《麦克白》主人公的悲剧心理

《麦克白》在现代莎评中自身几乎转换成了充满原型的心理悲剧，它在女巫、鬼魂、超自然因素及阴暗的色彩等笼罩下充分展示悲剧主人公的潜意识心理及其极力保持心灵内外对统一的平衡的努力；主人公本我狂野的欲望及其在事后的病态心理表现正是他们意识内外失控的心态，犹如进入黑夜的漫长旅程。     

A light-hearted look at a lion-hearted organ (or, a perspective from three standard deviations beyond the norm) Part 2 (of 2 parts)

Throughout history, the heart has been associated not only with its life-sustaining function but also with its close ties to the human emotions. In this literature and internet review, we attempt to gather and organize information from both of these perspectives as they relate to the heart in the following 11 categories: (1) fun facts, (2) medical photography, (3) history, (4) languages (etymology), (5) nonmedical English expressions, (6) death, (7) the arts, (8) movie titles, (9) song titles, (10) Shakespeare, and (11) the Bible. Part 1 (previously published) covered the first five topics, and Part 2 will cover the last six topics. These data may be useful to those who are engaged in teaching about the cardiovascular system.     

The slit catheter: a comparison with the wick catheter in the measurement of compartment pressure

The slit catheter, a new instrument for the measurement of compartment pressure, has been compared with the wick catheter in experimental conditions. The two catheters were inserted into the anterior tibial compartments of 8 human legs and controlled external pressures were applied by means of an inflatable limb bag. The mean resting intramuscular pressure of 8.5 ± 6.2 mmHg for the slit and 8.7 mmHg ± 6.2 mmHg for the wick catheter agrees with that of other workers, and the slit catheter records a pressure at all applied external pressures not significantly different from the wick catheter (paired t test).The slit catheter provides a simple and inexpensive way of estimating compartment pressure which is as accurate as a method widely used both experimentally and clinically in North America.     

Some observations on ceruloplasmin in burned patients

An abnormal form of ceruloplasmin has been observed in the serum of some severely burned patients. In patients with burn areas between 20 and 60 per cent the group showing abnormal ceruloplasmin had 1 survivor out of 16 cases; the group showing normal ceruloplasmin had 24 survivors out of 25 cases. A similar abnormal ceruloplasmin was observed in the freeze-dried plasma with which the groups were transfused on admission to the Wessex Regional Burns Centre. However, the appearance of the abnormal form in 2 long-surviving patients some weeks after transfusion had ceased, argues that the transfusion fluid is not the source of the abnormal protein.     

Failed Debridement and Implant Retention Does Not Compromise the Success of Subsequent Staged Revision in Infected Total Knee Arthroplasty

BackgroundPeriprosthetic joint infection (PJI) is the leading cause of early revisions after total knee arthroplasty. Debridement, antibiotics, and implant retention (DAIR) procedures are often the initial treatment for PJI. However, there is concern that failed DAIR undermines the future success of revision procedures. This study aims to investigate the impact of DAIR on the success of subsequent staged revisions for PJI.MethodsA multicenter retrospective review was performed over a 15-year period. Treatment success was defined as implant retention without the use of long-term suppressive antibiotics. This was compared between patients who underwent a staged revision as the first procedure for PJI (staged-only) and patients who failed DAIR before staged revision (F-DAIR). Competing risk survival analysis was performed to compare the 2 groups and considered for patient demographics, American Society of Anesthesiologists score, organism type, body mass index, age of prosthesis, and duration of symptoms.ResultsOf 291 eligible patients, 63 underwent staged revision and 228 underwent DAIR as the first procedure for PJI. Of the 228 DAIR patients, 75 failed DAIR and underwent subsequent staged revision (F-DAIR). At mean follow-up of 6.2 years, the success rate was 72% in the F-DAIR group and 81% in the staged-only group. On survival analysis, there was no significant difference in subdistribution hazard ratio comparing the probability of failure (implant retention) in the 2 treatments groups (subdistribution hazard ratio = 0.72; 95% confidence interval 0.32-1.61; P = .42).ConclusionThis study suggested that a previously failed DAIR does not compromise the success rate of a subsequent staged revision.     

Richard III : du préjudice à la revendication

ObjectivesThis article sets out to explore the revengeful, retribution logic of Shakespeare's Richard III.MethodsThe method consists in a review of the literature (critical essays, psychiatric and psychoanalytic writings) on this historical play so as to define the central issue. This well-known figure of Shakespearean drama leads us to explore the question of perceived grievances and litigious or querulous paranoia (see Sérieux & Capgras, Clérambault, Lacan, etc) underpinning demands for one's for rights. On this point it is useful to recall the distinction between querulous delusion and interpretation delusion.ResultsMoving from the initial wrong or grievance sustained to a feeling of injustice and then on to the hateful claims precipitating the character into his criminal course, Richard III provides all the clinical components that enable this tragedy to be read in the light of querulous paranoia. The querulant – who sees himself as a victim of the Other – following in from the initial wrong, throws himself body and soul into obtaining reparation (the querulous paranoid subject can be summed up as “reparation is owed to me”). The trajectory chosen by Richer III takes him from being “deformed, unfinished, sent before my time into this breathing world” to “being determined to be a villain” by removing anyone standing in his way to the throne – or suspected of doing so.DiscussionThus the central element at the outset is the wrong or prejudice sustained (“I that am curtailed of this fair proportion”) that demands retribution at all costs. Richard III, deformed from birth, accuses the Other (“dissembling Nature”, his mother) and wants that Other to pay what is owing, thus inflicting on others the initial injustice. His bloodthirsty, destructive frenzy, his murderous enterprise devoid of any form of empathy, regret, or guilt, the details provided on his childhood and youth, his relationships with the law and with others all contribute to making Richard III above all a querulant or a persecuted persecutor with illusions of grandeur. Thus the central element in the discussion relates to the harm or prejudice sustained – damage that can also be encountered in other forms of psychosis, such as melancholy. The prejudice is interpreted and processed differently according to the person, and in particular according to whether the subject relates the wrongdoing to himself or accuses the Other of being responsible. For Richard III, the Other must be subjected to crime and punishment.ConclusionThe dark figure of Richard III, however terrible, criminal, and full of hate he may be, is even so not indifferent to us, and not without echoes for us. Freud analyzed him in this manner in 1916. In fact, any subject carries within him some sort of feeling of injustice, any subject “has the right” to lay claim to some form of harm or prejuduce, and in a way we are all, on a small scale, querulous subjects. But Richard II shows us in a sense that according to the type of clinical profile to which we belong, the harm or prejudice and the resulting claims for retribution take on very different forms. The morbid claims for retribution by Richard III suggest an egocentric querulous aranoia, or perhaps egocentric querulous psychosis where an “idealism of justice” (Dide) predominates: the subject is intent on justice being done to him.     

抉择里的矛盾与矛盾里的抉择——对哈姆雷特以及“生存还是毁灭”的解析

基于对《哈姆雷特》创作背景的分析，认为哈姆雷特身上既有欧洲文艺复兴后期人文主义者共有的精神气质，也具有特定生存环境所赋予的人格特征。“生存还是毁灭”于哈姆雷特而言，既反映了他面临选择时的矛盾心理，更显示了他在矛盾中抉择的冷静和决绝。哈姆雷特的抉择响应的是良知和责任的呼唤，是以生命的毁灭来实现自己的永生。哈姆雷德的永恒魅力也正是在于这种毁灭与永生的绝然回转之中。     

All's well that ends well

Textual and contextual evidence suggests that the French king's fistula, a central plot device in Shakespeare's playAll's Well That Ends Well, is a fistula-in-ano. Anal fistula was known to the lay public in Shakespeare's time. In addition, Shakespeare may have known of the anal fistula treatise of John Arderne, an ancestor on Shakespeare's mother's side. Shakespeare's use of anal fistula differs from all previous versions of the story, which first appeared in Boccaccio'sDecameron and from its possible historical antecedent, the fistula of Charles V of France. This difference makes sense given the conventions of Elizabethan comedy, which included anal humor. It is also understandable when one looks at what wounds in different locations mean in European legend. In this light, it is not surprising that subsequent expurgations treat Boccaccio's and Shakespeare's fistulas differently, censoring only Shakespeare's. This reading has implications for the staging ofAll's Well That Ends Well, and for our view of the place of anal fistulas in cultural history.     

Proteins in blister fluid

Examination by two-dimensional immunoelectrophoresis (2DIE) of blister fluid resulting from burn injury showed that blister fluid contained most proteins observed in serum but lacked certain β-globulin components. Using an antiserum prepared against a blister fluid ‘pool’ in the 2DIE system some proteins appeared in blister fluid which were not present in serum. Some glycoproteins were present in blister fluid in different relative proportions from those in which they were observed in serum. The total concentration of protein in blister fluid approximated to that found in serum. Blister fluid contained much more lactate dehydrogenase (LDH) activity than was found in serum taken at the same time. Separation of the isoenzymes of LDH indicated this extra activity to be of local origin.     

Homicide et folie morale dans Richard III de Shakespeare : essai historique

The author first notes that the human species is peculiar in the animal world for the capacity of its members to commit violence intentionally. He recalls the philosophical thinking of Albert Camus on individual and collective crime and the theoretical position of Dr De Greeff on the neurobiological bases of homicidal behaviour. He then makes some general remarks about Shakespeare and his theatrical creations before demonstrating how the classic French psychiatric studies on madness are epitomized in the work of the brilliant English playwright. After briefly presenting the historical fresco that Richard III represents, the author attempts to define the criminological profile of king Richard III and to analyse the characteristics of his voluntary homicides driven by political ambition. The king's terrible physical congenital malformations are listed along with his pathological mental characteristics. While the former alienist physicians would have considered him as a depraved individual suffering from “moral insanity”, Shakespeare’ Richard might nowadays be diagnosed as a serial killer with personality disorders characterized by antisocial, narcissistic and paranoid traits. The author concludes that only the moral education of children and the fear of criminal repression can protect human beings from their innate tendencies to commit criminal violence, i.e. the dichotomy between nature and nurture constantly underpins their existence.