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The more common features of the disease are summarized in the acronym POEMS:
Papilledema (swelling of the optic disc) often but not always due to increased intracranial pressure) is the most common ocular sign of POEMS syndrome, occurring in ≥29% of cases. Less frequent ocular findings include cystoid macular edema, serous macular detachment, infiltrative orbitopathy, and venous sinus thrombosis.
Pulmonary disease/ Polyneuropathy: The lungs are often affected at more severe stages of the illness, although since by then physical exertion is usually limited by neuropathy, shortness of breath is unusual. Pulmonary hypertension is the most serious effect on the lungs, and there may also be restriction of chest expansion or impaired gas exchange.
Organomegaly: The liver may be enlarged, and less often the spleen or lymph nodes, though these organs usually function normally.
Edema: Leakage of fluid into the tissues is a common and often severe problem. This may take several forms, including dependent peripheral edema, pulmonary edema, effusions such as pleural effusion or ascites, or generalized capillary leakage (anasarca).
Endocrinopathy: In women, amenorrhea, and in men, gynecomastia, erectile dysfunction and testicular atrophy, are common early symptoms due to dysfunction of the gonadal axis. Other hormonal problems occurring in at least a quarter of patients include type 2 diabetes, hypothyroidism, and adrenal insufficiency.
Monoclonal paraprotein: In most cases a serum myeloma protein can be detected, although this is not universal. This may represent IgG or IgA, but the light chain type is almost always lambda. This is in contrast to most paraproteinemic neuropathies, in which the paraprotein is usually an IgM antibody.
Skin changes: A very wide variety of skin problems have been reported in association with POEMS syndrome. The most common is non-specific hyperpigmentation. The fingernails may be clubbed or white. There may be thickening of the skin, excess hair or hair in unusual places (hypertrichosis), skin angiomas or hemangiomas, or changes reminiscent of scleroderma.
The signs and symptoms of POEMS syndrome are highly variable. This often leads to long delays (e.g. 13–18 months) between the onset of initial symptoms and diagnosis. In addition to the signs and symptoms indicated by the POEMS acronym, the PEST acronym is used to describe some of the other signs and symptoms of the disease. PEST stands for Papilledema, evidence of Extravascular volume overload (ascites, pleural effusion, pericardial effusion, and lower extremity edema), Sclerotic bone lesions, and Thrombocytosis/erythrocytosis (i.e. increased in blood platelets and red blood cells). Other features of the disease include a tendency toward leukocytosis, blood clot formation, abnormal lung function (restrictive lung disease, pulmonary hypertension, and impaired lung diffusion capacity), very high blood levels of the cytokine vascular endothelial growth factor (VEGF), and an overlap with the signs and symptoms of multicentric Castleman disease.
MCD clinical features range from waxing and waning mild enlargement of the lymph nodes with B symptoms to more severe cases involving intense inflammation, widespread enlargement of lymph nodes enlargement of the liver and spleen, vascular leak syndrome with anasarca, fluid collections in the space around the lungs, and fluid collection in the abdomen's peritoneal space, organ failure, and even death. The most common 'B Symptoms' of MCD are high fevers, night sweats, weight loss, and loss of appetite. Acute episodes can display significant clinical overlap with acute viral illnesses, autoimmune diseases, hematologic malignancies, and even sepsis. Laboratory findings commonly include low red blood cell count, low or high platelet counts, low albumin, high gamma globulin levels, elevated C-reactive protein levels, elevated erythrocyte sedimentation rate, IL-6, vascular endothelial growth factor (VEGF), and fibrinogen; positive anti-nuclear antibody, anti-erythrocyte autoantibodies, and anti-platelet antibodies; and protein spilling into the urine, and polyclonal marrow plasmacytosis. Castleman disease is seen in POEMS syndrome and is implicated in 10% of cases of paraneoplastic pemphigus.
Castleman disease, also known as giant lymph node hyperplasia, lymphoid hamartoma, or angiofollicular lymph node hyperplasia, is a group of uncommon lymphoproliferative disorders that share common lymph node histological features. The disease is named after Benjamin Castleman.
Castleman's disease has two main forms: It may be localized to a single lymph node (unicentric) or occur systemically (multicentric).
The unicentric form can usually be cured by surgically removing the lymph node, with a 10-year survival of 95%.
Multicentric Castleman disease (MCD) involves hyperactivation of the immune system, excessive release of proinflammatory chemicals (cytokines), proliferation of immune cells (B cells and T cells), and multiple organ system dysfunction. Castleman disease must be distinguished from other disorders that can demonstrate "Castleman-like" lymph node features, including reactive lymph node hyperplasia, autoimmune disorders, and malignancies. Multicentric Castleman's disease is associated with lymphoma and Kaposi's sarcoma.
There are several types of immune-mediated neuropathies recognised. These include
- Chronic inflammatory demyelinating polyneuropathy (CIPD) with subtypes:
- Classical CIDP
- CIDP with diabetes
- CIDP/monoclonal gammopathy of undetermined significance
- Sensory CIDP
- Multifocal motor neuropathy
- Multifocal acquired demyelinating sensory and motor neuropathy (Lewis-Sumner syndrome)
- Multifocal acquired sensory and motor neuropathy
- Distal acquired demyelinating sensory neuropathy
- Guillain-Barre syndrome with subtypes:
- Acute inflammatory demyelinating polyradiculoneuropathy
- Acute motor axonal neuropathy
- Acute motor and sensory axonal neuropathy
- Acute pandysautonomia
- Miller Fisher syndrome
- IgM monoclonal gammopathies with subtypes:
- Waldenstrom's macroglobulinemia
- Mixed cryoglobulinemia, gait ataxia, late-onset polyneuropathy syndrome
- Myelin-associated glycoprotein-associated gammopathy, polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes syndrome (POEMS)
For this reason a diagnosis of chronic inflammatory demyelinating polyneuropathy needs further investigations.
The diagnosis is usually provisionally made through a clinical neurological examination. Patients usually present with a history of weakness, numbness, tingling, pain and difficulty in walking. They may additionally present with fainting spells while standing up or burning pain in extremities. Some patients may have sudden onset of back pain or neck pain radiating down the extremities, usually diagnosed as radicular pain. These symptoms are usually progressive and may be intermittent.
Autonomic system dysfunction can occur; in such a case, the patient would complain of orthostatic dizziness, problems breathing, eye, bowel, bladder and cardiac problems. The patient may also present with a single cranial nerve or peripheral nerve dysfunction.
On examination the patients may have weakness, and loss of deep tendon reflexes (rarely increased or normal). There may be atrophy (shrinkage) of muscles, fasciculations (twitching) and loss of sensation. Patients may have multi-focal motor neuropathy, as they have no sensory loss.
Most experts consider the necessary duration of symptoms to be greater than 8 weeks for the diagnosis of CIDP to be made.
Typical diagnostic tests include:
- Electrodiagnostics – electromyography (EMG) and nerve conduction study (NCS). In usual CIDP, the nerve conduction studies show demyelination. These findings include:
1. a reduction in nerve conduction velocities;
2. the presence of conduction block or abnormal temporal dispersion in at least one motor nerve;
3. prolonged distal latencies in at least two nerves;
4. absent F waves or prolonged minimum F wave latencies in at least two motor nerves. (In some case EMG/NCV can be normal).
- Serum test to exclude other autoimmune diseases.
- Lumbar puncture and serum test for anti-ganglioside antibodies. These antibodies are present in the branch of CIDP diseases comprised by anti-GM1, anti-GD1a, and anti-GQ1b.
- Sural nerve biopsy; biopsy is considered for those patients in whom the diagnosis is not completely clear, when other causes of neuropathy (e.g., hereditary, vasculitic) cannot be excluded, or when profound axonal involvement is observed on EMG.
- Ultrasound of the periferal nerves may show swelling of the affected nerves
- MRI can also be used in the diagnosic workup
In some cases electrophysiological studies fail to show any evidence of demyelination. Though conventional electrophysiological diagnostic criteria are not met, the patient may still respond to immunomodulatory treatments. In such cases, presence of clinical characteristics suggestive of CIDP are critical, justifying full investigations, including sural nerve biopsy.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated inflammatory disorder of the peripheral nervous system. The disorder is sometimes called chronic relapsing polyneuropathy (CRP) or chronic inflammatory demyelinating polyradiculoneuropathy (because it involves the nerve roots). CIDP is closely related to Guillain–Barré syndrome and it is considered the chronic counterpart of that acute disease. Its symptoms are also similar to progressive inflammatory neuropathy. An asymmetrical variant of CIDP is known as Lewis-Sumner Syndrome.
A brainstem stroke syndrome is a condition involving a stroke of the brainstem. Because of their location, they often involve impairment both of the cranial nuclei and of the long tracts.
A person may have vertigo, dizziness and severe imbalance without the hallmark of most strokes – weakness on one side of the body. The symptoms of vertigo, dizziness or imbalance usually occur together; dizziness alone is not a sign of stroke. Brainstem stroke can also cause diplopia, slurred speech and decreased level of consciousness. A more serious outcome is locked-in syndrome.
The following text lists signs and symptoms of Angelman syndrome and their relative frequency in affected individuals.
Angelman syndrome (AS) is a genetic disorder that mainly affects the nervous system. Symptoms include a small head and a specific facial appearance, severe intellectual disability, developmental disability, speech problems, balance and movement problems, seizures, and sleep problems. Children are usually happy in nature and have a particular interest in water. The symptoms generally become noticeable by one year of age.
Angelman syndrome is typically due to a new mutation rather than one inherited from a person's parents. Angelman syndrome is due to a lack of function of part of chromosome 15 inherited from a person's mother. Most of the time, it is due to a deletion or mutation of the UBE3A gene on that chromosome. Occasionally, it is due to inheriting two copies of chromosome 15 from a person's father and none from their mother. As the father's versions are inactivated by a process known as genomic imprinting, no functional version of the gene remains. Diagnosis is based on symptoms and possibly genetic testing.
No cure is available. Treatment is generally supportive in nature. Anti-seizure medications are used in those with seizures. Physical therapy and bracing may help with walking. Those affected have a nearly normal life expectancy.
AS affects 1 in 12,000 to 20,000 people. Males and females are equally frequently affected. It is named after a British pediatrician, Harry Angelman, who first described the syndrome in 1965. An older term, "happy puppet syndrome", is generally considered pejorative. Prader–Willi syndrome is a separate condition, caused by a similar loss of the father's chromosome 15.
Bibliomania can be a symptom of obsessive–compulsive disorder which involves the collecting or even hoarding of books to the point where social relations or health are damaged.
Radiophobia is an obsessive fear of ionizing radiation, in particular, fear of X-rays. While in some cases radiation may be harmful (i.e. radiation-induced cancer, and acute radiation syndrome), the effects of poor information, understanding, or a traumatic experience may cause unnecessary or even irrational fear. The term is also used in a non-medical sense to describe the opposition to the use of nuclear technology (i.e. nuclear power) arising from concerns disproportionately greater than actual risks would merit.
Millie McCoy and Christine McCoy (July 11, 1851 – October 8, 1912) were American conjoined twins who went by the stage names "The Carolina Twins", "The Two-Headed Nightingale" and "The Eighth Wonder of the World". The Twins traveled throughout the world performing song and dance for entertainment.
Kate Allatt is a mother-of-three from Sheffield, South Yorkshire. She has successfully recovered from locked-in syndrome. Now she runs "Fighting Strokes", and devotes her life to assisting those with locked-in syndrome.
In Chinese alchemy, elixir poisoning refers to the toxic effects from elixirs of immortality that contained metals and minerals such as mercury and arsenic. The official "Twenty-Four Histories" record numerous Chinese emperors, nobles, and officials who ironically died from taking elixirs in order to prolong their lifespans. The first emperor to die from elixir poisoning was likely Qin Shi Huang (d. 210 BCE) and the last was Yongzheng (d. 1735). Despite common knowledge that immortality potions could be deadly, fangshi and Daoist alchemists continued the elixir-making practice for two millennia.
Melancholia (from , '), also lugubriousness, from the Latin "lugere", to mourn; moroseness, from the Latin "morosus", self-willed, fastidious habit; wistfulness, from old English "wist": intent, or saturnine, was a concept in ancient and pre-modern medicine. Melancholy was one of the four temperaments matching the four humours. In the 19th century, "melancholia" could be physical as well as mental, and melancholic conditions were classified as such by their common cause rather than by their properties.
Bibliomania is not to be confused with bibliophilia, which is the usual love of books and is not considered a clinical psychological disorder.
Other abnormal behaviours involving books include book-eating (bibliophagy), compulsive book-stealing (bibliokleptomania), and book-burying (bibliotaphy).
Samuel Taylor Coleridge (21 October 1772–25 July 1834) was an English poet, critic, and philosopher who was, along with his friend William Wordsworth, one of the founders of the Romantic Movement in England and one of the Lake Poets. He wrote the poems "The Rime of the Ancient Mariner" and "Kubla Khan", as well as the prose "Biographia Literaria".
Coleridge was widely known to have been a regular user of opium as a relaxant, analgesic, antidepressant, and treatment for numerous health concerns. "Kubla Khan" was apparently written under the drug's influence, but the degree to which he used the drug as a creative enhancement is not clear. Although Coleridge largely kept his addiction as hidden as possible from those close to him, it became public knowledge with the 1822 publication of "Confessions of an English Opium Eater" by his close friend Thomas de Quincey. The "Confessions" painted a rather negative picture of Coleridge and his reputation suffered accordingly.
Where Coleridge first developed his opium habit is an issue of some scholarly dispute but it clearly dates from a fairly youthful period in his life. Coleridge’s own explanation is clearly laid out in a letter to Joseph Cottle;
However, most scholars agree that Coleridge had resorted to the use of Laudanum (the tincture form of opium) before this date, particularly during times of nervousness and stress. Because Laudanum was widely available and widely used as an analgesic as well as a general sedative, many people were given the drug for all sorts of medical and nervous complaints. Coleridge was probably given the drug numerous times in his youth during several bouts of rheumatic illness. Small medicinal dosages seldom lead to full-blown addiction but for Coleridge, who experienced the painful return of the symptoms many times in his life, it surely introduced him to the use of the drug much earlier than his story to Cottle admits.
Regardless of when and where Coleridge’s opium addiction began, it is clear that the more reliant on the drug he became, the more his work suffered, the less he was able to focus and concentrate, and the more strained his relations became. In fact, it is arguable that any analysis of Coleridge’s life must be done against the constant background of opium usage. But as important as the issue of opium is in Coleridge’s life, it is never a straightforward issue because he often hid it from public and familial view and at other times he exaggerated its importance to his work. In the 1816 publication of his major ‘opium’ poems Coleridge purposely drew a connection between his creative work and his opium usage. Desperate for some financial success with his poetry, Coleridge intentionally attempted to portray himself as a dreamy opium eater because he, perhaps rightly, believed that it would draw a morbid fascination to his work. Opium played an interesting role in the public image of Romantic literature. There was, for a long time, a kind of cult glamorization of the drug and a morose allure to stories of its usage for respectable members of the bourgeoisie who were titillated by such taboo subjects. It was with this in mind that Coleridge generated an image of himself as dreamy poet who created drug induced fantasies.
This dreamy image of himself began even before he was widely known to have been addicted to opium. In one of a series of biographical letters written to his friend Thomas Poole, Coleridge painted this picture of himself, a picture that would always endure. Coleridge writes:
This slothful image was one that endured even with some of Coleridge’s close friends and may have been consciously created by Coleridge in the earlier part of his career in order to draw attention away from his addiction. It was only later that Coleridge perceived an advantage to drawing attention not to himself as simply a slothful scholar but a dreamy opium eater.
The most popular story that connects Coleridge’s work with his opium usage was told by Coleridge in his well-known preface to the poem Kubla Khan. Coleridge wrote:
The sleep of this story is said by Coleridge to be a sleep of opium, and Kubla Khan may be read as an early poetic description of this drug experience. The fact that the poem is generally regarded as one of Coleridge's best is one of the reasons for the continuing interest and debate about the role that opium may have played in his creative output, and in Romanticism in general.
Coleridge, in his lucid moments, understood the problems with which he struggled better than most. In an 1814 letter to his friend John Morgan, Coleridge wrote about his difficulties.
In some respects, Coleridge's life bears a resemblance to that of a modern opiate addict. Unfortunately, as much as Coleridge had some grasp of his addictions and its results, as well as an unusually sharp sense of how this addiction might be treated, many of his closest friends and peers did not understand. The people who might have served him best, like Southey and Wordsworth, were far too willing to maintain his image as slothful and selfish; this despite the professional help that he constantly bestowed upon them. Men like Robert Southey, naturally conservative in outlook were not forward looking enough to comprehend the possibility of Coleridge’s addiction being a largely physical dependence, despite the fact that Coleridge himself, as well as a growing number of professionals like his friend Gillman, were aware of the physical aspect of drug reliance. On more than one occasion Coleridge pointed to the fact that physical restraint might eventually lead to a cure, and on several occasions under the treatment of Dr. Gillman, he was led thus to the edge of freedom from the drug on which he had formed such a dependence. Southey wrote from the position of moral indignation and explicitly denied the physical aspect of the drug issue. Southey wrote to Cottle:
BDSM is a variety of often erotic practices or roleplaying involving bondage, discipline, dominance and submission, sadomasochism, and other related interpersonal dynamics. Given the wide range of practices, some of which may be engaged in by people who do not consider themselves as practicing BDSM, inclusion in the BDSM community or subculture is usually dependent upon self-identification and shared experience.
The term "BDSM" is first recorded in a Usenet posting from 1991, and is interpreted as a combination of the abbreviations B/D (Bondage and Discipline), D/s (Dominance and submission), and S/M (Sadism and Masochism). BDSM is now used as a catch-all phrase covering a wide range of activities, forms of interpersonal relationships, and distinct subcultures. BDSM communities generally welcome anyone with a non-normative streak who identifies with the community; this may include cross-dressers, body modification enthusiasts, animal roleplayers, rubber fetishists, and others.
Activities and relationships within a BDSM context are often characterized by the participants taking on complementary, but unequal roles; thus, the idea of informed consent of both the partners is essential. The terms "submissive" and "dominant" are often used to distinguish these roles: the dominant partner ("dom") takes psychological control over the submissive ("sub"). The terms "top" and "bottom" are also used: the top is the instigator of an action while the bottom is the receiver of the action. The two sets of terms are subtly different: for example, someone may choose to act as bottom to another person, for example, by being whipped, purely recreationally, without any implication of being psychologically dominated by them, or a submissive may be ordered to massage their dominant partner. Despite the bottom performing the action and the top receiving they have not necessarily switched roles.
The abbreviations "sub" and "dom" are frequently used instead of "submissive" and "dominant". Sometimes the female-specific terms "mistress", "domme" or "dominatrix" are used to describe a dominant woman, instead of the gender-neutral term "dom". Individuals who can change between top/dominant and bottom/submissive roles—whether from relationship to relationship or within a given relationship—are known as "switches". The precise definition of roles and self-identification is a common subject of debate within the community.
The etymology of English elixir derives from Medieval Latin "", from Arabic ("al-ʾiksīr"), probably from Ancient Greek ("xḗrion" "a desiccative powder for wounds"). "Elixir" originated in medieval European alchemy meaning "A preparation by the use of which it was sought to change metals into gold" (elixir stone or philosopher's stone) or "A supposed drug or essence with the property of indefinitely prolonging life" (elixir of life). The word was figuratively extended to mean "A sovereign remedy for disease. Hence adopted as a name for quack medicines" (e.g., Daffy's Elixir) and "The quintessence or soul of a thing; its kernel or secret principle". In modern usage, "elixir" is a pharmaceutical term for "A sweetened aromatic solution of alcohol and water, serving as a vehicle for medicine" ("Oxford English Dictionary", 2nd ed., 2009). Outside of Chinese cultural contexts, English "elixir poisoning" usually refers to accidental contamination, such as the 1937 Elixir sulfanilamide mass poisoning in the United States.
"Dān" 丹 "cinnabar; vermillion; elixir; alchemy" is the keyword for Chinese immortality elixirs. The red mineral cinnabar ("dānshā" 丹砂 lit. "cinnabar sand") was anciently used to produce the pigment vermilion ("zhūhóng" 朱紅) and the element mercury ("shuǐyín" 水銀 "watery silver" or "gǒng" 汞).
According to the "ABC Etymological Dictionary of Old Chinese", the etymology of Modern Standard Chinese "dān" from Old Chinese "*tān" (< *"tlan" ?) 丹 "red; vermillion; cinnabar", "gān" 矸 in "dāngān" 丹矸 from *"tân-kân" (< *"tlan-klan" ?) "cinnabar; vermillion ore", and "zhān" from *"tan" 旃 "a red flag" derive from Proto-Kam-Sui *"h-lan" "red" or Proto-Sino-Tibetan *"tja-n" or *"tya-n" "red". The *"t-" initial and *"t-" or *"k-" doublets indicate that Old Chinese borrowed this item. (Schuessler 2007: 204).
Although the word "dan" 丹 "cinnabar; red" frequently occurs in oracle script from the late Shang Dynasty (ca. 1600-1046 BCE) and bronzeware script and seal script from the Zhou Dynasty (1045-256 BCE), paleographers disagree about the graphic origins of the logograph 丹 and its ancient variants 𠁿 and 𠕑. Early scripts combine a 丶 dot or ⼀ stroke (depicting a piece of cinnabar) in the middle of a surrounding frame, which is said to represent:
- "jǐng" 井 "well" represents the mine from which the cinnabar is taken" ("Shuowen Jiezi")
- "the crucible of the Taoist alchemists" (Léon Wieger )
- "the contents of a square receptacle" (Bernhard Karlgren)
- "placed in a tray or palette to be used as red pigment" (Wang Hongyuan 王宏源)
- "mineral powder on a stretched filter-cloth" (Needham and Lu).
Many Chinese elixir names are compounds of "dan", such as "jīndān" 金丹 (with "gold") meaning "golden elixir; elixir of immortality; potable gold" and "xiāndān" 仙丹 (with "Daoist immortal") "elixir of immortality; panacea", and "shéndān" 神丹 (with "spirit; god") "divine elixir". "Bùsǐ zhī yào" 不死之藥 "drug of deathlessness" was another early name for the elixir of immortality. Chinese alchemists would "liàndān" 煉丹 (with "smelt; refine") "concoct pills of immortality" using a "dāndǐng" 丹鼎 (with "tripod cooking vessel; cauldron") "furnace for concocting pills of immortality". In addition, the ancient Chinese believed that other substances provided longevity and immortality, notably the "língzhī" 靈芝 ""Ganoderma" mushroom".
The transformation from chemistry-based "waidan" 外丹 "external elixir/alchemy" to physiology-based "neidan" 內丹 "internal elixir/alchemy" gave new analogous meanings to old terms. The human body metaphorically becomes a "ding" "cauldron" in which the adept forges the Three Treasures (essence, life-force, and spirit) within the "jindan" Golden Elixir within the "dāntián" 丹田 (with "field") "lower part of the abdomen".
In early China, alchemists and pharmacists were one in the same. Traditional Chinese Medicine also used less concentrated cinnabar and mercury preparations, and "dan" means "pill; medicine" in general, for example, "dānfāng" 丹方 semantically changed from "prescription for elixir of immortality" to "medical prescription". "Dan" was lexicalized into medical terms such as " dānjì" 丹劑 "pill preparation" and "dānyào" 丹藥 "pill medicine".
The Chinese names for immortality elixirs have parallels in other cultures and languages, for example, Indo-Iranian "soma" or "haoma", Sanskrit "amrita", and Greek "ambrosia".
Some types of BDSM play include, but are not limited to:
- Animal roleplay
- Bondage
- Breast torture
- Cock and ball torture (CBT)
- Erotic electrostimulation
- Edgeplay
- Flogging
- Golden showers (urinating)
- Human furniture
- Japanese bondage
- Medical play
- Paraphilic infantilism
- Predicament bondage
- Pussy torture
- Sexual roleplay
- Spanking
- Suspension
- Torture
- Tickle torture
- Wax play
Radiation, most commonly in the form of X-rays, is used frequently in society in order to produce positive outcomes. The primary use of radiation in healthcare is in the use of radiography for radiographic examination or procedure, and in the use of radiotherapy in the treatment of cancerous conditions. Radiophobia can be a fear which patients experience before and after either of these procedures, it is therefore the responsibility of the healthcare professional at the time, often a Radiographer or Radiation Therapist, to reassure the patients about the stochastic and deterministic effects of radiation on human physiology. Advising patients and other irradiated persons of the various radiation protection measures that are enforced, including the use of lead-rubber aprons, dosimetry and Automatic Exposure Control (AEC) is a common method of informing and reassuring radiophobia sufferers.
Similarly, in industrial radiography there is the possibility of persons to experience radiophobia when radiophobia sufferers are near industrial radiographic equipment.
The name "melancholia" comes from the old medical belief of the four humours: disease or ailment being caused by an imbalance in one or other of the four basic bodily liquids, or humours. Personality types were similarly determined by the dominant humor in a particular person. According to Hippocrates and subsequent tradition, melancholia was caused by an excess of black bile, hence the name, which means "black bile", from Ancient Greek μέλας ("melas"), "dark, black", and χολή ("kholé"), "bile"; a person whose constitution tended to have a preponderance of black bile had a "melancholic" disposition. In the complex elaboration of humorist theory, it was associated with the earth from the Four Elements, the season of autumn, the spleen as the originating organ and cold and dry as related qualities. In astrology it showed the influence of Saturn, hence the related adjective "saturnine".
Melancholia was described as a distinct disease with particular mental and physical symptoms in the 5th and 4th centuries BC. Hippocrates, in his "Aphorisms", characterized all "fears and despondencies, if they last a long time" as being symptomatic of melancholia. When a patient could not be cured of the disease it was thought that the melancholia was a result of demonic possession.
In his study of French and Burgundian courtly culture, Johan Huizinga noted that "at the close of the Middle Ages, a sombre melancholy weighs on people's souls." In chronicles, poems, sermons, even in legal documents, an immense sadness, a note of despair and a fashionable sense of suffering and deliquescence at the approaching end of times, suffuses court poets and chroniclers alike: Huizinga quotes instances in the ballads of Eustache Deschamps, "monotonous and gloomy variations of the same dismal theme", and in Georges Chastellain's prologue to his Burgundian chronicle, and in the late fifteenth-century poetry of Jean Meschinot. Ideas of reflection and the workings of imagination are blended in the term "merencolie", embodying for contemporaries "a tendency", observes Huizinga, "to identify all serious occupation of the mind with sadness".
Painters were considered by Vasari and other writers to be especially prone to melancholy by the nature of their work, sometimes with good effects for their art in increased sensitivity and use of fantasy. Among those of his contemporaries so characterised by Vasari were Pontormo and Parmigianino, but he does not use the term of Michelangelo, who used it, perhaps not very seriously, of himself. A famous allegorical engraving by Albrecht Dürer is entitled "Melencolia I". This engraving has been interpreted as portraying melancholia as the state of waiting for inspiration to strike, and not necessarily as a depressive affliction. Amongst other allegorical symbols, the picture includes a magic square and a truncated rhombohedron. The image in turn inspired a passage in "The City of Dreadful Night" by James Thomson (B.V.), and, a few years later, a sonnet by Edward Dowden.
The most extended treatment of melancholia comes from Robert Burton, whose "The Anatomy of Melancholy" (1621) treats the subject from both a literary and a medical perspective. Burton wrote in the 17th century that music and dance were critical in treating mental illness, especially melancholia.
in 10th century Persian physician Al-Akhawayni describes Melancholia as a chronic illness and relates it to brain, which is one of the main aspects of his view on Melancholia. He describes Melancholia’s initial clinical manifestations as "suffering from an unexplained fear, inability to answer questions or providing false answers, self-laughing and self-crying and speaking meaninglessly, yet with no fever"
In the Encyclopédie of Diderot and d'Alembert, the causes of melancholia are stated to be similar to those that cause Mania: "grief, pains of the spirit, passions, as well as all the love and sexual appetites that go unsatisfied."
In April 1816 Coleridge's friend and physician, Joseph Adams, put him in touch with a Highgate doctor named James Gillman with the intention of placing Coleridge in his full-time care and effect a cure to his addiction problems. Although Gillman initially had no intention of taking this stranger into his household, he was so charmed by the poet on their first meeting that he agreed to take him in and attempt a cure. Coleridge spent most of the rest of his life in the Gillman house with only brief periods away. James Gillman was ahead of his time as a physician of addiction and although he was never able to entirely stop Coleridge’s intake of opium, he managed to bring it under greater control for many years. It is surely to Gillman’s treatment and friendship that we owe much of Coleridge’s later prose works, particularly his Biographia Literaria, Lay Sermons, and Opus Maximum.
Coleridge virtually became a member of the Gillman family and even accompanied them on annual vacations. On a number of occasions when Coleridge was away from the Gillman household, he fell back into excessive opium use. Each time Gillman managed to step in and return Coleridge to his home and to controlled, less harmful opium dosages. The pharmacy where the poet obtained his prescribed supply (and sometimes, an illicit addition to it) still exists in the High Street, though moved a few dozen yards from the original premises. Gillman later became one of the great champions of Coleridge’s reputation and commonly defended his friend in polite society and in print with one of the earliest biographies of Coleridge.
Coleridge’s reputation was somewhat restored during his years at Highgate and in his lucid periods he became a kind of elder-statesman of the literary establishment and was visited by many of the period’s most important writers and thinkers. Despite Gillman’s care, however, Coleridge was overcome with respiratory problems and enlargement of the heart. Coleridge died at the age of 61.
Millie and Christine (the "Carolina Twins") were born in Columbus County, North Carolina on July 11, 1851, to Jacob and Monemia McKoy who were slaves of blacksmith, Jabez McKay. The McKay farm was near the town of Whiteville. Prior to the sisters' birth, their mother had borne seven other children, five boys and two girls, all of ordinary size and form. The twins were conjoined at the lower spine and stood at an approximately 90-degree angle to each other.
The twins were first sold at 10 months of age to South Carolinian John C. Pervis. Pervis and McKay reached an agreement where Pervis exhibited the girls for pay and then paid a percentage to McKay. Fourteen months after the original sale, they were sold to a showman, Brower, who had the backing of a wealthy merchant named Joseph Pearson Smith. Brower first exhibited the twins at North Carolina's first state fair, held in 1853. They were constantly being called "Freaks of Nature". The North Carolina state fair was a success for Brower and The Carolina Twins; however, Brower's fortune changed over the next months. Brower was conned by a Texas adventurer, who offered land worth an estimated forty-five thousand dollars as a purchase price for the twins. Brower accepted, sent the twins on to the Texan, and then waited several days for the deeds before realizing that he had been swindled. Brower returned to North Carolina to relate the loss to Joseph Pearson Smith. Since Brower was left destitute, Smith was given the promissory note and was now the owner of The Carolina Twins. Millie and Christine were handled by several managers before being reclaimed by Smith in Britain in 1857.
On 1 January 1863 the Emancipation Proclamation ended their slave status and they were no longer anyone's property. Before their emancipation, the girls had been showcased in fairs and freak shows in several U.S. cities and even Montreal, Canada.
Smith traveled to Britain to collect the girls and brought with him their mother, Monemia, from whom they had been separated. He and his wife provided the twins with an education and taught them to speak five languages, dance, play music, and sing. During their time in Britain, they met Queen Victoria. For the rest of the century, the twins enjoyed a successful career as "The Two-Headed Nightingale", and appeared with the Barnum circus. In 1869, a biography on the twins, titled "History and Medical Description of the Two-Headed Girl", was sold during their public appearances. Joanne Fish Martell, former court reporter, discovered a memoir written by the girls at the age of 17 and with that and other sources, created her book "Millie-Christine: Fearfully and Wonderfully Made", which was published in 2000. The twins' motto was "As God decreed, we agreed," and they strove to turn impediments into assets. As toddlers, they were clumsy and fell down quite frequently. They eventually developed a sideways walk that turned into a crowd-pleasing dance style. They were able to master keyboard duets with one soprano and one alto voice, and learned to harmonize.
When they were in their 30's, the twins moved back to the farm where they were born, which their father had bought from Jabez McKay and left to them.
On October 8, 1912, Millie and Christine died at age 61 of tuberculosis; Christine died 12 hours after her sister. They were buried in unmarked graves but in 1969 they were moved to a cemetery in Whiteville.