase and lipase. While amylase remains an important initial test due to its availability and sensitivity, it lacks specificity. Lipase has greater sensitivity in alcoholic pancreatitis and late presentations, but can also be nonspecifically elevated. No single test can accurately diagnose, assess severity, or determine the etiology of acute pancreatitis. Multiple tests and factors like time of testing must be considered.
Este documento proporciona dosis pediátricas recomendadas para varios medicamentos, incluidos antibióticos, antiinflamatorios, analgésicos y otros. Para cada medicamento, se especifican las dosis recomendadas según la edad y el peso del niño, así como la presentación del medicamento. El documento busca ser una guía rápida para la dosificación pediátrica correcta de diferentes medicamentos comúnmente recetados.
This article discusses the diagnosis and treatment of Asperger's syndrome using the case of a 15-year-old male patient, Marc. It reviews the history and diagnostic criteria of Asperger's, compares it to high-functioning autism, examines comorbid conditions, and discusses evidence-based assessment and treatment recommendations. The key recommendations are for early diagnosis and intervention focusing on enhancing social skills through individualized education programs tapping into special interests.
This document provides a concise history of Asperger Syndrome, beginning with its origins and descriptions by Hans Asperger and Leo Kanner in the 1940s. It discusses how Asperger Syndrome was included as a diagnosis in the DSM-IV in 1994 but faced significant controversies regarding its diagnostic criteria and differentiation from autism. Specifically, the precedence given to an autism diagnosis and difficulties defining language and cognitive criteria meant that AS was nearly indistinguishable from high-functioning autism. This led the DSM-5 to remove AS as a separate diagnosis and merge it into the single category of Autism Spectrum Disorder. The document examines the debates around whether AS qualitatively differed from autism or was simply a
The document is the 5th edition of the Handbook of Transfusion Medicine edited by Dr Derek Norfolk and published by TSO for the United Kingdom Blood Services. It contains 12 chapters that provide guidance on various aspects of transfusion medicine including blood donation and testing, blood components, safe transfusion practices, adverse effects of transfusion, alternatives to transfusion, effective transfusion in different clinical settings such as surgery, critical care, medical patients, obstetrics and pediatrics. It also covers topics such as therapeutic apheresis, management of patients who refuse transfusion and appendices with references and acknowledgements.
El cáncer cervicouterino es un importante problema de salud mundial y la cuarta causa de cáncer más común en mujeres. Afecta principalmente a países en desarrollo y se debe principalmente a la infección por virus del papiloma humano, especialmente los tipos 16 y 18. Presenta mayor incidencia en mujeres de bajos recursos económicos y educativos.
El documento describe el proceso de hematopoyesis y la producción de eritrocitos. Específicamente, 1) la hematopoyesis comienza con células madre pluripotentes que se diferencian en varias líneas celulares incluyendo eritrocitos, 2) la eritropoyesis está regulada por la eritropoyetina que estimula la producción de eritrocitos, 3) los eritrocitos maduros transportan oxígeno y tienen un ciclo de vida de 100 a 120 días.
Este documento describe la fisiopatología de la ictericia. Explica que la bilirrubina se produce a partir del catabolismo del grupo heme y es transportada unida a albúmina en el plasma. En el hígado, la bilirrubina se conjuga con ácido glucurónico para convertirse en bilirrubina conjugada, que es soluble y no tóxica, pudiendo excretarse a través de la bilis. La ictericia se produce cuando los niveles de bilirrubina en sangre superan los límites normales, lo que le da
El documento describe la termorregulación en los animales homeotérmicos y homotérmicos. Explica que los animales homeotérmicos como los mamíferos y aves pueden regular internamente su temperatura corporal, mientras que la temperatura de los animales homotérmicos depende del ambiente. Además, detalla los mecanismos fisiológicos que permiten a los animales homeotérmicos mantener su temperatura constante a pesar de las variaciones en la temperatura ambiental, como la producción y disipación controlada del calor.
Este documento presenta información sobre diferentes tipos de fármacos vasodilatadores, incluyendo nitratos, nitroprusiato, inhibidores de la fosfodiesterasa-5 como sildenafil, y agonistas de canales de potasio como diazóxido y minoxidil. También discute casos clínicos en los que se podrían usar estos medicamentos para tratar hipertensión de emergencia y otras afecciones.
El documento describe la insuficiencia cardiaca, definiéndola como la incapacidad del corazón para bombear suficiente sangre para satisfacer las necesidades metabólicas del organismo. Explica que su fisiopatología depende de la enfermedad de base y enumera factores de riesgo como la hipertensión arterial, diabetes y obesidad. Finalmente, presenta un caso clínico de un paciente con insuficiencia cardiaca crónica probablemente causada por su etilismo.
Este documento resume diferentes tipos de tumores del intestino delgado, incluyendo tumores benignos, adenocarcinomas, linfomas y sarcomas. Describe sus síntomas, métodos de diagnóstico y tratamiento. También cubre pólipos intestinales, incluyendo adenomas, hiperplásicos y síndromes de poliposis como la poliposis adenomatosa familiar y el síndrome de Turcot.
Este documento presenta información sobre diferentes tipos de diuréticos. Brevemente describe: 1) Los diuréticos de asa como furosemida y bumetanida que actúan inhibiendo el cotransportador Na-K-2Cl en el asa de Henle; 2) Los diuréticos tiazídicos como hidroclorotiazida que inhiben la reabsorción de sodio y cloro en el túbulo contorneado distal; 3) Los ahorradores de potasio como amilorida y triamtereno que inhiben el intercambiador
Este documento describe las dislipidemias, trastornos caracterizados por un aumento de colesterol o triglicéridos en la sangre. Define las dislipidemias y explica que pueden causar xantomas, aterosclerosis y un aumento del riesgo cardiovascular, excepto la anemia. Además, describe la epidemiología de la aterosclerosis y los objetivos del tratamiento farmacológico de las dislipidemias.
El documento trata sobre tumores del SNC en adultos. Describe que existen una gran variedad de tumores primarios y secundarios en el SNC, siendo los tumores secundarios más frecuentes en adultos el cáncer de mama, pulmón, melanoma y renal. Además, explica que los glioblastomas son tumores primarios altamente malignos del SNC que representan alrededor del 20% de todos los tumores intracraneales. Finalmente, señala que el tratamiento de los glioblastomas incluye cirugía, corticoesteroides, quimiot
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
the illness of vincenct van gogh
1. Am J Psychiatry 159:4, April 2002 519
Reviews and Overviews
The Illness of Vincent van Gogh
Dietrich Blumer, M.D. Vincent van Gogh (1853–1890) had an ec-
centric personality and unstable moods,
suffered from recurrent psychotic epi-
sodes during the last 2 years of his ex-
traordinary life, and committed suicide at
the age of 37. Despite limited evidence,
well over 150 physicians have ventured a
perplexing variety of diagnoses of his ill-
ness. Henri Gastaut, in a study of the art-
ist’s life and medical history published in
1956, identified van Gogh’s major illness
during the last 2 years of his life as tempo-
ral lobe epilepsy precipitated by the use
of absinthe in the presence of an early
limbic lesion. In essence, Gastaut con-
firmed the diagnosis originally made by
the French physicians who had treated
van Gogh. However, van Gogh had earlier
suffered two distinct episodes of reactive
depression, and there are clearly bipolar
aspects to his history. Both episodes of de-
pression were followed by sustained peri-
ods of increasingly high energy and en-
thusiasm, first as an evangelist and then
as an artist. The highlights of van Gogh’s
life and letters are reviewed and dis-
cussed in an effort toward better under-
standing of the complexity of his illness.
(Am J Psychiatry 2002; 159:519–526)
Vincent van Gogh’s life has become a legend. Within the
short span of 10 years, he persevered to overcome many
struggles and failures to accomplish, through often fever-
ish but always disciplined efforts, his goal to create excep-
tional works of art for the people. This study of the illness
of Vincent van Gogh is based chiefly on Gastaut’s article on
the topic (1), monographs about the artist (2–4), and van
Gogh’s own letters (5, 6).
The Life of van Gogh
Origins
Vincent van Gogh’s ancestry includes Dutch preachers,
art dealers, and artisans. Both his father and paternal
grandfather were preachers; his paternal great-grandfather
was a gold wiredrawer who also was a catechism teacher.
No incidences of mental illness are recorded among van
Gogh’s ancestors. His mother married at the age of 31, had
a stillborn first son, and 1 year later gave birth to Vincent.
Vincent was a moody child, self-willed, and often annoy-
ing. At the age of 12, he was sent to a boarding school for
the next 4 years. A photograph of Vincent as an adolescent
and later self-portraits suggest a significant craniofacial
asymmetry. Gastaut (1) submitted that this physical fea-
ture and early temperamental changes suggest that Vin-
cent had suffered an early brain injury, probably at birth.
His intense emotionality, which was evident early and be-
came frequently unbearable in his adult life, is set forth in
his own statement: “I am a man of passion, capable and
prone to undertake more or less foolish things which I hap-
pen to repent more or less” (3).
Vincent had five younger siblings, three sisters and two
brothers. The steadfast support of his brother Theo made
Vincent’s work possible; Theo died 6 months after Vin-
cent’s suicide. After a failed marriage, Cornelis, the young-
est sibling, enlisted as a volunteer in the Boer army in
South Africa; he may have committed suicide or been
killed in battle. The youngest sister, Wilhelmina, to whom
Vincent wrote a series of letters, was interned in a psychi-
atric asylum at the age of about 35, a few years after Vin-
cent’s death; she was said to suffer from schizophrenia and
died in the asylum at the age of 79. His mother, with whom
Vincent exchanged occasional letters, lived to the age of
87, surviving not only her husband but all of her sons. Her
three sons all died in their 30s, while the three daughters
lived into their 70s.
Failed Careers and Beginnings as an Artist
At the age of 16, Vincent began to work as an apprentice
for an art dealer in a firm founded by an uncle. After 4
years near his family in The Hague, he was transferred to
London, where he stayed for 2 years. During that time, he
suffered a severe disappointment in his first amorous in-
fatuation and became deeply depressed. For months he
remained gloomy, renounced any social life, and commu-
nicated little with his family. His thoughts turned increas-
ingly toward religion. As he became more passionately in-
volved in religion, he lost all interest in his job as an art
dealer, the financial aspects of which he disdained, and
was dismissed by his firm. He devoted the next 4 years to
his calling as a preacher. He failed to obtain a formal theol-
ogy degree and eventually worked as an evangelist in a
miserably poor mining district in Belgium. There, he
shared his last belongings with his brethren and soon
looked dirt poor and black faced himself. His extreme
charitable behavior was viewed by his superiors as incom-
patible with the dignity of an ecclesiastic position. When
he refused to moderate his deportment, van Gogh was dis-
2. 520 Am J Psychiatry 159:4, April 2002
ILLNESS OF VAN GOGH
missed by the church; he again suffered a marked depres-
sion. To the great distress of his parents, he abandoned the
religious beliefs that had sustained him and began to ad-
here to socialist ideals and agnostic views. “Though I have
changed, I am the same,” he wrote in a letter to Theo (6).
“My only anxiety is, how can I be of use in the world?” At
the age of 27, he resolved to become an artist with the pas-
sion to produce works of art for the people.
Largely on his own, van Gogh pursued his new career
with singular intensity. He was able to persevere in spite of
lack of recognition, thanks to the unfailing financial and
moral support from his brother Theo, who had become an
art dealer in Paris. The life of van Gogh is well documented
through a steady flow of letters to Theo (5) and others (6).
He experienced his second passionate and ill-fated infatu-
ation with an ardent and incredibly stubborn pursuit of
his recently widowed cousin Kee, who scorned him. He
then alienated most of his family by living with a prostitute
and her two children for over a year. Theo warned Vincent
that their father planned to put him in a lunatic asylum.
After he returned to live with his parents for a period, Vin-
cent and his father quarreled frequently and violently. He
painted Still Life With Bible, in which next to an open bible
was the novel La Joie de Vivre, written by the socialist and
agnostic Emile Zola. In 1885, his father died suddenly at
the door of their home when returning from a walk. Vin-
cent’s devotion to art remained intense all the while.
Paris: Onset of Illness
After 6 years as an artist in the Netherlands and Bel-
gium, Vincent joined Theo in Paris for 2 years (1886–1888).
There he met many painters who were to become famous,
Paul Gauguin among them, and was strongly influenced
by the impressionist movement. While in Paris, he began
to suffer from minor paroxysms consisting of episodes of
sudden terror, peculiar epigastric sensations, and lapses
of consciousness. Observers reported occasions of an ini-
tial tonic spasm of the hand and a peculiar stare, followed
by a confusional-amnestic phase. His use of absinthe, an
alcoholic beverage with convulsant properties favored by
French artists, appears to have played a crucial role in the
precipitation of van Gogh’s illness. He tended to be untidy
and quarrelsome; his irascible temper caused many un-
pleasant scenes and rendered him an undesirable in a
number of places. He lived with his brother and often kept
him up much of the night with endless disputes. Theo re-
mained sympathetic, yet increasingly felt his brother’s
presence a burden. Theo described Vincent in a letter to
their younger sister as follows: “It seems as if he were two
persons: one, marvelously gifted, tender and refined, the
other, egotistic and hard hearted. They present themselves
in turns, so that one hears him talk first in one way, then in
the other, and always with arguments on both sides. It is a
pity that he is his own enemy, for he makes life hard not
only for others but also for himself” (3). All along, Vincent
persisted in perfecting his art.
Provence: A Major Illness Unfolds
When van Gogh left for Arles in southern France early in
1888, he was an accomplished artist, although not recog-
nized and still dependent on regular financial support
from Theo, who believed in his genius. He would now cre-
ate perhaps the most intense paintings ever produced; yet
in Arles his illness evolved and reached psychotic dimen-
sions for the first time before the end of 1888.
Vincent wrote after his arrival in Arles, “I was surely
about to suffer a stroke when I left Paris. It affected me
quite a bit when I had stopped drinking and smoking so
much, and as I began to think instead of knocking the
thoughts from my head. Good heavens, what despair and
how much fatigue I felt at that time” (5). Yet he soon re-
sumed his former habits of using absinthe and cognac. He
explained in a letter how he was coping with his state of
heightened emotionality: instead of thinking of disastrous
possibilities, he would throw himself completely into his
work, and “if the storm within gets too loud, I take a glass
more to stun myself” (5). He became more disturbed. Fe-
verish creative activity alternated with episodes of listless-
ness to the point of exhaustion. Unpredictable mood
shifts of dysphoria alternating with euphoria or with “in-
describable anguish” became more frequent. Excerpts of
letters written after his first breakdown best document his
mental states that before had been present to a lesser de-
gree. “I am unable to describe exactly what is the matter
with me; now and then there are horrible fits of anxiety,
apparently without cause, or otherwise a feeling of empti-
ness and fatigue in the head.…and at times I have attacks
of melancholy and of atrocious remorse” (6). “There are
moments when I am twisted by enthusiasm or madness or
prophecy, like a Greek oracle on the tripod. And then I
have great readiness of speech” (5). He became more
prone to violent rages and noticed an increasing lack of
sexual arousal. He frequently complained of feeling faint
and of having “poor circulation” and a “weak stomach.” He
continued to write to Theo, often daily, reporting on the
creation of his works in precise detail. And he kept paint-
ing. When he announced to Theo his first painting of a
starry night, he wrote, “It is good for me to work hard. But
that does not keep me from having a terrible need of—
shall I say the word—yes, of religion. Then I go out at night
to paint the stars” (6). Indeed, in a zeal reminiscent of his
selfless efforts as an evangelist, he relentlessly devoted
himself to create works of art for the people.
Vincent felt lonely in Arles and with Theo’s help per-
suaded Gauguin to join him in the fall of 1888 to establish
together a “Studio of the South.” The relationship of the
two artists became increasingly quarrelsome, and Vincent
wrote, “Our dispute is at times excessively animated like
with electricity, at times we end up with tired and empty
heads, like an electric battery after discharge” (5). Gau-
guin’s visit lasted only 2 months and ended in catastrophe.
On Christmas Eve 1888, after Gauguin already had an-
nounced he would leave, van Gogh suddenly threw a glass
3. Am J Psychiatry 159:4, April 2002 521
DIETRICH BLUMER
of absinthe in Gauguin’s face, then was brought home and
put to bed by his companion. A bizarre sequence of events
ensued. When Gauguin left their house, van Gogh fol-
lowed and approached him with an open razor, was re-
pelled, went home, and cut off part of his left earlobe,
which he then presented to Rachel, his favorite prostitute.
The police were alerted; he was found unconscious at his
home and was hospitalized. There he lapsed into an acute
psychotic state with agitation, hallucinations, and delu-
sions that required 3 days of solitary confinement. He re-
tained no memory of his attacks on Gauguin, the self-mu-
tilation, or the early part of his stay at the hospital.
His murderous gesture directed against Gauguin was re-
ported by the intended victim in his memoirs. The scan-
dalous event in the house of prostitution and van Gogh’s
subsequent hospitalization were recorded in the local
press. Some plausible explanations later were offered for
the strange happenings. Already psychotic, van Gogh may
have carried out the attack on Gauguin driven by halluci-
natory command voices and may have cut off part of his
own ear in self-punishment for his offensive voices. This
psychotic logic was perhaps influenced by van Gogh’s
knowledge of the bullfight ritual, in which the matador
presents a cut-off ear of the killed bull to a fair lady of his
choice.
At the hospital, Felix Rey, the young physician attending
van Gogh, diagnosed epilepsy and prescribed potassium
bromide. Within days, van Gogh recovered from the psy-
chotic state. About 3 weeks after admission, he was able to
paint Self-Portrait With Bandaged Ear and Pipe, which
shows him in serene composure. At the time of recovery
and during the following weeks, he described his own
mental state in letters to Theo and his sister Wilhelmina:
“The intolerable hallucinations have ceased, in fact have
diminished to a simple nightmare, as a result of taking po-
tassium bromide, I believe.” “I am rather well just now, ex-
cept for a certain undercurrent of vague sadness difficult to
explain.” “While I am absolutely calm at the present mo-
ment, I may easily relapse into a state of overexcitement on
account of fresh mental emotion.” He also noted “three
fainting fits without any plausible reason, and without re-
taining the slightest remembrance of what I felt” (5, 6).
After 2 weeks in the hospital, van Gogh was still followed
by Dr. Rey but evidently was not sufficiently warned to ab-
stain from absinthe. He suffered another two psychotic
episodes with brief hospitalizations. Following the humil-
iation of being taunted publicly by juveniles and confined
to the hospital for the fourth time upon the demand of
concerned citizens, van Gogh voluntarily entered the asy-
lum at Saint-Rémy in May 1889. During the full year he re-
mained there, he experienced three psychotic relapses
with prominent amnesia, at least twice upon leaves to
Arles with resumption of his use of absinthe in the com-
pany of old friends and Rachel. Dr. Peyron, an old-fash-
ioned physician who had served in the French navy, was
the medical director at Saint-Rémy; he maintained Dr.
Rey’s diagnosis of epilepsy but failed to continue treat-
ment with potassium bromide. The last psychotic episode
was the most protracted, lasting from February to April
1890; van Gogh experienced terrifying hallucinations and
severe agitation. Upon recovery, he complained bitterly of
the religious content of his episodes and wished to get
away from the nuns who cared for him. While at Saint-
Rémy, he produced some 300 works of art, among them
several copies of religious scenes by older masters and the
transcendental masterpiece Starry Night, which was
painted in June 1889.
Auvers: The Suicide
Theo became engaged toward the end of 1888, married
4 months later, and became a father in early 1890. Each
event coincided with an exacerbation of van Gogh’s condi-
tion; he may have been drinking more whenever he felt
that his unique bond with Theo was threatened. Shortly
before entering the asylum at Saint-Rémy, Vincent had
written to his brother, “And without your friendship I
would be driven to suicide without pangs of conscience—
and as cowardly as I am, I would finally do it” (6). Theo had
continued to support his brother without fail. Suicidal ges-
tures by Vincent, reported at the time of his initial hospi-
talization in Arles and during his stay at the asylum, had
consisted of ingesting turpentine, paint, or lamp oil and
were carried out in a confusional state. Such an episode
was described by the painter Signac (who had been per-
mitted to take van Gogh from the hospital in Arles to visit
his studio). Signac described van Gogh as being entirely
rational until after suffering a minor attack, at which point
he put a bottle of turpentine to his mouth and had to be
brought back to the hospital.
At discharge from the asylum in May 1890, van Gogh was
judged cured by his physician. The artist then moved north
of Paris to Auvers-sur-Oise, where he spent the last 10
weeks of his life. Theo had recommended Auvers, where
van Gogh could live near Paul Gachet, a physician and
friend of the artists. He abstained from drinking by now
and remained free from seizures and confusional episodes.
His art was beginning to gain recognition, and a painting
had been sold. But further financial support became un-
certain as Theo’s health began to fail. There were some bit-
ter words between the brothers, and Vincent felt himself to
be a burden. Still, he worked at a furious pace, completing
70 paintings and 30 drawings during his 70 days at Auvers.
The heavenly bodies, so luminous in the past, now were
absent from his skies, except for a single peculiar occasion
(The White House at Night With Figures and a Star). He
painted immense fields of wheat under dark and stormy
skies, commenting, “It is not difficult to express here my
entire sadness and extreme loneliness” (6). In one of his
last paintings, Wheat Field With Crows, the black birds fly
in a starless sky, and three paths lead nowhere. He bor-
rowed a gun from his innkeeper “to scare the crows away”
when he was painting. There still was another episode of
4. 522 Am J Psychiatry 159:4, April 2002
ILLNESS OF VAN GOGH
fury directed at Dr. Gachet, who had failed to frame a paint-
ing by Guillaumain as van Gogh had demanded. Vincent
gestured toward the gun in his pocket, but he walked away.
In his last letter sent to Theo, he mentioned that he wanted
to replenish his stock of paint and asked for help to this
end. Three days later, on a Sunday, Vincent shot himself in
the lower chest or upper belly in a field outside Auvers. “I
couldn’t stick it any longer, so I shot myself,” he told a
friend (3). He died 2 days later with Theo next to him. It has
been assumed that his Field With Stacks of Wheat, a bright
picture of grain harvested and sheaved, may have been his
very last—a symbol of work completed (3).
Theo died 6 months after his brother, reportedly from a
kidney disease with uremia and a prolonged delirious
state. His widow made sure the treasure of art Theo had
collected from Vincent and kept mostly unframed in their
home was passed on to posterity. Within a few years after
his death, Vincent van Gogh was acknowledged as one of
the famous artists of modern times.
Epilogue
An analysis of van Gogh’s illness and emotionality must
not obscure the fact that the great artist also had great
strengths (4). Apart from distinct episodes of madness
when he used absinthe and had seizures, he maintained a
remarkable degree of lucidity during his stormy life, as is
well documented in his letters.
Vincent remained marvelously creative until his death.
He did not paint during his major crises except during the
last prolonged episode at Saint-Rémy. There he painted,
before full recovery, a few canvases from memory, which
he referred to as “reminiscences of the North.” Jan Hulsker
(3) pointed out that these paintings are the only works of
his entire voluminous oeuvre to show signs of a transient
mental collapse.
Almost invariably, van Gogh drew and painted from na-
ture. The influence of his exceptional emotional and spiri-
tual intensity on his art is most evident when van Gogh de-
viated from the depiction of natural scenes, particularly in
the rendering of the sky, in several of his masterpieces. He
had confessed to a “terrible need for religion” when he
painted his first picture of a starry night (over the river
Rhone) in September 1888. Starry Night, painted in June
1889 at Saint-Rémy, is undoubtedly van Gogh’s most mys-
terious picture. The artist, usually so verbal, never re-
vealed the origin of his scene of a spectacularly transfig-
ured sky. Tralbaut (2) commented on Starry Night, “The
fire that smoldered within him and broke out in hallucina-
tions of the senses has here been set down on canvas in a
most striking fashion.” With this painting, van Gogh may
have immortalized his memory of a particularly haunting
and perhaps recurrent vision of apocalyptic dimension ex-
perienced during a twilight state. The vision is set in the fa-
miliar surroundings of the soft hills and flame-shaped cy-
presses of Provence, and yet the village with its church
spire is reminiscent of van Gogh’s native Brabant. He
seems to be telling us, “This is where I come from, this is
where I am now, and here is my universe of overpowering
storms.”
Discussion
The illness of van Gogh has perplexed 20th-century
physicians, as is evident from the nearly 30 different diag-
noses that have been offered, from lead poisoning or
Ménière’s disease to a wide variety of psychiatric disor-
ders. Many writers have acknowledged the epilepsy but
considered the psychiatric disorder an independent men-
tal illness. Monroe (7, 8) recognized the unique episodicity
of van Gogh’s mental changes, the role of absinthe in his
illness, and an underlying epileptoid limbic dysfunction
that was associated with his creativity but also, if overly in-
tense, would render him ill. Earlier, in an exceptionally
well-documented study, Gastaut (1) reasoned that the art-
ist’s psychiatric changes were based on temporal lobe epi-
lepsy produced by the use of absinthe in the presence of
an early limbic lesion.
Earlier in his life, van Gogh experienced two prolonged
episodes of reactive depression. Both episodes were fol-
lowed by a prolonged period of hypomanic or even manic
behavior: first as evangelist to the poor miners in Belgium
and then as the quarrelsome and overly talkative artist in
exciting Paris. The major illness of his last 2 years devel-
oped in the presence of seizures, and its nature has re-
mained controversial. The known details of his psychiatric
illness will be reviewed together with what is known about
the psychopathology of individuals with epilepsy, and dif-
ferential diagnostic considerations will follow.
Views of Gastaut and the Earlier
French Physicians
Felix Rey, the young physician who attended van Gogh
in Arles and diagnosed his epilepsy, was familiar with the
psychiatric aspects of epilepsy as they were taught in
France during the second half of the 19th century. In fact,
Aussoleil, a medical school companion of Felix Rey, wrote
a dissertation on larvate epilepsy and worked nearby
when van Gogh was admitted to the hospital in Arles (1).
In 1860, Morel (9) listed the symptoms that were to be so
prominent in van Gogh’s illness:
Under the term larvate epilepsy I have described a vari-
ant of epilepsy which does not reveal itself by the actual
minor or major attacks, but on the contrary by all the
other symptoms which accompany or precede ordinary
epilepsy characterized by seizures, that is: periodic al-
ternation of excitement and depression; manifestations
as it were of sudden fury without sufficient grounds and
for most trivial reasons; a usually most irritable disposi-
tion; amnesia, as usually occurs in epilepsy, of danger-
ous acts carried out during momentary or transient
rages. Some epileptics of this type have even experi-
enced genuine auditory and visual hallucinations.
5. Am J Psychiatry 159:4, April 2002 523
DIETRICH BLUMER
Morel had already recognized the highly conscientious
(hypersocial) disposition of such patients that contrasted
strikingly with their proneness to outbursts of violent
anger.
Gastaut (10) pointed out that premodern psychiatrists
who had studied institutionalized patients with epilepsy
chiefly had observed individuals with mesial temporal
sclerosis, as documented by their neuropathologic stud-
ies. His findings linked premodern psychiatric views of ep-
ilepsy to modern epileptology. Gastaut published his
study of van Gogh in 1956, after he had conducted a series
of investigations on carefully selected groups of patients
with different forms of epilepsy. He documented that cer-
tain behavioral and emotional changes among patients
with epilepsy were specifically related to mesial (limbic)
temporal lobe epilepsy: episodic irritability contrasting
with an otherwise hypersocial disposition, slow-adhesive
(viscous) personality traits, and a global hyposexuality
(11–13). This temporal lobe syndrome associated with ep-
ilepsy was manifest in van Gogh.
Gastaut pointed out that the three major interictal be-
havior changes of patients with mesial temporal lobe epi-
lepsy—heightened emotionality (with enhanced anger,
moods, and fear), viscosity (adhesiveness), and hyposexu-
ality—represent the very opposites of the Klüver-Bucy
syndrome observed after bilateral temporal lobe resec-
tions in animal experiments—placidity, flighty attention
span, and hypersexuality (14, 15). He noted that this was
not a surprising finding considering that interictally, be-
cause of the effects of the irritative lesion, patients with
temporal lobe epilepsy present a state of excitation of the
temporal limbic system as opposed to a state of depres-
sion after the ablation experiment. While viscosity and hy-
posexuality tend to be relatively persistent, the heightened
emotionality tends to appear in a highly labile or alternat-
ing pattern.
Gastaut recognized the crucial role of absinthe in the
manifestation of van Gogh’s major psychiatric symptoms.
By his own confession, van Gogh required “a glass too
much” to numb his inner storms when they became too
intense. The artist was not known to become intoxicated
and may not have been drinking more than many of his
contemporaries, but he was particularly vulnerable to the
epileptogenic properties of absinthe, the favorite drink of
the French artists of his time. Oil of wormwood (from the
herb Artemisia absinthium) constitutes the toxic principle
of the alcoholic drink absinthe. Wormwood oil contains
the terpene compound thujone, a structural isomer of
camphor. Both thujone and camphor induce convulsions
and were used during the 1920s and 1930s in the study of
models for epilepsy; von Meduna considered the use of
thujone for the convulsive therapy of schizophrenia before
using camphor (16, 17). In 1873, Magnan (18) described
for the first time what he termed épilepsie absinthique,
and later neurologic textbooks of the period referred to the
relationship of absinthe and epilepsy. In the early part of
the 20th century, absinthe became outlawed in most
countries because of its psychotoxic effects.
During his stay in Paris, where he was introduced to ab-
sinthe, van Gogh developed complex partial seizures with
gradual accentuation of partially preexisting emotional
and behavioral changes. In most patients with temporal
lobe epilepsy, psychiatric changes tend to occur only grad-
ually and in a less violent form. In van Gogh, perhaps be-
cause of an early temporal-limbic lesion, these changes
became fully evident soon, characterized by heightened
emotionality with the opposite poles of irritability and hy-
perethical or hyperreligious trends, by meticulous atten-
tion to detail and stubborn persistence in speech and writ-
ing (viscosity), and by hyposexuality (11–13). His seizures
and his psychotic episodes were precipitated by the use of
absinthe and stopped once he abstained.
Modern Concepts of the Neuropsychiatric
Disorders of Epilepsy
The presence of seizures, the intermittent and pleomor-
phic symptoms of the interictal phase, the prolonged am-
nestic-confusional psychotic episodes at the height of van
Gogh’s illness, and, finally, the profile of his personality
traits all suggest a diagnosis of epilepsy-related illness.
While in Arles, van Gogh developed an interictal dys-
phoric disorder with the near complete range of its inter-
mittent and pleomorphic (affective-somatoform) symp-
toms: irritability, depressive and euphoric moods, anxiety,
anergia, insomnia, and pains. The artist probably also had
a fear of heights, but phobic symptoms cannot be consid-
ered a well-established symptom of dysphoric disorder.
Interictal dysphoric disorder was well recognized by pre-
modern psychiatrists from the German language area as
the most common psychiatric disorder (Verstimmungs-
zustand) associated with epilepsy (19, 20). The validity
and the importance of this diagnostic concept have been
affirmed (21–24). At least three of its seven symptoms
need to be present, each to a troublesome degree, to meet
the diagnostic criteria for interictal dysphoric disorder. In
his letters, van Gogh referred to his dysphoric symptoms
as “attacks of melancholy,” “moments of enthusiasm or
madness,” “fits of anxiety,” or a transient “feeling of empti-
ness and fatigue,” rendering a lucid picture of highly epi-
sodic mental states that clearly are more intermittent and
pleomorphic than those experienced by an individual
with the more sustained mood changes of manic-depres-
sive illness. He also reported insomnia and stomach pains
but was not outspoken about his frightening outbursts of
rage, which were well documented by Gauguin and many
others. While his stomach pains are of uncertain origin,
van Gogh clearly reported six of the seven cardinal symp-
toms of interictal dysphoric disorder.
Interictal dysphoric disorder, not recognized in its en-
tirety by Gastaut, represents a refinement of the descrip-
tion by early French psychiatrists that included only the
most striking features of the disorder: periodic alternation
6. 524 Am J Psychiatry 159:4, April 2002
ILLNESS OF VAN GOGH
of excitement and depression and episodes of fury (9). The
validity of interictal dysphoric disorder as a diagnostic en-
tity is confirmed by its specific etiology, phenomenology,
course, and its response to specific psychotropic medi-
cation (24, 25). The disorder tends to appear interictally
during predominance of seizure-suppressing inhibitory
mechanisms. This phenomenon was termed “forced nor-
malization” by Landolt, who observed that dysphoric
moods, as well as psychotic episodes, tend to be associated
with EEG normalization (26, 27). Dysphoric symptoms
also tend to be present in the prodromal and particularly in
the postictal phase, when they seem to result from the
acute engagement of inhibitory responses at the time of
seizure events. It is assumed that still poorly defined inhib-
itory mechanisms exert psychotoxic effects in both the in-
terictal and the peri-ictal phases of epilepsy (23, 24).
Severe dysphoric disorders may become readily associ-
ated with psychotic symptoms (19, 20, 28). At the height of
his illness, van Gogh became hallucinatory, paranoid, and
delusional with confusional-amnestic features, all known
to occur in psychosis due to epilepsy. Psychosis due to ep-
ilepsy may follow a flurry of seizures (i.e., postictal psycho-
sis), appearing often but not invariably with amnestic-
confusional features. Alternatively, the psychosis may oc-
cur during the interictal phase, in the absence of clouded
consciousness, particularly when seizure activity has be-
come suppressed. In both instances, psychosis, like the
dysphoric symptoms, seems to result from excessive in-
hibitory activity that has become either acutely engaged in
the postictal phase by the preceding seizure activity or
predominant in the interictal phase. A third type of epi-
lepsy-associated psychosis, termed para-ictal psychosis
(29), occurs with ongoing frequent seizure activity and
combines features of both the postictal and the interictal
psychoses; this type of psychosis is now rare because of
the advent of effective antiepileptic medication. The
psychotic symptoms seen in van Gogh apparently were
precipitated by the epileptogenic absinthe, but no modern
experience with this substance exists. From what is known,
his psychotic episodes neither followed a flurry of seizures
nor occurred at times when his seizures had diminished,
and his prolonged psychotic episodes may be best classi-
fied as para-ictal. While interictal psychoses require psy-
chotropic medication, para-ictal psychoses respond to
improved antiepileptic medication (28), and van Gogh
was probably correct when he recognized a beneficial ef-
fect on his psychosis from Dr. Rey’s prescription of potas-
sium bromide. Recurrences followed the initial episode,
when he relapsed into using absinthe, and were perhaps
more prolonged when he was not treated with potassium
bromide during his year in the asylum.
There has been fair agreement among experts about the
personality traits observable among patients with epilepsy
(19, 20, 30–33). Vincent’s viscosity was manifest by his in-
tense clinging to people he loved, his persevering on de-
tails, and a tendency to debate endlessly and to write ex-
cessively. Gastaut viewed viscosity as the characteristic
core trait of an individual with temporal lobe epilepsy (11,
13). Gastaut also pointed out how van Gogh’s hypersocial,
spiritual, and even hyperreligious personality contrasted
sharply with his episodes of anger to the point of fury (1), a
conflict that other authors have considered the dynamic
core issue in patients with epilepsy and heightened emo-
tionality (34).
Before becoming an artist, van Gogh had been devoted to
a religious career for years and had served as an utterly self-
less evangelist; religious motives later reemerged in his art-
work. Yet his episodic rages are well documented, became
notorious once he used absinthe, and reached a peak with
his acute illness and the murderous gesture directed at
Gauguin. He represents an example of the heightened con-
flict between fury and atonement—good and evil forces—
that has so often been noted among individuals afflicted
with epilepsy. Paroxysmal episodes of irritability to the
point of rage on the one hand and a (remorseful) highly eth-
ical, selfless, helpful, and often hyperreligious disposition
on the other had been noted by observers before Gastaut,
from Morel and Kraepelin to Freud and Szondi.
In his essay “Dostoevsky and Parricide,” Freud (35) ren-
dered a coherent picture of the contradictory personality
of this great author who had epilepsy. Elements seen in
Dostoevsky’s life and novels included experiencing the
threat of repeated uncontrollable acts of violence, feeling
guilt and the need for atonement, seeking forgiveness and
help from God, attempting to adhere to a strict moral
code, and proving oneself to be the mildest, kindest, most
helpful person possible. In Szondi’s genetically based sys-
tem of human drives (24, 34, 36), the tendency to accumu-
late and discharge crude affects (anger, hate, vengeance,
envy, or jealousy) is paired with the opposite tendency to
make amends (repentance, tolerance, kindness, helpful-
ness, or piety). These two tendencies determine ethical
behavior and appear most pronounced in epilepsy.
Suicidal attempts infrequently may be carried out in a
state of acute postictal depression (37, 38). The artist’s ear-
lier suicide attempts probably had been of this nature and
were not consciously planned. In patients with interictal
dysphoric disorder, the moods of euphoria tend to be brief,
their depressive moods more prominent. With the latter
comes a suicidal risk that is 4–25-fold higher among pa-
tients with epilepsy over the rate in the general population
and is particularly associated with chronic temporal lobe
epilepsy (39). Suicide tends to occur, peculiarly, at a time
when a long-standing seizure disorder has been brought
into remission and often comes as a surprise (37, 40).
Supported by his brother Theo, van Gogh had lived for
his art. Theo was the one person in his life who had faith in
Vincent’s extraordinary accomplishments and had been,
in fact, the lifeline throughout his career as an artist. With
Theo’s support threatened, the storm within became less
bearable. When considering the forward-looking tone of
his last letter to Theo, Hulsker had no doubt that the sui-
7. Am J Psychiatry 159:4, April 2002 525
DIETRICH BLUMER
cidal act resulted from a momentary impulse (3). For the
last few months of his life, van Gogh had abstained from
absinthe and was free from both seizures and psychosis.
Depressive moods were more prevalent, although not per-
sistent. His productivity had been unbroken in Auvers,
and his suicide was not anticipated by those who knew
him. It seems to have occurred with a final attack of mel-
ancholy, resulting from a still persistent dysphoric disor-
der. One needs to remember, however, that van Gogh had
experienced marked depressive episodes before his sei-
zure disorder.
Differential Diagnostic Considerations
Several authors have offered a tentative diagnosis of
schizophrenia for van Gogh. In view of both the absence of
any of the fundamental symptoms of the disorder and the
presence of psychotic episodes with amnestic-confu-
sional features and complete recovery, this diagnosis ap-
pears improbable, in spite of the fact that late-onset
schizophrenia was diagnosed in one of his sisters.
The diagnosis of neurosyphilis has to be considered in
view of van Gogh’s lifestyle (he was treated for gonorrhea
in 1882), the prevalence of the disease at the time, and its
diverse symptoms. However, none of the relatively specific
symptoms of the disease was ever noted. Above all, this di-
agnosis is unlikely, since he did not show any persistent
impairment of mental or somatic functions.
Following two major disappointments (an unrequited
early love and a failed career as an evangelist), van Gogh
clearly experienced prolonged episodes of depression;
both events preceded major career changes. He also expe-
rienced sustained periods of hypomania or mania. His ca-
reer as an evangelist ended when he developed a sort of al-
truistic religious mania. A bipolar history of prolonged
periods of extremely high levels of energy, enthusiasm,
and productivity alternating with episodes of depression
is not uncommon among writers and artists, and the hy-
pomanic phase is often not identified (41). The artist’s in-
creasingly elevated mood during his exciting stay in Paris
probably was a factor in his use of absinthe, the substance
that precipitated his second major illness.
Vincent experienced seizures only after his use of ab-
sinthe with its convulsant property. He never experienced
generalized seizures but had only partial seizures, suggest-
ing the presence of a latent epileptogenic zone, most likely
in the mesial-temporal area, that was activated by his use
of absinthe. As postulated by Gastaut, a perinatal brain le-
sion may have resulted in van Gogh’s severe reaction to ab-
sinthe: the partial seizures, the marked interictal dyspho-
ric disorder, and the psychotic episodes with prominent
amnesia. When he became increasingly ill during the last 2
years of his life, van Gogh did not experience any of the
sustained mood changes characteristic of bipolar disor-
der. Instead, he experienced sudden and brief changes of
depressive mood, elation, anxiety, or fury, and his intense
artistic efforts were frequently disrupted by episodes of
listlessness; these intermittent pleomorphic changes de-
veloped after onset of seizures and are specific for the dys-
phoric disorder of epilepsy.
While interictal dysphoric disorder and psychosis tend
to become manifest after an interval of years following on-
set of epilepsy, there are also patients with dysphoric or
epileptoid traits in the absence of overt seizures; these pa-
tients often have identifiable subtle brain lesions (24, 42).
The existence of an epileptoid temperament analogous to
schizoid or cyclothymic temperaments, before or inde-
pendent of the respective major illness, was often debated
in the premodern psychiatric literature when epilepsy was
a major topic (20). The early intense emotionality of van
Gogh, with the contrasting poles of explosive irritability on
the one hand and goodness and religiosity on the other,
may be considered an expression of this temperament in-
dependent from his cyclothymic disposition.
Vincent van Gogh’s suicide may have been an unex-
pected event, perhaps precipitated by a dysphoric mood;
remission of the seizures may have favored the final de-
pressive event. But when he had recovered from his severe
illness upon discharge from the asylum, the support from
his brother, upon whom he had depended totally for his
career as an artist, had become seriously threatened. Al-
though the artist had been able to remain productive, a
depressive mood had become more evident. In the past,
he had reacted to crucial losses with marked depression,
and this illness probably was the main factor in his death.
Received Feb. 16, 2001; revisions received June 4, July 19, and Aug.
30, 2001; accepted Sept. 5, 2001. From the Department of Psychia-
try, University of Tennessee Health Science Center. Address reprint re-
quests to Dr. Blumer, Department of Psychiatry, University of Tennes-
see Health Science Center, 135 N. Pauline St., Suite 633, Memphis, TN
38105.
The author thanks David Armbruster, Ph.D., for editorial assistance.
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