Joseph A. Silverman

Body image and perfectionism of ballerinas: comparison and contrast with anorexia nervosa.

The authors studied a group of young ballerinas through responses to a questionnaire and intensive interviews. The young women described a life characterized by complete dedication in which academics, social life, and pleasures were sacrificed and a program of intensive exercise and practice became their main activity. They tended to feel overweight in spite of being thin and continued to diet or to employ other means to become even thinner. Two heuristic conclusions were reached: (a) the goal of thinness was in part a flight from conflicts about adult sexuality that arose at puberty; and (b) repetitive practice was engaged in for its own sake, not for career advancement, in an attempt to lose themselves in a transcendental quest for perfection. A comparison was made between this group and girls of the same age with anorexia nervosa. Several similarities but many more differences were found. Findings are based on a very small sample and must be interpreted cautiously, but directions for further studies are implied.

Anorexia nervosa: Clinical observations in a successful treatment plan

This poorly understood disease has been studied in 27 girls and two boys. Metabolic aberrations included electrocardiographic abnormalities, hypovitaminosis A, hypercarotenemia, abnormal oral glucose tolerance curves, decreased xylose excretion, decreased excretion of luteinizing (LH) and follicle-stimulating hormones (FSH), decreased serum thyroxine levels, absence of diurnal variation of plasma concentrations of glucocorticoids, elevation of blood urea nitrogen, bone marrow hypoplasia, and leukopenia. With restoration of proper nutrition, most of these abnormalities (except FSH and LH) were corrected. An effective method for inpatient treatment is described. There were no deaths during this period of study.

Louis-Victor Marcé, 1828-1864: anorexia nervosa's forgotten man

An English translation of Marcés original description of anorexia nervosa is reproduced with a brief comment on the author and his work.

Lithium carbonate therapy during pregnancy: apparent lack of effect upon the fetus. A case report.

Abstract A manic patient on lithium carbonate treatment was discovered to be in the seventh month of pregnancy. The drug was continued until term with no untoward effects on the infant. During the first 10 days of life, the lithium was completely cleared from the newborn infants blood in an exponential manner.

Anorexia nervosa: Clinical and metabolic observations

Historical and clinical data collected over a 15-year period from the study of 100 young inpatients with anorexia nervosa are presented. A clinical management program with zero mortality is described.

Anorexia nervosa: A cause of pericardial effusion?

SummaryEchocardiographic studies revealed the presence of pericardial effusion in 4 patients with anorexia nervosa, whose weights had fallen by 38 to 53% of their body weight at the onset of disease. Each patient had a normal or small cardiac image on chest roentgenogram. The presence of increased pericardial fluid may partially explain the decreased voltage on the electrocardiogram, and the distant heart sounds heard in some of these patients.The cause of the pericardial effusion is not clear. It may possibly occur in other diseases that produce marked weight loss and cachexia.

Sir William Gull (1819–1890) Limner of anorexia nervosa and myxoedema.

On Friday, October 24, 1873, at a meeting of the Clinical Society of London, Sir William Gull achieved a coup de maitre by delivering two seminal reports. The fîrst was called, “Anorexia Nervosa, (Apepsia Hysterica, Anorexia Hysterica)”. The second was entitled, “On a Cretinoid State supervening in Adult Life in Women.” The manuscript on anorexia was regarded by Gull’s peers to be significant, but of lesser importance. The essay on hypothyroidism was generally regarded to be Gull’s chef d’oeuvre. One hundred and twenty-four years later, the situation has reversed itself: the anorexia paper is heralded, while the other manuscript is all but forgotten. Gull’s life, death and contributions will be reviewed.

Lasègue's editorial riposte to Gull's contributions on anorexia nervosa

One week after Sir William Gull read his seminal report on anorexia nervosa to the Clinical Society of London, a brief account was published (Anonymous, 1873). In Paris, Charles Lasègue, editor of Archives Générales de Médecine read the report and printed an immediate editorial riposte, parts of which will be quoted in this communication.