A Brief History of Time: Anorexia Nervosa

Il faut manger pour vivre et non pas vivre pour manger.
(One should eat to live and not live to eat.)
- Moliere (1622 – 1673): L'Avare (The Miser)

Some hae(have) meat and cannot eat,
Some cannot eat that want it:
But we hae meat and we can eat,
Sae let the Lord be thankit.
- Robert Burns (1759 – 1796): The Kirkcudbright Grace

This is not about Stephen Hawking’s famous book that sold over 9m copies world-wide, but a collection of material that relates to Anorexia Nervosa in a chronological order. You see, I believe in free sharing of knowledge.

First introduction of the term Anorexia

Sir William Withey Gull (1816 – 1890) first used the term:

“In… 1868, I referred to a peculiar form of disease occurring mostly in young women, and characterized by extreme emaciation…. At present our diagnosis of this affection is negative, so far as determining any positive cause from which it springs…. The subjects…are…chiefly between the ages of sixteen and twenty-three…. My experience supplies at least one instance of a fatal termination…. Death apparently followed from the starvation alone…. The want of appetite is, I believe, due to a morbid mental state…. We might call the state hysterical.”

Source: Anorexia Nervosa (apepsia hysterica, anorexia hysterica).
Transactions of the Clinical Society of London, 1874, 7: 22-28.
Classic description of Anorexia Nervosa.

Earliest published accounts

Richard Morton (1637-98), a London physician: The Treaty in his book Phthisiologia, or a Treatise of Consumptions, first published in Latin in 1694.

Ernest-Charles Lasègue (1816 - 1883), a professor of clinical medicine in Paris: “De l’Anorexie Hysterique” containing descriptions of eight patients.

More recent views

Girl in a Chemise circa 1905 Pablo Picasso (1881-1973)
Tate Collection

Anna Freud’s psychoanalytic view (1958):

• Adolescent emotional upheavals are inevitable
• Anorexia Nervosa is the outward manifestation of the battle between the ego and eating, with the former struggling for it’s very survival

Bruch (1966): relentless pursuit of thinness

Crisp (1967): weight phobia

Russell (1970 ): a morbid fear of becoming

Crisp (1967 - 1980):

• Anorexia nervosa serves to protect the individual from adolescent turmoil.
• Anorexia nervosa reflects a phobic avoidance of sexual maturation.
• Unsettling effects of sexual maturation at puberty may drive the female adolescent to a pursuit of thinness leading to greater acceptance, self-control and self-esteem.
• Anorexia nervosa tends to appear in families with buried, but unresolved, parental conflicts.
  

Palazzoli (1978) on women’s role (not just Anorexia Nervosa)

• Women are expected to be beautiful, smart and well-groomed.
• They are expected to have a career and yet be romantic, tender and sweet.
• They are expected to devote a great deal of time to their personal appearance even while competing in business and professions.
• In marriage, they are expected to play the part of the ideal wife cum mistress cum mother.
• They are expected to put away her hard-earned diplomas to wash nappies and perform other menial chores.
• The modern woman is therefore exposed to a terrible social ordeal, and the conflicting demands and dual image of the female body as sex symbol and as commodity.
• An adolescent girl may develop feelings of insecurity and alienation toward her changing body.

Finally, it is appropriate to close with two quotes:

L'appetit vient en mangeant.
(The appetite grows by eating.)
- Rabelais (1494 - 1553): Gargantua

One hath no better thing under the sun than to eat, and to drink, and to be merry ...
- Ecclesiastes 8.15

Other Posts:
Anorexia Nervosa: Olanzapine (Zyprexa)-Veganism
Anorexia Nervosa: Bach
Anorexia Nervosa: What If!
Anorexia Nervosa: a cult?

The Book: The Cockroach Catcher

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