Misplaced Pages

#453546

62-567: Twilight sleep (English translation of the German word Dämmerschlaf ) is an amnesic state characterized by insensitivity to pain with or without the loss of consciousness, induced by an injection of morphine and scopolamine , with the purpose of pain management during childbirth . The obstetric method originated in Germany and gained large popularity in New York City in the early 20th century. In

124-445: A cure or prevention. There are several extremely important case studies: Henry Molaison, R.B, and G.D. Henry Molaison , formerly known as H.M., changed the way people thought of memory. The case was first reported in a paper by William Beecher Scoville and Brenda Milner in 1957. He was a patient who had severe epilepsy attributed to a bicycle accident at the age of nine. Physicians were unable to control his seizures with drugs, so

186-495: A high rate of errors. Also contributing was the fact that twilight sleep did not actually cause a painless childbirth—the scopolamine produced amnesia, so the user did not remember the pain. Twilight sleep spread in popularity in New York through a grassroots female-led campaign that was closely connected to the first-wave feminism movement. Many of those active in the campaign were also suffragists, and they used techniques learned in

248-446: A home event to a medicalized hospital procedure. The twilight birth fad accelerated the decrease in perceived importance of midwives and presented male physicians as those best qualified to assist in delivery, giving doctors more control over the birthing process. The twilight birth movement also illustrates the power of public demand and media coverage in shaping the popularity of certain obstetric techniques. Amnesia Amnesia

310-458: A list in the first place. However, H.M.'s working and short-term memory seemed to be intact. He had a normal digit span and could hold a conversation that did not require him to recall past parts of the conversation. Once Molaison stopped thinking about the lists he was unable to recall them again from long-term memory. This gave researchers evidence that short-term and long-term memory are in fact two different processes. Even though he forgot about

372-442: A lower level of RbAp48 protein compared to normal, healthy mice. In people with amnesia, the ability to recall immediate information is still retained, and they may still be able to form new memories. However, a severe reduction in the ability to learn new material and retrieve old information can be observed. People can learn new procedural knowledge. In addition, priming (both perceptual and conceptual) can assist amnesiacs in

434-449: A patient loses the recent memories, then personal memories, and finally intellectual memories. He implied that the most recent memories were lost first. Case studies have played a large role in the discovery of amnesia and the parts of the brain that were affected. The studies gave important insight into how amnesia affects the brain. The studies also gave scientists the resources into improving their knowledge about amnesia and insight into

496-431: A patient with amnesia might have a loss of declarative memory, this loss might vary in severity as well as the declarative information that it affects, depending on many factors. For example, LSJ was a patient who had retrograde declarative memory loss as the result of bilateral medial temporal lobe damage, but she was still able to remember how to perform some declarative skills. She was able to remember how to read music and

558-426: A person. The three categories are head trauma (example: head injuries), traumatic events (example: seeing something devastating to the mind), or physical deficiencies (example: atrophy of the hippocampus ). The majority of amnesia and related memory issues derive from the first two categories as these are more common and the third could be considered a subcategory of the first. Among specific causes of amnesia are

620-687: A personal digital device to keep track of day-to-day tasks. Reminders can be set up for appointments when to take medications, birthdays and other important events. Many pictures can also be stored to help amnesiacs remember names of friends, family, and co-workers. Notebooks, wall calendars, pill reminders and photographs of people and places are low-tech memory aids that can help as well. While there are no medications available to treat amnesia, underlying medical conditions can be treated to improve memory. Such conditions include but are not limited to low thyroid function , liver or kidney disease , stroke , depression , bipolar disorder and blood clots in

682-412: A result of the surgery and became very agitated. Even five days after being released from the hospital he was unable to remember what had happened to him. Aside from memory impairment, none of his other cognitive processes seemed to be affected. He did not want to be involved in much research, but through memory tests he took with doctors, they were able to ascertain that his memory problems were present for

SECTION 10

#1732855141454

744-420: Is a deficit in memory caused by brain damage or brain diseases , but it can also be temporarily caused by the use of various sedative and hypnotic drugs. The memory can be either wholly or partially lost due to the extent of damage that is caused. There are two main types of amnesia: These two types are not mutually exclusive; both can also occur simultaneously. Case studies also show that amnesia

806-530: Is a rare example of anterograde amnesia in fiction. Amnesiacs Baden-W%C3%BCrttemberg Cooperative State University The DHBW is the direct successor to the Staatliche Berufsakademie Baden-Württemberg . The first Berufsakademie was founded in 1974 as a new type of educational institution and recognized by the state of Baden-Württemberg in 1982. It grew quickly to include seven institutions at eleven different locations. By 2009

868-450: Is cognitive or occupational therapy. In therapy, amnesiacs will develop the memory skills they have and try to regain some they have lost by finding which techniques help retrieve memories or create new retrieval paths. This may also include strategies for organizing information to remember it more easily and for improving understanding of lengthy conversation. Another coping mechanism is taking advantage of technological assistance, such as

930-404: Is divided into three-month phases alternating between the college and the cooperative education partner. The college phases provide traditional undergraduate education while the other phases provide insight and work experience in the field of the cooperative education partner. The dual education program operates on a non-stop, twelve-month schedule. Students are granted vacation days as stipulated in

992-438: Is mostly just a rumor in the world. It's a rare condition, and usually a brief one. In books and movies, though, versions of amnesia lurk everywhere, from episodes of Mission Impossible to metafictional and absurdist masterpieces, with dozens of stops in between. Amnesiacs might not much exist, but amnesiac characters stumble everywhere through comic books, movies, and our dreams. We've all met them and been them. Lethem traces

1054-417: Is often depicted that a second blow to the head, similar to the first one which caused the amnesia, will then cure it. In reality, however, repeat concussions may cause cumulative deficits including cognitive problems, and in extremely rare cases may even cause deadly swelling of the brain associated with second-impact syndrome . Fictional depictions of amnesia are almost universally retrograde; Memento

1116-437: Is still no actual cure remedy for amnesia so far. To what extent the patient recovers and how long the amnesia will continue depends on the type and severity of the lesion. French psychologist Theodule-Armand Ribot was among the first scientists to study amnesia. He proposed Ribot's Law which states that there is a time gradient in retrograde amnesia. The law follows a logical progression of memory loss due to disease. First,

1178-459: Is typically associated with damage to the medial temporal lobe . In addition, specific areas of the hippocampus (the CA1 region ) are involved with memory. Research has also shown that when areas of the diencephalon are damaged, amnesia can occur. Recent studies have shown a correlation between deficiency of RbAp48 protein and memory loss . Scientists were able to find that mice with damaged memory have

1240-576: The New York Times published an article on twilight sleep and the work of Hanna Rion Ver Beck, who had recently written a book entitled The Truth About Twilight Sleep . In that article, Beck said that the consensus of 69 medical reports she had looked at said that "scopolamin-morphin is without danger to the child". Despite its popularity among patients, twilight sleep faced serious resistance from American doctors. Many physicians accused Gauss and Kronig of propagandizing women for financial gain. Because

1302-758: The Garden of Eden . Anesthesia's use was popularized in 1853 by Queen Victoria ’s decision to use chloroform for pain relief during the birth of her eighth child, Prince Leopold, Duke of Albany . In 1899, a Dr Schneiderlin recommended the use of hyoscine and morphine for surgical anesthesia, and it began to be used as such sporadically. The use of this combination to ease birth was first proposed by Austrian physician Richard von Steinbuchel in 1902, before being picked up and further developed by Carl Gauss and Bernhardt Kronig in Freiburg , Germany, beginning in 1903. The method came to be known as "Dämmerschlaf" ("twilight sleep") or

SECTION 20

#1732855141454

1364-401: The pseudorandom sequences experiment just as healthy people; therefore, procedural learning can proceed independently of the brain system required for declarative memory. Some patients with amnesia are able to remember skills that they had learned without being able to consciously recall where they had learned that information. For example, they may learn to do a task and then be able to perform

1426-464: The suffrage movement to increase awareness of twilight sleep. The procedure was initially heralded as the dawning of "a new era for woman and through her for the whole human race." Advocates of twilight birth, including Hanna Rion, saw the fight for pain management in childbirth as strongly connected to the fight for gender equality . They described childbirth as "unnatural" and "unnecessary" and believed that male physicians did not adequately recognize

1488-705: The "Freiburg method" when performed according to Gauss and Kronig's specific technique. Gauss and Kronig's research showed that the use of scopolamine during childbirth resulted in fewer complications and a faster recovery. The two presented their findings on the use of scopolamine during childbirth at the 1906 National Obstetrics Conference in Berlin, Germany. They recorded preferred dosages and adverse side effects of scopolamine, which included slowed pulse, bradypnea , delirium , dilated pupils , flushed skin , and thirst. Its usage spread slowly, and different clinics experimented with different dosages and ingredients. By 1907, Gauss

1550-486: The Freiburg technique, considered the gold standard of twilight birth, patients were first given an intramuscular injection of 1 ⁄ 150 grain (0.432  mg ) of scopolamine and 1 ⁄ 2 grain (32.4 mg) of morphine . Forty five minutes later, a second scopolamine injection of the same dosage was administered. A memory test was then given, and subsequent smaller doses of scopolamine were given based on

1612-457: The United States began traveling to Germany to receive twilight sleep during childbirth. A June 1914 McClure's Magazine article titled, "Painless Childbirth" published by Marguerite Tracy and Constance Leupp about twilight sleep was instrumental in increasing awareness of the procedure in the United States. The article garnered a massive public response, prompting thousands of women to write

1674-417: The adverse side effects of scopolamine. Prior to the 20th century, childbirth predominantly happened in the home, without access to any medical interventions for pain management . Doctors (primarily, if not all men) were now managing the vast majority of childbirths as opposed to midwives or Doulas. Many women were fearful of the process of giving birth, creating a large desire for pain management. But despite

1736-445: The areas of the brain that are affected in anterograde amnesia, as well as how amnesia works. H.M.'s case showed that memory processes are consolidated into different parts of the brain and that short-term and working memory are not usually impaired in cases of amnesia. Another famous historical case of amnesia was that of Clive Wearing . Clive Wearing was a conductor and musician who contracted herpes simplex virus. This virus affected

1798-460: The brain) that was caused from a heart bypass surgery, R.B. demonstrated a loss of anterograde memory, but almost no loss of retrograde memory, with the exception of a couple of years before his surgery, and presented no sign of any other cognitive impairment. It was not until after his death that researchers had the chance to examine his brain, when they found his lesions were restricted to the CA1 portion of

1860-455: The brain. Wernicke–Korsakoff syndrome involves a lack of thiamin and replacing this vitamin by consuming thiamin-rich foods such as whole-grain cereals, legumes (beans and lentils), nuts, lean pork, and yeast can help treat it. Treating alcoholism and preventing alcohol and illicit drug use can prevent further damage, but in most cases will not recover lost memory. Although improvements occur when patients receive certain treatments, there

1922-565: The combined student enrolment across all institutions had reached 23,409 students, involving around 8,000 cooperative education partners and over 90,000 graduated alumni. On March 1, 2009, all institutions in the state of Baden-Württemberg were consolidated to form the Duale Hochschule Baden-Württemberg . DHBW offers job integrated learning (JIL) programs only. Job integrated learning (JIL) defines those work integrated learning (WIL) programs with compulsory internships, in which

Twilight sleep - Misplaced Pages Continue

1984-561: The demands of female patients, little relief was offered before the mid-19th century. Chemical anesthesia during labor was first introduced in 1847, receiving support from women and reluctance from physicians. The legacy of the Bible in the Anglo-American medical community was clear. While pain relief was seen as a necessary part of surgery, many physicians viewed painful childbirth as a natural, divinely ordained punishment for Eve ’s behavior in

2046-655: The difficulties of maternity. Twilight sleep was seen as liberating women from the danger and pain imposed on them by their own bodies. Early feminists in Manhattan formed the National Twilight Sleep Association in 1914, which advocated for wider use. They organized pro-twilight sleep materials, lectures, and encouraged local New York physicians to offer the practice; articles appeared in the New York Times , The Ladies' Home Journal , and Reader's Digest praising twilight birth. A moving picture showing

2108-446: The following: Many forms of amnesia fix themselves without being treated. However, there are a few ways to cope with memory loss if treatment is needed. Since there are a variety of causes that form different amnesia, there are different methods that response better with the certain type of amnesia. Emotional support and love as well as medication and psychological therapy have been proven effective. One technique for amnesia treatment

2170-489: The hippocampal regions of the brain. Because of this damage, Wearing was unable to remember information for more than a few moments. Wearing's non-declarative memory was still functioning but his declarative memory was impaired. To him, he felt that he had just come to consciousness for the first time every time he was unable to hold on to information. This case also can be used as evidence that there are different memory systems for declarative and non-declarative memory. This case

2232-416: The hippocampus has a lesion , and thus the hippocampus could not make connections to the cortex. After an ischemic episode (an interruption of the blood flow to the brain), an MRI of patient R.B. following surgery showed his hippocampus to be intact except for a specific lesion restricted to the CA1 pyramidal cells. In one instance, transient global amnesia was caused by a hippocampal CA1 lesion. While this

2294-542: The hippocampus. This case study led to important research involving the role of the hippocampus and the function of memory. Patient G.D. was a white male born in 1940 who served in the Navy. He was diagnosed with chronic kidney failure and received hemodialysis treatment for the rest of his life. In 1983, he went to the hospital for elective parathyroidectomy . He also had a left thyroid lobectomy because of severe loss of blood in his left lobe. He began having cardiac problems as

2356-416: The individual's performance on the memory tests. When performed properly, the drug combination caused a drowsy state and relieved the pain only partially, whilst creating amnesia such that the woman giving birth sometimes would not remember any pain, although these results were variable. Because of how variable the scopolamine dosages are between patients, and the need for accurate assessment of performance on

2418-570: The information is non-declarative knowledge. However, in some situations, people with dense anterograde amnesia do not remember the episodes during which they previously learned or observed the information. Some people with amnesia show abnormal amount of memory loss, confusion, and difficulty recalling other people or places. People who recover often do not remember having amnesia. Declarative memory can be broken down into semantic memory and episodic memory. Semantic memory being that of facts, episodic memory being that of memory related to events. While

2480-478: The learning of fresh non-declarative knowledge. Individuals with amnesia also retain substantial intellectual, linguistic, and social skills despite profound impairments in the ability to recall specific information encountered in prior learning episodes. The term is from Ancient Greek  'forgetfulness'; from ἀ- (a-)  'without' and μνήσις (mnesis)  'memory'. Individuals with amnesia can learn new information, particularly if

2542-402: The lists, he was still able to learn things through his implicit memory . The psychologists would ask him to draw something on a piece of paper, but to look at the paper using a mirror. Though he could never remember ever doing that task, he would improve after doing it over and over again. This showed the psychologists that he was learning and remembering things unconsciously. In some studies it

Twilight sleep - Misplaced Pages Continue

2604-511: The magazine asking for information about doctors able to perform the method. In the year after the publication of the McClure article, several books such as Motherhood without Pain were published that universally praised the procedure. Newspapers and magazines began pressuring American obstetricians to adopt the method of pain management in their own clinics. Twilight sleep gained a " faddish " popularity in New York City from 1914 to 1916. In 1915,

2666-408: The medial temporal lobe or to the neocortex. Some patients with anterograde amnesia can still acquire some semantic information, even though it might be more difficult and might remain rather unrelated to more general knowledge. H.M. could accurately draw a floor plan of the home in which he lived after surgery, even though he had not lived there in years. There is evidence that the hippocampus and

2728-399: The medial temporal lobe may help to consolidate semantic memories, but then they are more correlated with the neocortex. While lesions of the hippocampus normally lead to the loss of episodic memory, if there is any effect on semantic memory, it is more varied and usually does not last as long. One reason that patients could not form new episodic memories is likely because the CA1 region of

2790-504: The memory test, the twilight sleep method required skillful, well-trained practitioners for proper execution. To effectively keep women in an amnesic state, sensory isolation was necessary. Women gave birth in a darkened room, and the birth attendants wore uniforms designed to minimize noise. Women were sometimes blind-folded, had their ears plugged with oil-soaked cotton, or were tied to padded beds with leather straps to "promote sleep." Sensory deprivation also prevented delirium , one of

2852-440: The neurosurgeon Scoville tried a new approach involving brain surgery. He removed his medial temporal lobe bilaterally by doing a temporal lobectomy. His epilepsy did improve, but Molaison lost the ability to form new long-term memories (anterograde amnesia). He exhibited normal short-term memory ability. If he was given a list of words, he would forget them in about a minute's time. In fact, he would forget that he had even been given

2914-412: The next 9.5 years until his death. After he died, his brain was donated to science, photographed, and preserved for future study. Global amnesia is a common motif in fiction despite being extraordinarily rare in reality. In the introduction to his anthology The Vintage Book of Amnesia , Jonathan Lethem writes: Real, diagnosable amnesia – people getting knocked on the head and forgetting their names –

2976-425: The operation. Researchers also found that, when asked, Molaison could answer questions about national or international events, but he could not remember his own personal memories. After his death Molaison donated his brain to science, where they were able to discover the areas of the brain that had the lesions which caused his amnesia, particularly the medial temporal lobe. This case study provided important insight to

3038-416: The private, quiet birthing rooms like those used in Freiburg for sensory isolation. At its peak, there was such demand from women for twilight sleep that many physicians who were not adequately trained in the technique felt that the success of their obstetric practices depended on offering it. Thus, many untrained nurses and physicians were administering morphine and scopolamine at improper dosages, leading to

3100-431: The procedure, one of the first medical movies, was also created and screened for interested women. Prominent NTSA member Mary Boyd's lectures about twilight sleep would draw crowds of nearly 300 women. She would end her lectures with the campaign's popular saying: “You women… will have to fight for it, for the mass of doctors are opposed to it.” Boyd and Tracy saw twilight sleep as a turning point in medicine, describing it as

3162-427: The role of obstetricians in the United States. Obstetricians could no longer have a financially viable practice that did not include pain management during childbirth . The use of morphine and scopolamine in twilight birth also positioned drug intervention as the main measure used in pain management during labor. Because twilight birth was performed in a hospital setting, it greatly contributed to changing childbirth from

SECTION 50

#1732855141454

3224-579: The roots of literary amnesia to Franz Kafka and Samuel Beckett , among others, fueled in large part by the seeping into popular culture of the work of Sigmund Freud , which also strongly influenced genre films such as film noir . Amnesia is so often used as a plot device in films, that a widely recognized stereotypical dialogue has even developed around it, with the victim melodramatically asking "Where am I? Who am I? What am I?", or sometimes inquiring of their own name, "Bill? Who's Bill?" In movies and television, particularly sitcoms and soap operas , it

3286-462: The student has to be employed by a single company during the complete duration of the study program and in which lectures and internships are geared to maximize applied learning and the transfer of knowledge. Therefore, the recruitment is exclusively done by the cooperative education partners, while the DHBW only has to verify the higher education entrance qualification . The three-year dual education program

3348-624: The task later without any recollection of learning the task. According to fMRI studies, the acquisition of procedural memories activates the basal ganglia , the premotor cortex and the supplementary motor area, regions which are not normally associated with the formation of declarative memories. This type of dissociation between declarative and procedural memory can also be found in patients with diencephalic amnesia such as Korsakoff's syndrome . Another example demonstrated by some patients, such as K.C. and H.M, who have medial temporal damage and anterograde amnesia, still have perceptual priming. Priming

3410-428: The techniques used in art. She had preserved skill-related declarative memory for some things even though she had deficits in other declarative memory tasks. She even scored higher on skill-related declarative memory than the control in watercolor techniques, a technique that she used in her professional career before she acquired amnesia. The loss of semantic information in amnesia is most closely related with damage to

3472-507: The treatment's greatest popularity overlapped with World War I , women who advocated for the German technique were also accused of being disloyal to the United States. The use of twilight sleep began to decline in the United States after 1916 due to a number of factors. In the setting of New York City, it was extremely difficult to perform properly according to the Freiburg method. The dosages of morphine and scopolamine needed to be precise to avoid overdose, and NYC hospitals typically lacked

3534-457: The “first time… that the whole body of patients have risen to dictate to the doctors.” The campaign dwindled after one of its leaders, Frances X. Carmody, died of hemorrhage giving birth while using twilight sleep, though her husband and doctor asserted that her death was unrelated to the use of twilight sleep. While twilight sleep began to wane in popularity after 1915, it permanently altered obstetric care and created irrevocable changes in

3596-503: Was a temporary case of amnesia, it still shows the importance of the CA1 region of the hippocampus in memory. Episodic memory loss is most likely to occur when there has been damage to the hippocampus. There is evidence that damage to the medial temporal lobe correlates to a loss of autobiographical episodic memory. Some retrograde and anterograde amnesiacs are capable of non-declarative memory, including implicit learning and procedural learning. For example, some patients show improvement on

3658-550: Was accomplished in many different experiments of amnesia, and it was found that the patients can be primed; they have no conscious recall of the event, but the response is there. Those patients did well in the word fragment completion task. There is some evidence that non-declarative memory can be held onto in the form of motor skills. This idea was disputed, though, because it is argued that motor skills require both declarative and non-declarative information. There are three generalized categories in which amnesia could be acquired by

3720-604: Was found that H.M.'s perceptual learning was intact and that his other cognitive skills were working appropriately. It was also found that some people with declarative information amnesia are able to be primed. Studies were completed consistently throughout Molaison's lifetime to discover more about amnesia. Researchers did a 14-year follow-up study on Molaison. They studied him for a period of two weeks to learn more about his amnesia. After 14 years, Molaison still could not recall things that had happened since his surgery. However, he could still remember things that had happened prior to

3782-421: Was more evidence that the hippocampus is an important part of the brain in remembering past events and that declarative and non-declarative memories have different processes in different parts of the brain. Patient R.B. was a normally functioning man until the age of 52. At age 50, he had been diagnosed with angina and had surgery for heart problems on two occasions. After an ischemic episode (reduction of blood to

SECTION 60

#1732855141454

3844-481: Was performing the Freiburg method on all of his pregnant patients, and wealthy German women began to travel to Freiburg for childbirth to receive Kronig and Gauss's twilight sleep method. The Women's Clinic of the State University of Baden , where Gauss was a physician, had the city's lowest rates of maternal and neonatal mortality, further increasing the procedure's popularity. Eventually, wealthy pregnant women from

#453546