Reposted at JMG's request. ----------------------------- The following is a comment on the Naked Capitalism site. The commenter, who goes by the handle IM Doc, is a doctor in a smallish hospital in a smallish town. He’s had a lot of experience with all this. The bottom half of his (long) comment here might be of interest. —————————————– IM Doc September 4, 2021 at 3:17 pm I have been doing a great deal of research about a past pandemic which I have never spent much time investigating – the Great Russian Flu of the 1890s. This has always been thought to be an actual influenza – but recent genetic and virologic studies are showing us that this was very likely the introduction of Coronavirus OC43 to the world. Many many physicians at the time were chronicling that the symptoms of this “flu” were different than any other influenza had ever been. Even Sir William Osler, in written statements in his textbooks of Internal Medicine, was of the notion that the symptoms exhibited by patients during that pandemic of the 1890s were really not like the normal flu. His books were written in the decades immediately leading up to the “real” influenza pandemic of 1918. And the one symptom that over and over described by numerous physicians that were writing at the time, including Sir Arthur Conan Doyle, was depression. This just does not happen to any degree in true INFLUENZA and many remarked on the difference. It must be noted that the word “depression” is a rather modern word and a modern construct. This construct is from our very reductionist, form-filling out, check the boxes modern medicine. “Depression” today is a drop bucket of multiple different diagnoses of the past. FYI, there are many things like this in medicine, not just depression. Conan Doyle and Osler would have used more prominently the diagnosis “melancholia” to describe what we commonly use as “depression” today. But interestingly enough, contemporaneous medical writers of the 1890s often used a completely different word with a completely different diagnostic meaning to describe what they were seeing in patients of that pandemic. That word is ACEDIA. I have seen it used repeatedly in my research of the pandemic of the 1890s. The difference is completely lost on us today – but it is actually a very important distinction. ACEDIA is an old medieval concept which is very difficult to describe. Basically it means a depression of the soul. A SPIRITUAL depression. While melancholia was more of a behavioral depression. Mainly having to do with living with consequences of behavior or reaction to events in a patient’s life. Interestingly, when I am really talking to these POST COVID patients today – it is indeed more consistent with the spiritual and soul exhaustion of ACEDIA – and not behavioral or reactive like most depressions are. I have occasionally seen this ACEDIA type of depression before, but it is now just one patient after the other. I am also seeing ACEDIA like depression repeatedly in patients who have never had COVID. It is a sign of the times. In the days of Osler and Conan Doyle, they had no way to test patients for the presence of the virus and just assumed everyone had been infected by the miasma. I think today I am seeing this in POST COVID patients and non-infected as well. The writers of that era in the 1890s were unequivocal in what they were seeing in their coronavirus pandemic – an epidemic of ACEDIA in those who had had the illness. I find it profoundly fascinating that the exact same type of thing is happening in our coronavirus patients and our COVID world today.
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branchandroot
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Date: 2021-09-07 04:39 pm (UTC)-----------------------------
The following is a comment on the Naked Capitalism site. The commenter, who goes by the handle IM Doc, is a doctor in a smallish hospital in a smallish town. He’s had a lot of experience with all this. The bottom half of his (long) comment here might be of interest.
—————————————–
IM Doc
September 4, 2021 at 3:17 pm
I have been doing a great deal of research about a past pandemic which I have never spent much time investigating – the Great Russian Flu of the 1890s. This has always been thought to be an actual influenza – but recent genetic and virologic studies are showing us that this was very likely the introduction of Coronavirus OC43 to the world.
Many many physicians at the time were chronicling that the symptoms of this “flu” were different than any other influenza had ever been. Even Sir William Osler, in written statements in his textbooks of Internal Medicine, was of the notion that the symptoms exhibited by patients during that pandemic of the 1890s were really not like the normal flu. His books were written in the decades immediately leading up to the “real” influenza pandemic of 1918. And the one symptom that over and over described by numerous physicians that were writing at the time, including Sir Arthur Conan Doyle, was depression. This just does not happen to any degree in true INFLUENZA and many remarked on the difference.
It must be noted that the word “depression” is a rather modern word and a modern construct. This construct is from our very reductionist, form-filling out, check the boxes modern medicine. “Depression” today is a drop bucket of multiple different diagnoses of the past. FYI, there are many things like this in medicine, not just depression.
Conan Doyle and Osler would have used more prominently the diagnosis “melancholia” to describe what we commonly use as “depression” today. But interestingly enough, contemporaneous medical writers of the 1890s often used a completely different word with a completely different diagnostic meaning to describe what they were seeing in patients of that pandemic. That word is ACEDIA. I have seen it used repeatedly in my research of the pandemic of the 1890s.
The difference is completely lost on us today – but it is actually a very important distinction. ACEDIA is an old medieval concept which is very difficult to describe. Basically it means a depression of the soul. A SPIRITUAL depression. While melancholia was more of a behavioral depression. Mainly having to do with living with consequences of behavior or reaction to events in a patient’s life.
Interestingly, when I am really talking to these POST COVID patients today – it is indeed more consistent with the spiritual and soul exhaustion of ACEDIA – and not behavioral or reactive like most depressions are. I have occasionally seen this ACEDIA type of depression before, but it is now just one patient after the other. I am also seeing ACEDIA like depression repeatedly in patients who have never had COVID. It is a sign of the times. In the days of Osler and Conan Doyle, they had no way to test patients for the presence of the virus and just assumed everyone had been infected by the miasma. I think today I am seeing this in POST COVID patients and non-infected as well.
The writers of that era in the 1890s were unequivocal in what they were seeing in their coronavirus pandemic – an epidemic of ACEDIA in those who had had the illness. I find it profoundly fascinating that the exact same type of thing is happening in our coronavirus patients and our COVID world today.