{"id":7364,"date":"2021-12-23T00:00:00","date_gmt":"2021-12-22T23:00:00","guid":{"rendered":"https:\/\/instrid.sk\/uncategorized\/ciernu-smrt-vystriedala-nova-pandemia-ktora-nicila-telo-aj-mozog\/"},"modified":"2021-12-23T00:00:00","modified_gmt":"2021-12-22T23:00:00","slug":"ciernu-smrt-vystriedala-nova-pandemia-ktora-nicila-telo-aj-mozog","status":"publish","type":"post","link":"https:\/\/instrid.sk\/en\/archiv\/ciernu-smrt-vystriedala-nova-pandemia-ktora-nicila-telo-aj-mozog\/","title":{"rendered":"\u010ciernu smr\u0165 vystriedala nov\u00e1 pand\u00e9mia, ktor\u00e1 ni\u010dila telo aj mozog"},"content":{"rendered":"<p>V roku 1495 vypukla epid\u00e9mia novej a hroznej choroby medzi vojakmi franc\u00fazskeho Karola VIII., ke\u010f vtrhol do Neapola v prvej talianskej vojne, a jej n\u00e1sledn\u00fd dopad na n\u00e1rody Eur\u00f3py bol zni\u010duj\u00faci \u2013 bol to syfilis alebo \u201eve\u013ek\u00e9 kiahne\u201c. Hoci nemal tak\u00fa <strong>stra\u0161n\u00fa \u00famrtnos\u0165 ako bubonick\u00fd mor, jeho sympt\u00f3my boli bolestiv\u00e9 a odpudzuj\u00face \u2013 objavenie sa genit\u00e1lnych vredov, po ktor\u00fdch nasledovali \u0161kared\u00e9 abscesy a vredy na zvy\u0161ku tela a siln\u00e9 bolesti<\/strong>. Lie\u010div bolo m\u00e1lo a sotva \u00fa\u010dinn\u00e9, <strong>lie\u010dby ortu\u0165ou, ktor\u00e9 \u013eudia zn\u00e1\u0161ali, boli bolestiv\u00e9 a mnoh\u00ed pacienti zomreli na otravu ortu\u0165ou<\/strong>.<\/p>\n<p>&nbsp;<\/p>\n<p><em>\u201eAk by som dostal ot\u00e1zku, ktor\u00e1 zo v\u0161etk\u00fdch chor\u00f4b je najni\u010divej\u0161ia, bez v\u00e1hania by som odpovedal, je to t\u00e1, ktor\u00e1 u\u017e nieko\u013eko rokov beztrestne z\u00fari&#8230; <strong>Ak\u00e1 n\u00e1kaza takto nap\u00e1da cel\u00e9 telo, tak ve\u013emi odol\u00e1va lek\u00e1rskemu umeniu, sa tak \u013eahko nao\u010dkuje a tak kruto mu\u010d\u00ed pacienta<\/strong>?\u201c Desiderius Erazmus<\/em><\/p>\n Pacient trpiaci syfilisom, kresba ceruzkou. Zdroj: slate.com\n<p>O <strong>\u013eu\u010foch s du\u0161evn\u00fdmi chorobami sa predpokladalo, \u017ee s\u00fa posadnut\u00ed zl\u00fdmi duchmi<\/strong>. Lek\u00e1rske ch\u00e1panie du\u0161evn\u00fdch por\u00fach be\u017ene koexistovalo s n\u00e1bo\u017eensk\u00fdm, mor\u00e1lnym a nadprirodzen\u00fdm u\u017e v \u0161estn\u00e1stom storo\u010d\u00ed. Lek\u00e1rske te\u00f3rie v tej dobe \u010derpali z te\u00f3rie, ktor\u00e1 pripisovala fyzick\u00e9 aj du\u0161evn\u00e9 choroby nerovnov\u00e1he v \u0161tyroch z\u00e1kladn\u00fdch telesn\u00fdch zlo\u017ek\u00e1ch.<\/p>\n<p>&nbsp;<\/p>\n<p>V <strong>dev\u00e4tn\u00e1stom storo\u010d\u00ed bol neurosyfilis jednou z najroz\u0161\u00edrenej\u0161\u00edch a najsmrte\u013enej\u0161\u00edch foriem degenerat\u00edvnych du\u0161evn\u00fdch chor\u00f4b<\/strong>, ktor\u00e9 psychiatria pozn\u00e1.<\/p>\n<p>Domnievali sa, \u017ee\u00a0v\u0161eobecn\u00e1 paral\u00fdza du\u0161evne chor\u00fdch je sp\u00f4soben\u00e1 <strong>zlou dedi\u010dnos\u0165ou, \u201eslab\u00fdm charakterom\u201c alebo mor\u00e1lne pochybn\u00fdm \u017eivotom<\/strong>. To sa zmenilo v roku 1913, ke\u010f japonsk\u00fd bakteriol\u00f3g Hideyo Noguchi, pracuj\u00faci na Rockefellerovej univerzite v New Yorku, na\u0161iel stopy Treponema pallidum \u2013 \u0161pir\u00e1lovitej bakt\u00e9rie zodpovednej za syfilis \u2013 v mozgoch zosnul\u00fdch \u013eud\u00ed so v\u0161eobecnou paral\u00fdzou.<strong> V tom \u010dase mala a\u017e jedna tretina pacientov v psychiatrick\u00fdch lie\u010debniach sympt\u00f3my, ktor\u00e9 sa teraz daj\u00fa jasne vystopova\u0165 a prip\u00edsa\u0165 syfilisu<\/strong>.<\/p>\n<p>&nbsp;<\/p>\n<h3>Hyst\u00e9ria<\/h3>\n<p><strong>Hyst\u00e9ria, p\u00f4vodne pova\u017eovan\u00e1 za gynekologick\u00fd stav postihuj\u00faci iba \u017eeny<\/strong>, bola \u010diasto\u010dne prepracovan\u00e1 na neurologick\u00e9 ochorenie v\u010faka \u00fasiliu v\u00fdznamn\u00e9ho franc\u00fazskeho neurol\u00f3ga Jean-Martina Charcota z dev\u00e4tn\u00e1steho storo\u010dia. Sympt\u00f3my, ktor\u00e9 videl u svojich pacientov \u2013<strong> \u010diasto\u010dn\u00e1 paral\u00fdza, k\u0155\u010de, probl\u00e9my so zrakom a tiky<\/strong> \u2013 vyzerali neurologicky. V posledn\u00fdch rokoch storo\u010dia v\u0161ak kritici Charcota a dokonca aj niektor\u00ed z jeho b\u00fdval\u00fdch loj\u00e1lnych \u0161tudentov dospeli k z\u00e1veru, \u017ee ide o <strong>ist\u00fd druh podvodu \u2013 psychick\u00fa poruchu vyd\u00e1vaj\u00facu sa za neurologick\u00fa<\/strong>. Jeden z jeho \u0161tudentov Babinski dokonca navrhol, aby sa neurol\u00f3gia \u00faplne vzdala pojmu hyst\u00e9ria a nahradila ho pojmom \u201epitiatizmus\u201c. Mnoh\u00ed zast\u00e1vali n\u00e1zor, \u017ee hyst\u00e9ria sa uk\u00e1zala ako hlbok\u00fd probl\u00e9m mysle, ktor\u00fd sp\u00f4sobuje, \u017ee postihnut\u00fd sa spr\u00e1va, ako keby bol chor\u00fd. Neurosyfilis bol medzit\u00fdm pova\u017eovan\u00fd za ochorenie mozgu, ktor\u00e9 m\u00f4\u017ee vyvola\u0165 simulakrum du\u0161evnej choroby.<\/p>\n S\u00e9ria troch fotografi\u00ed zobrazuj\u00facich takzvan\u00fa \u201ehysterick\u00fa\u201c z\u00edvaj\u00facu \u017eenu. Zdroj: wellcomecollection.org\n<p><strong>Odhalenie hyst\u00e9rie ako psychologickej diagn\u00f3zy dopomohlo sl\u00e1ve a v\u00fdvoju Sigmunda Freuda<\/strong> a jeho novej sf\u00e9ry psychoanal\u00fdzy. Nakoniec to tie\u017e viedlo k povojnovov\u00e9mu neo-freudovsk\u00e9mu smeru, \u017ee problematick\u00e9 spr\u00e1vanie bez pridru\u017eenej choroby by sa napriek tomu malo pova\u017eova\u0165 za medic\u00ednske. No zatia\u013e \u010do psychologick\u00e9 ch\u00e1panie hyst\u00e9rie zmenilo psychiatriu, neurol\u00f3govia sa st\u00e1le sna\u017eili pom\u00f4c\u0165 pacientom so sympt\u00f3mami, ktor\u00e9 by predch\u00e1dzaj\u00faca gener\u00e1cia ozna\u010dila za hysterick\u00e9.<\/p>\n<p>&nbsp;<\/p>\n<p>Medzit\u00fdm zistenie, \u017ee v\u0161eobecn\u00e1 paral\u00fdza bola sympt\u00f3mom pohlavne prenosnej choroby, podnietilo \u010fal\u0161ie gener\u00e1cie psychiatrov. <strong>Pustili sa do p\u00e1trania<\/strong>, ktor\u00e9 bolo st\u00e1le do zna\u010dnej miery nesplnen\u00e9,<strong> n\u00e1js\u0165 biologick\u00e9 z\u00e1klady pre in\u00e9 du\u0161evn\u00e9 poruchy<\/strong>, najm\u00e4 \u0165a\u017ek\u00e9 stavy, ako je schizofr\u00e9nia. A\u017e nesk\u00f4r sa uk\u00e1zalo, \u017ee neurosyfilis je nevhodn\u00fdm modelom pre \u010doko\u013evek, \u010do zjavne nes\u00favis\u00ed s infekciou alebo z\u00e1palom v oblasti front\u00e1lneho a tempor\u00e1lneho laloku.<\/p>\n<p>&nbsp;<\/p>\n<h3>Syfilis vs. hyst\u00e9ria<\/h3>\n<p>Na za\u010diatku boli oba stavy v\u0161eobecne uzn\u00e1van\u00e9 ako podvodn\u00edci alebo \u201enapodob\u0148ovatelia\u201c in\u00fdch chor\u00f4b, vr\u00e1tane seba navz\u00e1jom. <strong>Niektor\u00e9 pr\u00edpady syfilisu boli takmer ur\u010dite nespr\u00e1vne diagnostikovan\u00e9 ako hyst\u00e9ria a naopak<\/strong>. Ale e\u0161te d\u00f4le\u017eitej\u0161ie je, \u017ee sex &#8211; a hlbok\u00e9 obavy z neho &#8211; hrali d\u00f4le\u017eit\u00fa \u00falohu v sk\u00fasenostiach pacientov s oboma poruchami.<\/p>\n<p>Mnoho doktorov a myslite\u013eov nazna\u010duje, \u017ee to nebola n\u00e1hoda. Vek Freuda bol aj vekom syfilisu. Freud a v\u0161eobecnej\u0161ie psychoanal\u00fdza sa zamerala na potla\u010den\u00e9 sexu\u00e1lne fant\u00e1zie a traumy, preto\u017ee pre pacientov vtedy hanebn\u00fd a <strong>desiv\u00fd pr\u00edzrak syfilisu hrozivo visel nad ka\u017ed\u00fdm sexu\u00e1lnym stretnut\u00edm<\/strong>.<\/p>\n Hyst\u00e9ria v hist\u00f3ri\u00ed (ilustra\u010dn\u00e1 fotografia). Zdroj: littlethings.com\n<h3>Neurosyfilis<\/h3>\n<p>Samotn\u00fd neurosyfilis mo\u017eno rozlo\u017ei\u0165 na skor\u00e9 \u0161t\u00e1dium zah\u0155\u0148aj\u00face meninge\u00e1lne a cievne \u0161trukt\u00fary a neskor\u00e9 \u0161t\u00e1dium postihuj\u00face parench\u00fdm mozgu a miechy.<\/p>\n<p>Niektor\u00e9 z psychiatrick\u00fdch sympt\u00f3mov, ktor\u00e9 boli op\u00edsan\u00e9 u nelie\u010den\u00fdch pacientov s neurosyfilisom, <strong>zah\u0155\u0148aj\u00fa zmeny osobnosti, agres\u00edvne spr\u00e1vanie, m\u00e1niu, sluchov\u00e9 a zrakov\u00e9 halucin\u00e1cie, il\u00fazie, paranoju, progres\u00edvne kognit\u00edvne po\u0161kodenie, ktor\u00e9 \u010dasto vedie k strate zamestnania, del\u00edriu a bludom<\/strong>. Kv\u00f4li v\u010dasnej lie\u010dbe len asi 10 % a\u017e 15 % pr\u00edpadov prim\u00e1rneho syfilisu prejde do terci\u00e1rneho syfilisu a z t\u00fdchto pr\u00edpadov menej ako 20 % m\u00e1 prim\u00e1rne psychiatrick\u00e9 sympt\u00f3my.<\/p>\n<p>Len m\u00e1lo \u010dl\u00e1nkov v s\u00fa\u010dasnej literat\u00fare popisuje psych\u00f3zu ako prv\u00fd prejav syfilisu. V skuto\u010dnosti je u mnoh\u00fdch pacientov nad 45 rokov, ktor\u00ed sa prejavuj\u00fa ako psychotici, <strong>diagnostikovan\u00e1 schizofr\u00e9nia s neskor\u00fdm n\u00e1stupom<\/strong>. Schizofr\u00e9nia s neskor\u00fdm n\u00e1stupom predstavuje 15 % a\u017e 20 % v\u0161etk\u00fdch diagn\u00f3z schizofr\u00e9nie a je typicky spojen\u00e1 s lep\u0161\u00edm premorbidn\u00fdm fungovan\u00edm, men\u0161\u00edm po\u010dtom negat\u00edvnych sympt\u00f3mov a menej z\u00e1va\u017en\u00fdm neurokognit\u00edvnym po\u0161koden\u00edm v porovnan\u00ed so schizofr\u00e9niou, ktor\u00e1 sa prejavuje v skor\u0161om veku.<\/p>","protected":false},"excerpt":{"rendered":"<p>V roku 1495 vypukla epid\u00e9mia novej a hroznej choroby medzi vojakmi franc\u00fazskeho Karola VIII., ke\u010f vtrhol do Neapola v prvej talianskej vojne, a jej n\u00e1sledn\u00fd<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[51],"tags":[],"class_list":["post-7364","post","type-post","status-publish","format-standard","hentry","category-archiv","two-columns"],"_links":{"self":[{"href":"https:\/\/instrid.sk\/en\/wp-json\/wp\/v2\/posts\/7364","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/instrid.sk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/instrid.sk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/instrid.sk\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/instrid.sk\/en\/wp-json\/wp\/v2\/comments?post=7364"}],"version-history":[{"count":0,"href":"https:\/\/instrid.sk\/en\/wp-json\/wp\/v2\/posts\/7364\/revisions"}],"wp:attachment":[{"href":"https:\/\/instrid.sk\/en\/wp-json\/wp\/v2\/media?parent=7364"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/instrid.sk\/en\/wp-json\/wp\/v2\/categories?post=7364"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/instrid.sk\/en\/wp-json\/wp\/v2\/tags?post=7364"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}