What is Dementia?
Dementia is the modern term that we use to describe a collection of diseases of the brain, like Alzheimer’s Disease, Lewy Body Dementia, or Vascular Dementia. These diseases vary in their symptoms, but all share these common features.
- Loss in ability to think
- Loss in memory
- Decrease in ability to make decisions
Dementia will affect between one in ten and one in twenty of all people over the age of 60 worldwide. Dementia has been affecting people at this rate since the beginning of mankind. Historically, different cultures have treated dementia patients differently throughout time, sometimes barbarically. In this article I will take you through the ages, and try to give you an understanding of how dementia patients were treated or described by the famous doctors of these times.
Pythagoras, arguably the most interesting philosopher of all time, considered life to be a progression through stages. The last two stages of life were considered ‘old age’. These two stages included features like the decline of both the body and mind, matching the dementia symptoms of today. Importantly, these later stages were considered by Pythagoras to be essential to life, and therefore dementia was not seen as a problem to be solved.
A couple of centuries later came Hippocrates, a philosopher known for his incredible and longstanding contributions to medicine. At the time, Hippocrates separated mental disorders into several classifications, such as mania, insanity, disobedience, paranoia, and hysteria. He believed that treatment of these so-called ‘diseases of the soul’ required a health-care model that included physical exercise, massages, diets, as well as divine treatment. However, he still believed that these ‘diseases of the soul’ were caused by the brain, and should be treated as physical disorders.
Plato also believed that dementia was a disease of the soul. He thought that to truly heal our soul, we must be the ones to do it. This led to a great deal of Plato’s patients sitting in large, open rooms by yourself for extended periods of time as a form of treatment. Asclepius, another Greek philosopher, claimed that music could be used as a therapy to treat diseases of the soul, a practice that has transformed from imaginary to medical over the years.
As a side note, Pythagoras was also one of the first physicians to push the idea of ‘encephalocentricism’, or the idea that the brain was the center of consciousness. Other philosophers of the same time period believed in ‘cardiocentrism’, or the idea that the heart is the center of intelligence.
Cicero, a Roman philosopher, wrote a book titled ‘On Old Age’ in the year before he was executed for royal treason at the age of 82. Cicero, in ‘On Old Age’, did not believe in the ‘fallacy’ of memory loss as you got older. He cleverly remarked in his book that “an old man never forgets where he had hidden his money”. He believed that losing your memory in age was a mere projection of the apathy of old men to the regular plights of young ones. He likely drew a line between dementia and growing old, as this was the beginning of an era of scientific discovery that would mark the beginning of something that resembled medicine as we know it today.
Galen, the so-called ‘father of neuroscience’, was the first of the Roman physicians to put a name to dementia, calling it ‘morosis’. Galen described morosis as the loss of memory and the loss of reason. These are two of the key symptoms of dementia that we use today. Whilst Galen did treat dementia as a disease, it was thought to be a side-effect of growing old and therefore; incurable.
The Dark Ages
It would be in later years that a stigma would begin to form around dementia. Although Hippocrates established medical science as we know it today, there was a significant backslide away from science and research in the western parts of the world, due in large part to the rise of the Christian church. This, as well as the endorsement of a book by the Pope, led to the horrific tales of witchcraft and stake-burning.
By the Middle Ages, medical literature was almost non-existent. Tales of red-hot iron treatments for hemorrhoids, bloodletting, and metal catheters plagued the streets of the justly-called Dark Ages. Dementia patients were represented to the general public as demon-possessed witches, too dangerous to keep around.
The 1486 medical tale, “Malleus Maleficarum”, or the Hammer of the Witches, provided the simplest Alzheimer’s cure that exists: burning on the stake. The Hammer of the Witches was endorsed by the pope at the time, Pope Innocent VIII, and contributed to the brutal persecution of mostly women throughout the 16th and 17th centuries. The bodies of hundreds of thousands of innocent, confused, and terrified men and women have been charred since 1486 in a practice that still continues to this day in some parts of the world.
The Early Modern Era
It wasn’t until the 18th century, with the rise of anatomical dissection of human bodies and brains that scientists were able to point to a physical symptom of dementia, that being the degradation of the brain. At the time there were many different academic groups functioning throughout Europe, and many of these believed that there was only one mental illness: insanity. All other mental diseases were still considered insanity, but just of varying degrees. Dementia was known as the final stage of insanity.
Even during this time of supposed enlightenment those living with dementia were confined to asylums and ‘treated’ with barbaric frontal lobe lobotomy – the frontal part of your brain would be separated from the rest of it; normally through the eye socket.
The ‘Modern’ Era
It wasn’t until 1880 that the idea of dementia as a diagnosis would be separated from the umbrella term of insanity. At this point there was a reorganization of patients to put Vascular Dementia and senile dementia in their own class of disease. It took until 1908, when Dr Alois Alzheimer discovered the presence of specific forms of brain degeneration in a young patient, that Alzheimer’s disease would be separated again. Lewy Body Dementia would be separated in a similar way, as Dr Friederich Lewy discovered abnormal brain deposits in a patient during 1912.
Today, the idea of throwing family members in asylums or burning them at stake sound repulsive, but that doesn’t mean that the stigma of being diagnosed with a cognitive disease doesn’t resonate deeply with people of today.
Oftentimes patients will shy away from the diagnosis of incurable diseases, not wanting to be considered a burden or a liability. We have a long way to go before we cure dementia, and but we should be looking back to the early Greek Philosophers to see how they treated dementia patients; as they were treated in life, with dignity and respect.
What Can You Do to Prevent Dementia?
- Avoid inhaling anything that isn’t air
- Stay at a healthy weight, whatever that might be for you
- Try and exercise for at least 30 minutes per day
- Stay mentally and socially involved, especially as you age
- Read books, join community clubs, have hobbies!
- Have the correct genetics: this is a big one.
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