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Hidden knowledge in the history of medicine: How did ancient doctors first describe "confusion"
Confusion has troubled doctors and patients throughout the history of medicine. It has been described as "fuzzy thinking" or "brain fog" and is when a person's state of arousal or awareness of their environment is lower than normal. Most people's description of this subjective feeling is that their thinking is like being shrouded in fog and they cannot concentrate clearly.
The term confusion was first proposed by the doctor George Greiner in 1817, who called it "darkness of consciousness." This term has been recognized as the main pathological feature of delirium.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) has historically included the concept of confusion in its definition of delirium. Although DSM-III-R and DSM-IV use "disturbance of consciousness" instead of "confusion of consciousness" in terminology, the essence of the two is the same. Confusion may be less severe than delirium, and it may be synonymous with subsyndromic delirium. Subsyndromic delirium is milder in severity, acuteness of onset, and duration, with relatively stable sleep-wake cycles and stable changes in motor function.
Psychopathology
Conceptual models of confusional consciousness suggest that the overall level of consciousness is regulated by a part of the brain responsible for awareness of oneself and the environment. Different proportions of the cause interfere with the normal functioning of this part, thereby affecting the overall level of consciousness. This system, known as "awakening" or "awakeness," is not necessarily accompanied by drowsiness, and many patients may experience confusion even when they remain awake.
"I feel awake, but not awake in another way."
This state causes the affected person to feel confused and confused, with many patients describing it as "foggy." Although confusion is often confused with depersonalization, there are significant differences between the two conditions. Subjective experiences mentioned by those affected also reveal a strong sense of dreaminess, as awareness, concentration, awareness of time and place, perception and consciousness are disrupted.
Manifestations in disease
Brain fog is a term mostly used to describe a subjective condition of cognitive impairment. It is defined as "a fluctuating state of perceived cognitive dysfunction that may affect a person's ability to participate in daily activities." Brain fog is a common symptom in many conditions where chronic pain is a major cause. Studies show that 15% to 40% of chronic pain patients face such challenges.
"Cognition cannot proceed without sufficient arousal."
Patients with chronic fatigue syndrome, hypothyroidism, and other conditions often report brain fog symptoms, which include memory problems, attention deficit, difficulty focusing, and decreased ability to multitask. Particularly among people with fibromyalgia, approximately 75% report significant difficulties with attention, memory, and multitasking.
Future research directions
As research advances, the understanding of brain fog and related symptoms is gradually deepening. A post-pandemic study has found that brain fog is common among people who have recovered from COVID-19, suggesting that the neurological and psychological symptoms associated with the new virus may look diverse. While the exact cause of brain fog is not yet fully understood, it underscores the importance of brain health to overall health.
"Is brain fog likely to become an important target for future medical research, promoting a deeper understanding of human thinking and consciousness?"
Research in this area still needs to collect more data for exploration and discussion. With the development of science, there may be effective treatments for brain fog in the future, helping people who suffer from chaotic thoughts to regain their ability to think clearly.
