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Insights Into Medical Communication

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Edited By Maurizio Gotti, Stefania Maria Maci and Michele Sala

This book analyses the subject of medical communication from a range of innovative perspectives, covering a broad spectrum of approaches and procedures that are particularly significant in this field.
In this volume, medical communication is analyzed from various viewpoints: not only from a merely linguistic angle, with a focus on the description of the genres used in medical and healthcare contexts, but also from a social and cultural standpoint, with an emphasis both on the doctor-patient relationship and on the social relevance of the other types of communicative links existing between the many communities involved in this type of interaction.
The study of some of the main fields typical of medical communication has highlighted a considerable variety of themes, data and research methods which are clearly representative of the eclectic interest in this specific domain and of the wide range of approaches developed for its investigation.
As the various chapters show, linguistic analysis proves to be highly applicable to textualizations involving multiple interactions and practices, and several kinds of participants, including different healthcare professionals, trainees and patients.
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‘Descriptive Psychopathology’ in Asylum Case Histories: The Case of John Horatio Baldwin

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1.  Introduction

Psychiatry in Great Britain at the turn of the 20th century underwent a nosological paradigm shift strongly influenced by the systematic efforts of German psychiatrist Emil Kraepelin (1856–1926) to ‘carve nature at the joints’ by separating mental illnesses into two major categories: those of thought and those of mood disorders. In the English-speaking world, Kraepelin’s categories were first debated academically, but they eventually permeated psychiatric vocabulary and practice and took on legal and forensic implications as they became ensconced in regulatory literature. Asylums were still at the forefront of psychiatric practice in the early 20th century; thus, documenting the practices of asylum doctors can offer a window into the early process of adopting the new nosology. In this chapter we focus on one of the key terms of the Kraeplinian nosology – Manic Depressive Insanity (MDI). We analyze its adoption in the clinical practice of one English asylum (Ticehurst) by looking in detail at the documented case history of the first patient formally diagnosed as ‘manic-depressive’ at that institution. Our goal was to chart the case notes documenting that patient’s symptoms longitudinally to see whether we could discern a pattern exhibiting the main characteristic of MDI, the cycling between mania, depression, and, occasionally ‘lucid intervals’, a pattern that could be visible in a retrospective historical analysis, but which attending doctors failed to perceive until the MDI diagnosis was adopted by the psychiatric community in Great Britain. We set that analysis against the backdrop of...

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