Abstract
Responses in pre-modern eras to anorexia nervosa (as now understood) varied widely, from religious piety and sanctity through fear and superstition. While noting briefly the limited conceptualizations from pre-modern history this article is primarily focused from the late 19th century, commencing with helpful but tentative formulations of anorexia nervosa for early-modern medicine that were laid out, consistently between themselves, by Lesègue, Gull and Osler. Yet that promising biomedical advent was superseded for more than a half-century by deep, internal divisions and bitter rifts that festered between three medical disciplines: neurology; Freudian psychotherapy; and Kraepelinian biological psychiatry. Mid–20th century developments preceded the 1960–1980s’ improved understanding of suffering and movement toward effective remediation introduced by Dr. Hilde Bruch.
Highlights
Helping sufferers, their families and their health care providers to have an understanding of their ailment or disorder is an essential first step toward overcoming it
History affords a critical perspective for assessing anorexia nervosa (AN) on account of it being consistently encumbered by both conceptual and clinical ambiguities that interfere with effective diagnosis and efficacious treatment
In the early 1890s as neuro-psychiatry emerged within medicine’s sub-discipline of neurology, Toronto Medical graduate Campbell Meyers returned after qualifying in Europe, and at Johns Hopkins, as a Bfriend and collaborator^ of Weir Mitchell [24]
Summary
Their families and their health care providers to have an understanding of their ailment or disorder is an essential first step toward overcoming it. Eating disorders (EDs1), and anorexia nervosa (AN), have long been characterized by unusually staggering complexity, even in comparison with other intractable functional (inorganic) mental disorders. This is the case from every aspect—origins and cause, nosology, their immediate physical and emotional effects, their long-range impact on sufferers’ and their families’ health and functioning, the treatment options and prognosis for recovery. An understanding of AN’s historical evolution offers an accessible, complementary perspective for sufferers and their families—in conjunction with scientific explanations, current treatment approaches and their prognoses. History affords a critical perspective for assessing AN on account of it being consistently encumbered by both conceptual and clinical ambiguities that interfere with effective diagnosis and efficacious treatment. The specific factors of these ambiguities have long included: a (varying) persistence of stigma; a lack of clinical legitimacy, exacerbated by non-
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