{"id":506,"date":"2013-05-10T21:27:34","date_gmt":"2013-05-10T21:27:34","guid":{"rendered":"http:\/\/harpa.blogg.is\/2013-05-10\/1318\/"},"modified":"2013-11-19T09:45:34","modified_gmt":"2013-11-19T09:45:34","slug":"1318","status":"publish","type":"post","link":"https:\/\/harpahreins.com\/blogg\/2013\/05\/10\/1318\/","title":{"rendered":"Malar\u00eda, brennisteinsol\u00eda og hiti vi\u00f0 ge\u00f0veiki"},"content":{"rendered":"

Julius Wagner-Jauregg<\/a> starfa\u00f0i sem ge\u00f0l\u00e6knir \u00ed V\u00ednarborg og af kl\u00edn\u00edskri reynslu sinni \u00fe\u00f3ttist hann hafa teki\u00f0 eftir a\u00f0 ge\u00f0sj\u00faklingum\u00a0af s\u00fdfilis sem fengu hitas\u00f3tt sk\u00e1na\u00f0i ge\u00f0veikin. Wagner-Jauregg f\u00f3r \u00fev\u00ed a\u00f0 pr\u00f3fa sig \u00e1fram me\u00f0 a\u00f0 framkalla hitas\u00f3ttarvi\u00f0br\u00f6g\u00f0 \u00ed sj\u00faklingum s\u00ednum, pr\u00f3fa\u00f0i m.a. a\u00f0 s\u00fdkja \u00fe\u00e1 me\u00f0 strept\u00f3kokkum<\/a> og turbeculini<\/a> (efni unni\u00f0 \u00far berklabakter\u00edunni, var tali\u00f0 gagnast til a\u00f0 l\u00e6kna berkla en reyndist \u00f3noth\u00e6ft til \u00feess, hins vegar var \u00fea\u00f0 seinna nota\u00f0 til a\u00f0 pr\u00f3fa h\u00fa\u00f0vi\u00f0br\u00f6g\u00f0 \u00feegar skima\u00f0 er fyrir berklum) en haf\u00f0i ekki erindi sem erfi\u00f0i. Lukkuhj\u00f3li\u00f0 sn\u00e9rist honum \u00ed hag \u00feegar hann f\u00e9kk malar\u00edusmita\u00f0an hermann \u00e1 taugadeildina s\u00edna. Malar\u00eda var miklu vi\u00f0r\u00e1\u00f0anlegri en \u00f6nnur alvarleg hitas\u00f3tt \u00fev\u00ed k\u00edn\u00edn var uppfundi\u00f0 og m\u00e1tti gefa vi\u00f0 malar\u00edu. Wagner-Jauregg sprauta\u00f0i bl\u00f3\u00f0i malar\u00edusmita\u00f0a sj\u00faklingsins \u00ed tvo sj\u00faklinga me\u00f0 s\u00fdfilisge\u00f0veiki (dementia paralytica) \u00feann 14. j\u00fan\u00ed 1917; svo nota\u00f0i hann bl\u00f3\u00f0i\u00f0 \u00far \u00feeim til a\u00f0 s\u00fdkja l\u00edtinn h\u00f3p s\u00fdfilis-ge\u00f0veikis-sj\u00faklinga. \u00deessir sj\u00faklingar fengu h\u00e1an hita. \u00deegar hitinn haf\u00f0i n\u00e1\u00f0 h\u00e1marki nokkrum sinnum var \u00feeim gefi\u00f0 k\u00edn\u00edn gegn malar\u00edunni. Og voru \u00fe\u00e1 fr\u00edskir af ge\u00f0veikinni, a\u00f0 mati Wagner-Jauregg.<\/font><\/p>\n

Wagner-Jauregg birti ni\u00f0urst\u00f6\u00f0ur tilrauna sinna \u00e1ri\u00f0 1918. \u00cd \u00feeim h\u00e9lt hann \u00fev\u00ed fram a\u00f0 uppundir 70% sj\u00faklinganna hef\u00f0i batna\u00f0 ge\u00f0veikin vi\u00f0 a\u00f0 s\u00fdkjast af malar\u00edu. \u00c1 \u00feessum t\u00edma var ge\u00f0veiki af v\u00f6ldum s\u00fdfilis st\u00f3rt vandam\u00e1l \u00e1 evr\u00f3pskum ge\u00f0veikrah\u00e6lum; H\u00fan var gersamlega \u00f3l\u00e6knandi og dau\u00f0daginn hr\u00e6\u00f0ilegur. Fr\u00e1 \u00fev\u00ed veikin braust \u00fat og \u00fear til menn d\u00f3u li\u00f0u a\u00f0 jafna\u00f0i \u00ferj\u00fa \u00e1r. Svo menn t\u00f3ku uppg\u00f6tvun Wagner-Jauregg fagnandi og \u00e1ri\u00f0 1927 f\u00e9kk hann N\u00f3belsver\u00f0launin fyrir uppfinningu s\u00edna, fyrstur ge\u00f0l\u00e6kna.<\/font><\/p>\n

\"Sokkur\u00cd Danm\u00f6rku vildu menn au\u00f0vita\u00f0 reyna \u00feetta l\u00edka. Sj\u00faklingar me\u00f0 dementia paralytica voru margir \u00fear: \u00c1ri\u00f0 1924 var \u00e1\u00e6tla\u00f0 a\u00f0 \u00feeir v\u00e6ru 10%-20% af \u00f6llum innl\u00f6gnum \u00e1 ge\u00f0veikah\u00e6li \u00ed Danm\u00f6rku, vi\u00f0 s\u00ed\u00f0ari t\u00edma athugun \u00e1 innl\u00f6gnum \u00e1 Sct. Hans sp\u00edtalann \u00ed Hr\u00f3arskeldu \u00e1 \u00e1rabilinu 1915-1921 reyndust sj\u00faklingar me\u00f0 s\u00fdfilis-ge\u00f0veiki vera 18% allra innlag\u00f0ra.<\/font><\/p>\n

Yfirl\u00e6knirinn \u00e1 Sct. Hans \u00ed Hr\u00f3arskeldu, Axel Bisgaard, l\u00fdsti dementia paralytica \u00e1 \u00feessa lei\u00f0, \u00e1ri\u00f0 1923:<\/font><\/p>\n

Fyrstu merki sj\u00fakd\u00f3msins eru venjulega minnistruflanir, a\u00f0 sj\u00faklingurinn er illa \u00e1tta\u00f0ur og lundin er \u00fdmist svarts\u00fdn e\u00f0a \u00ed sk\u00fdjunum. Oft er g\u00f6ngulag skrykkj\u00f3tt og v\u00f6\u00f0vakippir \u00ed andlitinu, einkum kringum munninn. Sj\u00faklingurinn \u00e1 erfitt me\u00f0 m\u00e1l, skrift hans er hrafnaspark og hann gerir urmul af villum. Sj\u00e1\u00f6ldrin eru sem t\u00edtuprj\u00f3nar. S\u00e9 sj\u00faklingur \u00ed sk\u00fdjunum sl\u00e6r hann um sig me\u00f0 st\u00f3rfenglegum hugmyndum og loftk\u00f6stulum, sem tengjast \u00e1 fur\u00f0ulegan h\u00e1tt og or\u00f0f\u00e6ri er undarlegt. Seinna meir lamast svona sj\u00faklingar oft a\u00f0 hluta og f\u00e1 krampak\u00f6st, samfara \u00fev\u00ed a\u00f0 sj\u00faklingurinn ver\u00f0ur \u00e6 slj\u00f3rri og a\u00f0 lokum alveg \u00fat \u00far heiminum.\u00a0\u00a0<\/font><\/p>\n

Myndin er \u00far Psychiatrie: Ein Lehrbuch f\u00fcr Studirende und Aerzte<\/i> eftir Emil Kraepelin (\u00fatg. 1899) og s\u00fdnir sokk sem s\u00fdfilisge\u00f0veikur sj\u00faklingur prj\u00f3na\u00f0i. Sem sj\u00e1 m\u00e1 kemst enginn \u00ed \u00feennan sokk.<\/font>
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Fyrstur til a\u00f0 pr\u00f3fa malar\u00edume\u00f0fer\u00f0ina \u00ed Danm\u00f6rku var Axel Bisgaard, yfirl\u00e6knir \u00e1 Sct. Hans. Hann f\u00f3r me\u00f0 tvo sj\u00faklinga s\u00edna til V\u00ednarborgar, til Wagner-Jauregg, og l\u00e9t smita \u00fe\u00e1 \u00fear. Bl\u00f3\u00f0i\u00f0 \u00far \u00feeim var svo nota\u00f0 til a\u00f0 smita fleiri og \u00feannig koll af kolli \u00e1 ge\u00f0sj\u00fakrah\u00fasum um alla Danm\u00f6rku. Fyrirm\u00e6lum Wagner-Jauregg var fylgt: Sj\u00faklingarnir skyldu f\u00e1 10 hitatoppa, \u00fear sem hitinn v\u00e6ri 40\u00b0-41\u00b0stig og svo m\u00e1tti gefa \u00feeim k\u00edn\u00edn. \u00deetta var au\u00f0vita\u00f0 hrossal\u00e6kning og talver\u00f0 h\u00e6tta \u00e1 a\u00f0 deyja af henni. Ni\u00f0urst\u00f6\u00f0ur deildarl\u00e6knis \u00e1 Sct. Hans, sem sko\u00f0a\u00f0i afdrif hundra\u00f0 malar\u00edus\u00fdktra kvenna, \u00e1ri\u00f0 1939, voru a\u00f0 13% hef\u00f0u l\u00e1tist \u00far malar\u00edunni. 1944 f\u00f3ru menn aftur yfir t\u00f6lurnar \u00e1 Sct. Hans og \u00fe\u00e1 var ni\u00f0ursta\u00f0an s\u00fa a\u00f0 af \u00f6llum sj\u00faklingum sem \u00feessi l\u00e6kningara\u00f0fer\u00f0 var pr\u00f3fu\u00f0 \u00e1 hef\u00f0u 7% l\u00e1tist af me\u00f0fer\u00f0inni. En jafnframt virtist 30-50% hafa batna\u00f0 svo d\u00f6nsku ge\u00f0l\u00e6knarnir voru \u00e1fram j\u00e1kv\u00e6\u00f0ir \u00ed gar\u00f0 \u00feessarar me\u00f0fer\u00f0ar.<\/font><\/p>\n

Menn h\u00f6f\u00f0u samt ekki hugmynd um af hverju malar\u00edus\u00fdkingin virka\u00f0i. Sumir h\u00e9ldu a\u00f0 malar\u00edan trufla\u00f0i einhvern veginn s\u00fdfilisbaker\u00eduna, sumir h\u00e9ldu a\u00f0 hitinn sj\u00e1lfur v\u00e6ri l\u00e6knandi, sumir h\u00e9ldu a\u00f0 malar\u00edan styrkti l\u00edkamann til a\u00f0 framlei\u00f0a m\u00f3tefni sem h\u00e6g\u00f0i \u00e1 s\u00e1ras\u00f3ttinni (s\u00fdfilisnum).<\/font><\/p>\n

Sm\u00e1m saman dr\u00f3 \u00far notkun \u00feessarar a\u00f0fer\u00f0ar \u00ed Danm\u00f6rku. Kom \u00fear \u00fdmislegt til, t.a.m. erfi\u00f0leikar vi\u00f0 a\u00f0 halda malar\u00edunni vi\u00f0, \u00fe.e.a.s. a\u00f0 hafa alltaf til rei\u00f0u smita\u00f0a sj\u00faklinga \u00ed m\u00f6rgum bl\u00f3\u00f0flokkum svo h\u00e6gt v\u00e6ri a\u00f0 smita a\u00f0ra sj\u00faklinga, n\u00fdjar hitah\u00e6kkandi a\u00f0fer\u00f0ir eins og hitakassar (sj\u00e1 undir lok \u00feessarar f\u00e6rslu), sem komu l\u00edkamshitanum \u00ed 40\u00b0, h\u00e9ldu innrei\u00f0 s\u00edna 1942 og loks \u00feegar pensill\u00edni\u00f0 kom \u00e1 marka\u00f0 eftir s\u00ed\u00f0ari heimsstyrj\u00f6ldina vann \u00fea\u00f0 \u00e1 s\u00fdfilis og dementia paralytica var\u00f0 s\u00e1rasjaldg\u00e6fur ge\u00f0sj\u00fakd\u00f3mur. Samt sem \u00e1\u00f0ur var haldi\u00f0 eitthva\u00f0 \u00e1fram a\u00f0 smita s\u00fdfilisge\u00f0veika me\u00f0 malar\u00edu, t.d. var \u00feeirri me\u00f0fer\u00f0 beitt \u00e1 13 sj\u00faklinga \u00e1ri\u00f0 1948 og 22 sj\u00faklinga \u00e1ri\u00f0 1949 \u00e1 Sct. Hans ge\u00f0sj\u00fakrah\u00fasinu. En svo h\u00e6ttu menn \u00feessu.<\/font><\/p>\n

M\u00e9r \u00feykir afar \u00f3l\u00edklegt a\u00f0 malar\u00edume\u00f0h\u00f6ndlun hafi nokkru sinni veri\u00f0 reynd \u00e1 \u00cdslandi, \u00fe\u00f3 ekki v\u00e6ri nema vegna f\u00e1mennis og erfi\u00f0leika vi\u00f0 a\u00f0 halda malar\u00edu h\u00e9r vi\u00f0. Dementia paralytica vir\u00f0ist heldur ekki hafa veri\u00f0 algengur ge\u00f0sj\u00fakd\u00f3mur h\u00e9rlendis. \u00cd fyrirlestrinum \u00c1hrif f\u00f6stu \u00e1 undirvitundina, sem \u00de\u00f3r\u00f0ur Sveinsson flutti \u00ed L\u00e6knaf\u00e9lagi Reykjav\u00edkur \u00ed desember 1922, sag\u00f0ist hann ekki hafa fengi\u00f0 sj\u00fakling me\u00f0 dementia paralytica h\u00e9rlendis en hef\u00f0i s\u00e9\u00f0 \u00fe\u00e1 hundru\u00f0um saman \u00ed \u00de\u00fdskalandi og Danm\u00f6rku. \u00cd lista yfir 300 sj\u00faklinga sem voru lag\u00f0ir inn \u00e1 Klepp 1933-36 hafa fimm karlar og ein kona \u00feessa sj\u00fakd\u00f3msgreiningu, \u00fe.e. 2% sj\u00faklinganna. (Helgi T\u00f3masson o.fl. 1937.) Svo \u00fea\u00f0 var engin kn\u00fdjandi \u00fe\u00f6rf fyrir l\u00e6kningu \u00e1 \u00feessum ge\u00f0sj\u00fakd\u00f3mi h\u00e9rlendis.<\/font>
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Brennisteinsol\u00edu-me\u00f0fer\u00f0<\/font><\/b><\/p>\n

G\u00f3\u00f0ur \u00e1rangur af malar\u00edume\u00f0fer\u00f0inni vi\u00f0 dementia paralytica bl\u00e9s ge\u00f0l\u00e6knum n\u00fdrri von i brj\u00f3st um a\u00f0 finna samb\u00e6rilegar me\u00f0fer\u00f0ir vi\u00f0 \u00f6\u00f0rum erfi\u00f0um ge\u00f0sj\u00fakd\u00f3mum. Menn horf\u00f0u \u00fear helst til ge\u00f0klofa, sem danskur yfirl\u00e6knir kalla\u00f0i \u201ehi\u00f0 mikla \u00f3l\u00e6knandi botnfall sem fyllir ge\u00f0veikrasp\u00edtalana.\u201c Yfirleitt er tali\u00f0 a\u00f0 50-60% sj\u00faklinga \u00e1 ge\u00f0sp\u00edt\u00f6lum \u00ed Evr\u00f3pu hafi veri\u00f0 haldnir ge\u00f0klofa. Helgi T\u00f3masson segir \u00ed greininni \u00c6\u00f0i hj\u00e1 sj\u00faklingum me\u00f0 schizophreni sem birtist \u00ed L\u00e6knabla\u00f0inu<\/i> 1932 um ge\u00f0klofa\/ge\u00f0klofasj\u00faklinga:<\/font>
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Engin t\u00e6ki eru \u00feekt, n\u00e9 \u00fatb\u00fana\u00f0ur, sem geti st\u00f6\u00f0va\u00f0 \u00f3r\u00f3ak\u00f6st \u00feeirra [- – -] ef ekkert v\u00e6ri a\u00f0hafst myndu sj\u00faklingarnir \u00e6\u00f0a til dau\u00f0a e\u00f0a koma st\u00f3rslasa\u00f0ir \u00far k\u00f6stunum, \u00fev\u00ed h\u00e9r er um hina band\u00f3\u00f0ustu allra brj\u00e1la\u00f0ra manna a\u00f0 r\u00e6\u00f0a.<\/font><\/p><\/blockquote>\n

Og svo alveg s\u00e9\u00a0 lj\u00f3st s\u00e9 vi\u00f0 hva\u00f0 var a\u00f0 etja er h\u00e9r hluti af sj\u00fakras\u00f6gu \u00far grein Helga:<\/font>
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I. 27 \u00e1ra karlma\u00f0ur, V. K., No 207\/98, veikur \u00ed 8 \u00e1r af mj\u00f6g sv\u00e6sinni schizophreni. H\u00e9r \u00e1 sp\u00edtalanum s\u00ed\u00f0an 1931. Er slj\u00f3r og uppleystur en f\u00e6r \u00f6\u00f0ru hvoru altaf hin hro\u00f0alegustu \u00e6\u00f0isk\u00f6st, sem standa nokkra daga til 2-3 vikur, r\u00e6\u00f0st \u00e1 allt og alla, br\u00fdtur og bramlar, er mj\u00f6g misskynjandi, skammast og \u00f6skrar, neytir hvorki svefns n\u00e9 matar. Vir\u00f0ist \u00ed lok kastanna oft alveg a\u00f0framkominn, gr\u00e1svartur \u00e1 lit, \u00feurr og altekinn.<\/font>
\n\u00a0\u00a0\u00a0 14.08. 1934: Byrjandi kast undir kv\u00f6ldi\u00f0. Fyrst ekki mj\u00f6g \u00e6stur og f\u00e6r \u00fev\u00ed kl. 20,30 1 g. Medinal. R\u00f3ast ekki vel af \u00fev\u00ed og f\u00e6r \u00fev\u00ed kl. 22 1,5 g. Chloral. \u00deetta dugar ekkert, hann ver\u00f0ur \u00e6stari og \u00e6stari, n\u00e6r \u00ed ofngrindina og r\u00edfur hana upp, hendir henni \u00ed gluggann og m\u00f6lbr\u00fdtur margar r\u00fa\u00f0ur. Hann hefir fr\u00e1 gamalli t\u00ed\u00f0 veri\u00f0 \u00ed belti \u00ed r\u00faminu, dansar n\u00fa me\u00f0 r\u00fami\u00f0 um stofuna, og ber og lemur. F\u00e6r kl. 23,30 scop.-morfin (1,5 mg-1 ctg.) og 10 m\u00edn. s\u00ed\u00f0ar aftur sama skamt. Ver\u00f0ur sm\u00e1msaman r\u00f3legur af \u00feessu og fellur \u00ed m\u00f3k, en vaknar kl. 4 engu betri. F\u00e9kk \u00fe\u00e1 aftur scop.-morfin, helmingi minni dosis, r\u00f3ast a\u00f0eins l\u00edti\u00f0, og er kl. 10 or\u00f0inn mj\u00f6g \u00f3\u00f0ur og \u00f3vi\u00f0r\u00e1\u00f0anlegur. Br\u00fdtur r\u00fa\u00f0u me\u00f0 hnefanum, sker sig d\u00e1l\u00edti\u00f0, vir\u00f0ist eins og \u00e1tta sig sn\u00f6ggvast, kvartar um \u00f3frelsi sitt og ilsku og h\u00e1gr\u00e6tur. Stuttu s\u00ed\u00f0ar aftur alveg sj\u00f3\u00f0vitlaus […]<\/font><\/p><\/blockquote>\n

Lyfl\u00e6knirinn Knud Schroeder<\/a>, yfirl\u00e6knir \u00e1 sj\u00fakrah\u00fasinu \u00ed \u00d3\u00f0insv\u00e9um, f\u00f3r a\u00f0 gera tilraunir me\u00f0 n\u00fdja hitaframkallandi me\u00f0fer\u00f0, sem hann hugsa\u00f0i \u00ed upphafi sem vi\u00f0b\u00f3t e\u00f0a valkost vi\u00f0 malar\u00edume\u00f0fer\u00f0ina og \u00e1tti a\u00f0 beita \u00e1 dementia paralytica. Hann fann upp \u00e1 a\u00f0 nota n\u00fdtt efni, brennisteinsol\u00edu (sulfosin), sem olli h\u00e1um hita \u00feegar \u00fev\u00ed var sprauta\u00f0 \u00ed v\u00f6\u00f0va. Schroeder h\u00e9lt \u00fev\u00ed fram a\u00f0 \u00fea\u00f0 v\u00e6ri au\u00f0veldara a\u00f0 eiga vi\u00f0 brennisteinsol\u00eduna en malar\u00edu og taldi l\u00edka a\u00f0 h\u00fan g\u00e6ti gagnast vi\u00f0 fleiri ge\u00f0sj\u00fakd\u00f3mum en dementia paralytica, t.d. ge\u00f0klofa (sem \u00ed Danm\u00f6rku var \u00fdmist kalla\u00f0ur dementia pr\u00e6cox e\u00f0a skizofreni), \u00fea\u00f0 v\u00e6ri um a\u00f0 gera a\u00f0 pr\u00f3fa. \u00cd greinunum sem hann skrifa\u00f0i setti hann aldrei fram neina sk\u00fdringu \u00e1 \u00fev\u00ed af hverju innsprautun me\u00f0 brennisteinsol\u00edu \u00e6tti a\u00f0 virka \u00e1 a\u00f0ra sj\u00fakd\u00f3ma en dementia paralytica, l\u00e9t duga a\u00f0 sta\u00f0h\u00e6fa a\u00f0 h\u00e1r hiti virtist hafa g\u00f3\u00f0 \u00e1hrif \u00e1 ge\u00f0klofasj\u00faklinga.<\/font><\/p>\n

Fyrstu ni\u00f0urst\u00f6\u00f0ur \u00e1 pr\u00f3funum hans \u00e1 brennisteinsol\u00edu voru birtar 1927, v\u00f6ktu mikla athygli og ger\u00f0u Knud Schroeder heimsfr\u00e6gan. A\u00f0fer\u00f0in var notu\u00f0 v\u00ed\u00f0a um heim og au\u00f0vita\u00f0 \u00ed Danm\u00f6rku. \u00c1 \u00e1ratugnum 1928-38 voru t.d. m\u00f6rg hundru\u00f0 sj\u00faklingar \u00e1 Vordinborg (Oringe) ge\u00f0veikrah\u00e6linu sprauta\u00f0ir me\u00f0 brennisteinsol\u00edu. Samt haf\u00f0i yfirl\u00e6knirinn \u00fear, Hjalmar Helweg, skrifa\u00f0 neikv\u00e6\u00f0an d\u00f3m um me\u00f0fer\u00f0ina \u00ed Ugeskrift for L\u00e6ger<\/i> 1929, sagt a\u00f0 l\u00e6kningarm\u00e1ttur hennar gegn ge\u00f0klofa v\u00e6ri ekki sannf\u00e6randi. Ge\u00f0l\u00e6knirinn J\u00f8rgen Ravn, sem vann \u00e1 Sct. Hans ge\u00f0sj\u00fakrah\u00fasinu, skrifa\u00f0i grein um brennisteinsol\u00edume\u00f0fer\u00f0ina \u00ed Nordisk Medicinsk Tidsskrift<\/i> 1934 \u00fear sem hann h\u00e9lt \u00fev\u00ed fram a\u00f0 ekki v\u00e6ri h\u00e6gt a\u00f0 telja batahlutfall ge\u00f0klofasj\u00faklinga sem sprauta\u00f0ir voru me\u00f0 s\u00falfosan neitt h\u00e6rra en \u00fea\u00f0 hlutfall sl\u00edkra sj\u00faklinga sem batna\u00f0i \u00e1n l\u00e6knisme\u00f0fer\u00f0ar. Hann sag\u00f0i og fr\u00e1 \u00fev\u00ed a\u00f0 hann hef\u00f0i \u00feurft a\u00f0 h\u00e6tta \u00feessari me\u00f0fer\u00f0 vegna sl\u00e6mra og h\u00e6ttulegra aukaverkana: Sj\u00faklingana s\u00e1rkenndi til \u00feegar sprauta\u00f0 var \u00ed v\u00f6\u00f0va, nokkrir h\u00f6f\u00f0u kasta\u00f0 upp, fengi\u00f0 k\u00f6ldu, horast og veikst \u00ed me\u00f0fer\u00f0inni. \u00cd einum sj\u00faklingi vildi hitinn ekki l\u00e6kka aftur og \u00feegar greinin var skrifu\u00f0 haf\u00f0i sj\u00faklingurinn haft hita \u00ed fimm m\u00e1nu\u00f0i og myndi l\u00edklega ekki lifa af, sag\u00f0i Ravn. \u00d3ttar Gu\u00f0mundsson segir \u00ed Kleppi \u00ed 100 \u00e1r: \u201e<\/i>\u00deessi me\u00f0fer\u00f0 \u00fe\u00f3tti v\u00edsindalegri [en malar\u00edume\u00f0fer\u00f0in] og f\u00e9ll sj\u00faklingum betur \u00ed ge\u00f0.\u201c (s. 70). \u00c9g veit ekki \u00e1 hva\u00f0a heimild \u00d3ttar byggir \u00feetta.<\/font><\/p>\n

Helgi T\u00f3masson, sem var r\u00e1\u00f0inn l\u00e6knir \u00e1 N\u00fdja Kleppi \u00e1ri\u00f0 1929 og var\u00f0 yfirl\u00e6knir \u00e1 Kleppi 1939, stunda\u00f0i sitt l\u00e6knisn\u00e1m \u00ed Danm\u00f6rku. Hann \u00fatskrifa\u00f0ist me\u00f0 cand. med gr\u00e1\u00f0u 1922 og dokorsgr\u00e1\u00f0u 1927, hvort tveggja fr\u00e1 Kaupmannahafnarh\u00e1sk\u00f3la. Helgi vann m.a. \u00ed Vordinborg, \u00e1 Sjette afdeling Kommunehospitalets \u00ed Kaupmannah\u00f6fn og \u00e1 Nyk\u00f8bing Sindssygehospital. L\u00edklega h\u00f6f\u00f0u \u00feessi sterku tengsl vi\u00f0 Danm\u00f6rku eitthva\u00f0 a\u00f0 segja \u00ed \u00fev\u00ed a\u00f0 Helgi nota\u00f0i brennisteinsol\u00edu-me\u00f0fer\u00f0ina t\u00f6luvert \u00e1 s\u00edna sj\u00faklinga \u00e1 Kleppi. \u00d3ttar Gu\u00f0mundsson (2007, s. 73) l\u00fdsir henni svona:<\/font>
\n\u00a0<\/p>\n

Sj\u00faklingarnir fengu sprautur a\u00f0 kveldi og s\u00ed\u00f0an var fylgst me\u00f0 hitanum. Venjulega voru \u00fea\u00f0 l\u00e6knanemar sem g\u00e1fu sprauturnar og skr\u00e1\u00f0u hitah\u00e6kkunina. Ekki fer miklum s\u00f6gnum af \u00e1rangri \u00feessarar me\u00f0fer\u00f0ar.<\/font><\/p><\/blockquote>\n

\u00cd grein Helga T\u00f3massonar, \u00c6\u00f0i hj\u00e1 sj\u00faklingum me\u00f0 schizophreni (\u00ed L\u00e6knabla\u00f0inu<\/i> 1934), minnist hann \u00e1 brennisteinsol\u00edume\u00f0fer\u00f0 (sulfosin) \u00ed tilvitnunum \u00ed tv\u00e6r sj\u00fakras\u00f6gur af \u00feremur. Vel a\u00f0 merkja er greinin skrifu\u00f0 til a\u00f0 hampa gj\u00f6f \u00f6rvandi lyfja (ephedrin) vi\u00f0 ge\u00f0klofa og kemur fram \u00ed \u00feessum d\u00e6mum a\u00f0 sulfosin hafi ekki virka\u00f0: \u201eFr\u00e1 mi\u00f0jum sept. til mi\u00f0s okt. reyndur sulfosink\u00far. En heldur virtist honum fara aftur \u00e1 me\u00f0an heldur en hitt\u201c segir \u00ed \u00f6\u00f0ru d\u00e6minu.<\/font>
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\u00d6nnur hitame\u00f0fer\u00f0 til ge\u00f0l\u00e6kninga<\/font><\/b><\/p>\n

\u00cd L\u00e6knabla\u00f0inu<\/i> jan.-feb. 1934 birtist me\u00f0al erlendra fr\u00e9tta:<\/font>
\n\u00a0<\/p>\n

Miki\u00f0 hefur veri\u00f0 skrifa\u00f0 um \u00fe\u00fd\u00f0ingu hitas\u00f3ttar, sem venjulega fylgir fars\u00f3ttum, og hefir h\u00fan veri\u00f0 \u00fdmist sko\u00f0u\u00f0 sem blessun e\u00f0a b\u00f6lvun. Enn er \u00feetta mikla m\u00e1l \u00f3\u00fatr\u00e6tt.<\/font>
\n\u00a0\u00a0\u00a0 \u00deegar Wagner-Jauregg t\u00f3k upp malarial\u00e6kning s\u00edna vi\u00f0 paralysis generalis var um \u00fea\u00f0 deilt, hvort heldur l\u00e6kningin v\u00e6ra [svo] a\u00f0 \u00feakka hitas\u00f3ttinni e\u00f0a einhverju \u00f6\u00f0ru. Hvort heldur sem er, \u00fe\u00e1 var\u00f0 \u00feetta til \u00feess a\u00f0 dr. W. R. Whitney kom til hugar a\u00f0 hita m\u00e6tti sj\u00faklingana me\u00f0 rafmagnsstuttbylgjum, og bj\u00f3 hann til \u00e1hald til \u00feessa. Gat hann hita\u00f0 menn me\u00f0 \u00fev\u00ed svo miki\u00f0 og svo lengi sem vera skyldi. \u00deetta var s\u00ed\u00f0an reynt vi\u00f0 paralysis gener., en \u00fe\u00f3tti ekki gefast jafnvel og gamla a\u00f0fer\u00f0in.<\/font>
\n\u00a0\u00a0\u00a0 S\u00ed\u00f0an hefir \u00feessi hital\u00e6kning veri\u00f0 reynd vi\u00f0 marga kvilla. Dr. C. F. Tenny (New York) segir hana hafa gefist vel vi\u00f0 b\u00f3lgur \u00ed grindarholi, arthritis, trega bl\u00f3\u00f0r\u00e1s \u00ed \u00fatlimum, neuritis, syfilis og gonorhoe.<\/font>
\n\u00a0\u00a0\u00a0 \u00deessi hital\u00e6kning er enn \u00e1 tilraunastigi, svo erfitt er um a\u00f0 d\u00e6ma. \u00de\u00f3 m\u00e1 ganga a\u00f0 \u00fev\u00ed v\u00edsu, a\u00f0 \u00feessi merkilega uppg\u00f6tvun reynist n\u00fdtileg til margra hluta.<\/font>
\n\u00a0\u00a0\u00a0 (Dumaresq les Bas \u00ed Lancet 27. febr. ’34).<\/font><\/p><\/blockquote>\n

\u00deessi litla fr\u00e9tt s\u00fdnir a\u00f0 h\u00e9rlendis fylgdust l\u00e6knar vel me\u00f0 n\u00fdjungum \u00ed hinum st\u00f3ra heimi. H\u00fan s\u00fdnir l\u00edka tr\u00fa \u00e1 l\u00e6kningargildi hita vi\u00f0 \u00fdmsum kvillum og tr\u00fa \u00e1 m\u00f6guleika rafmagns til l\u00e6kninga en \u00fea\u00f0 \u00e1tti aldeilis eftir a\u00f0 hafa \u00e1hrif \u00ed ge\u00f0l\u00e6kningum nokkrum \u00e1rum s\u00ed\u00f0ar og hefur enn \u00feann dag \u00ed dag.<\/font><\/p>\n

\"Hydroterm\"\u00cd Danm\u00f6rku f\u00f3ru menn a\u00f0 nota hitakassa til a\u00f0 l\u00e6kna s\u00fdfilissj\u00faklinga \u00e1ri\u00f0 1942 (\u00e1 Rigshospitalet – tveimur \u00e1rum s\u00ed\u00f0ar \u00e1 Sct. Hans). \u00cd hitak\u00f6ssum m\u00e1tti h\u00e6kka l\u00edkamshita sj\u00faklinganna og \u00feurfti \u00fe\u00e1 ekki lengur malar\u00eduna til \u00feess. Hitakassarnir voru \u00feannig a\u00f0 \u00ed \u00feeim h\u00e9lst 45-60\u00b0 hiti og rakastigi\u00f0 var 35-70%. \u00deetta var sem sagt eins og velheit finnsk s\u00e1na og v\u00e6ri sj\u00faklingur haf\u00f0ur n\u00f3gu lengi \u00ed kassanum h\u00e6kka\u00f0i l\u00edkamshitinn duglega. Ekki voru allir hrifnir, t.d. kvarta\u00f0i yfirl\u00e6knirinn \u00e1 Sct. Hans undan \u00fev\u00ed \u00ed br\u00e9fi til heilbrig\u00f0isyfirvalda a\u00f0 \u00feetta v\u00e6ri alltof d\u00fdrt, malar\u00edume\u00f0h\u00f6ndlunin v\u00e6ri mun \u00f3d\u00fdrari \u00fev\u00ed \u201eapparati\u00f0 notar 3.000 – 5.000 w\u00f6tt \u00e1 klukkustund [svo].\u201c Auk \u00feess, sag\u00f0i hann, hefur malar\u00edume\u00f0h\u00f6ndlun \u00feann kost a\u00f0 hana m\u00e1tti \u201ebeita l\u00edka mj\u00f6g \u00f3r\u00f3lega sj\u00faklinga, sem er erfitt \u00ed hitakassanum.\u201c<\/font><\/p>\n

Myndin er af hitakassa og einungis h\u00f6fu\u00f0 sj\u00faklingsbr\u00fa\u00f0unnar stendur upp \u00far honum. \u00deessi hitakassi er \u00e1 Glore Psychiatric Museum<\/a> \u00ed Missouri, Bandar\u00edkjunum.<\/font><\/p>\n

\u00c9g veit ekki til \u00feess a\u00f0 svona hitakassar hafi veri\u00f0 nota\u00f0ir \u00e1 \u00cdslandi (en \u00f3neitanlega minnir a\u00f0fer\u00f0in mj\u00f6g \u00e1 svita-vatnsl\u00e6kningar \u00de\u00f3r\u00f0ar Sveinssonar undir lok starfsferil hans, sj\u00e1 f\u00e6rsluna Upphaf ge\u00f0l\u00e6kninga \u00e1 \u00cdslandi<\/a>). Einhverjir eru enn vi\u00f0 sama heygar\u00f0shorni\u00f0 ef marka m\u00e1 \u00feessa n\u00fdju augl\u00fdsingu fr\u00e1 ge\u00f0l\u00e6knadeildinni vi\u00f0 h\u00e1sk\u00f3lann \u00ed Arizona<\/a> \u00fear sem augl\u00fdst er eftir \u00feunglyndissj\u00faklingum til a\u00f0 pr\u00f3fa gl\u00e6n\u00fdja l\u00e6knisme\u00f0fer\u00f0 vi\u00f0 \u00feunglyndi, nefnilega hitame\u00f0fer\u00f0 \ud83d\ude09<\/font><\/p>\n

Helgi T\u00f3masson nota\u00f0i talsvert, eins og fyrr sag\u00f0i, brennisteinsol\u00edu (sulfosan) til a\u00f0 l\u00e1ta ge\u00f0klofasj\u00faklinga f\u00e1 hita. Hann nota\u00f0i fleiri a\u00f0fer\u00f0ir til hins sama, t.d. hef \u00e9g eftir munnlegri heimild a\u00f0 \u00e1ri\u00f0 1955 hafi sumum sj\u00faklingum Helga veri\u00f0 teki\u00f0 bl\u00f3\u00f0 (\u00far bl\u00e1\u00e6\u00f0 \u00ed handlegg) og bl\u00f3\u00f0inu strax \u00e1 eftir sprauta\u00f0 \u00ed v\u00f6\u00f0va. Vi\u00f0m\u00e6landi minn taldi a\u00f0 \u00feetta hef\u00f0i veri\u00f0 gert til a\u00f0 \u201ef\u00e1 hitareaksj\u00f3n\u201c en hva\u00f0a tilgangi h\u00fan \u00e1tti a\u00f0 \u00fej\u00f3na vissi hann ekki.<\/font><\/p>\n

Helgi skrifa\u00f0i yfirlitsgreinina Shock \u00ed desemberhefti L\u00e6knabla\u00f0sins<\/i> 1934. \u00dear fjallar hann um efni sem eru til \u00feess a\u00f0 framkalla shock og \u00fear \u00e1 me\u00f0al:<\/font><\/p>\n

Bl\u00f3\u00f0<\/i> er teki\u00f0 \u00far venu, 10-20 cm3<\/sup>, og inj. subcutant<\/i> e\u00f0a intramuscul\u00e6rt<\/i>. Bl\u00f3\u00f0i\u00f0 m\u00e1 taka \u00far sj\u00faklingnum sj\u00e1lfum, \u00e1n \u00feess a\u00f0 blanda \u00fea\u00f0 nokkru antikoagulerandi efni, autoh\u00e6moterapi<\/i>, e\u00f0a \u00far \u00f6\u00f0rum, heteroh\u00e6motherapi<\/i>. Autoh\u00e6moterapi er b\u00e6\u00f0i au\u00f0veldari og framkallar v\u00e6gari shock.<\/font><\/p><\/blockquote>\n

Um einkennin af \u00feessu segir hann: \u201e[einkennin koma] eftir 4-6 klt.[svo], oft a\u00f0eins kuldahrollur, almenn vanl\u00ed\u00f0an, 38-39,5\u00b0, e\u00f0a a\u00f0eins sm\u00e1h\u00e6kkun \u00e1 hita.\u201c Og um l\u00e6kningargildi\u00f0 segir Helgi:<\/font>
\n\u00a0<\/p>\n

Vi\u00f0 \u00fdmsa taugasj\u00fakd\u00f3ma er shock-therapi miki\u00f0 notu\u00f0, fyrst og fremst dem. paralytica og a\u00f0rar myndir af lues [s\u00fdfilis] \u00ed taugakerfinu […] Vi\u00f0 fj\u00f6lda annarra taugasj\u00fakd\u00f3ma og ge\u00f0sj\u00fakd\u00f3ma hefir \u00fdmiskonar shock-therapi og veri\u00f0 reynd, en um \u00e1byggilega verkun ver\u00f0ur ekki tali\u00f0 a\u00f0 hafi veri\u00f0 a\u00f0 r\u00e6\u00f0a.<\/font><\/p><\/blockquote>\n

N\u00fa er afar \u00f3l\u00edklegt a\u00f0 Helgi hafi haft marga s\u00fdfilisge\u00f0veika sj\u00faklinga \u00e1ri\u00f0 1955, e.t.v. engan sl\u00edkan, svo hann hefur br\u00faka\u00f0 \u00feessa a\u00f0fer\u00f0 vi\u00f0 einhverju \u00f6\u00f0ru. Kannski bara einfaldlega til a\u00f0 r\u00f3a illme\u00f0f\u00e6rilega sj\u00faklinga me\u00f0 \u00fev\u00ed a\u00f0 l\u00e1ta \u00fe\u00e1 f\u00e1 hita e\u00f0a hitavellu?<\/font>
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Heimildir a\u00f0rar en efni sem kr\u00e6kt er \u00ed \u00far f\u00e6rslunni<\/b>:<\/font>
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H. Gu\u00f0m. Hitaveiki til l\u00e6kninga. L\u00e6knabla\u00f0i\u00f0<\/i> 20. \u00e1rg., s. 30. 1934.<\/font><\/p>\n

Helgi T\u00f3masson. Shock. L\u00e6knabla\u00f0i\u00f0 <\/i>20. \u00e1rg., s. 54-58. 1934<\/font><\/p>\n

Helgi T\u00f3masson. \u00c6\u00f0i hj\u00e1 sj\u00faklingum me\u00f0 schizophreni. L\u00e6knabla\u00f0i\u00f0<\/i> 20. \u00e1rg., s. 204-7. 1934.<\/font><\/p>\n

Helgi T\u00f3masson, Oddur \u00d3lafsson og Vi\u00f0ar P\u00e9tursson. \u201eL\u00edkamlegir\u201c sj\u00fakd\u00f3mar ge\u00f0veikra. L\u00e6knabla\u00f0i\u00f0<\/i> 23. \u00e1rg., s. 35-63. 1937.<\/font><\/p>\n

Kragh, Jesper Vaczy. \u00bbDen v\u00e6rste fjende vi have at k\u00e6mpe imod\u00ab Malariabenhandling og dementia paralytica i Danmark. Bibliotek for L\u00e6ger<\/i>. J\u00fan\u00ed 2006.<\/font><\/p>\n

Kragh, Jesper Vaczy. Det hvide snit. Psykokirurgi og dansk psykiatri 1922-1983<\/i>. Syddansk Universitetsforlag. 2010.<\/font><\/p>\n

\u00d3ttar Gu\u00f0mundsson. Kleppur \u00ed 100 \u00e1r<\/i>. JVP \u00fatg\u00e1fa, 2007.<\/font><\/p>\n

Psykiatriens Historie i Danmark<\/i>. Hans Reitzels Forlag, Kaupmannah\u00f6fn. 2008, ritstj\u00f3ri Jesper Vaczy Kragh.<\/font><\/p>\n

Shorter, Edward. A History of Psychiatry from the Era of the Asylum to the Age of Prozac<\/i>. John Wiley & Sons, Inc. Bandar\u00edkjunum. 1997.<\/font><\/p>\n

\u00de\u00f3r\u00f0ur Sveinsson. \u00c1hrif f\u00f6stu \u00e1 undirvitundina. Fyrirlestur \u00ed L\u00e6knaf\u00e9lagi Reykjav\u00edkur \u00feann 11. desember 1922. L\u00e6knabla\u00f0i\u00f0<\/i> 9. \u00e1rg, s. 226-31. 1923.<\/font>
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Julius Wagner-Jauregg starfa\u00f0i sem ge\u00f0l\u00e6knir \u00ed V\u00ednarborg og af kl\u00edn\u00edskri reynslu sinni \u00fe\u00f3ttist hann hafa teki\u00f0 eftir a\u00f0 ge\u00f0sj\u00faklingum\u00a0af s\u00fdfilis sem fengu hitas\u00f3tt sk\u00e1na\u00f0i ge\u00f0veikin. Wagner-Jauregg f\u00f3r \u00fev\u00ed a\u00f0 pr\u00f3fa sig \u00e1fram me\u00f0 a\u00f0 framkalla …<\/span> Read More …<\/span><\/a><\/span><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[10],"tags":[],"class_list":["post-506","post","type-post","status-publish","format-standard","hentry","category-saga_gedlaekninga"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/506","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/comments?post=506"}],"version-history":[{"count":1,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/506\/revisions"}],"predecessor-version":[{"id":579,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/506\/revisions\/579"}],"wp:attachment":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media?parent=506"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/categories?post=506"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/tags?post=506"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}