in Psychiatry Bites

Psychiatry bites – 20 February 2009

Last night I went to a lecture on Brain Fag Syndrome. BFS is a so called culture bound syndrome which, it is generally held, was initially described in 1960 in Nigeria.  The syndrome is characterised by unpleasant sensory disturbances around the head and neck, which appear or become more intense when the patient attempts to study, affecting concentration, under standing and retention. Further efforts to study aggravate the somatic symptoms, which in turn further impair intellectual activity.

Reservations about validity of Brain Fag as a diagnostic criteria aside (including why western psychiatric conditions should be considered any more solid than those of other cultures), last night’s genuine revelation was that the presenter, in an impressive feat of scholarship, has turned the history of Brain Fag on its head having found references to ‘Brain Fag’ in the British Press as early as the 1880s, and also in the press of North America and India between the 1880s and 1940s.

It’s difficult to imagine why no one should have spotted this before, but does remind me of the tendency for diseases not be named after those that first described them.  For example in the UK Graves’ disease, a thyroid disorder, is named after Robert Graves who discribed goitre with exophthalmos in 1935 however this was first described in Italy in 1802


Novelist Tom Wolfe, author of seminal books, The Electric Kool Aid Acid Test and Bonfire of the Vanities, wrote an article in 1996 on neuroscience: Sorry, but your soul just died.  I read it first in 1997 or so and was mightly impressed.  I’ve just re-read it and it’s an engaging mish-mash of ideas;  his predictions for 2006 are off the mark, being as he predicts that the digital revolution will be overshadowed by one of neuroscience.  I like the two paragraphs with which he signs off:

Recently I happened to be talking to a prominent California geologist, and she told me: “When I first went into geology, we all thought that in science you create a solid layer of findings, through experiment and careful investigation, and then you add a second layer, like a second layer of bricks, all very carefully, and so on. Occasionally some adventurous scientist stacks the bricks up in towers, and these towers turn out to be insubstantial and they get torn down, and you proceed again with the careful layers. But we now realize that the very first layers aren’t even resting on solid ground. They are balanced on bubbles, on concepts that are full of air, and those bubbles are being burst today, one after the other.”

I suddenly had a picture of the entire astonishing edifice collapsing and modern man plunging headlong back into the primordial ooze. He’s floundering, sloshing about, gulping for air, frantically treading ooze, when he feels something huge and smooth swim beneath him and boost him up, like some almighty dolphin. He can’t see it, but he’s much impressed. He names it God.

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