醫 史 學 제13권 제1호(통권 제24호) 2004년 6월 Korean J Med Hist 13∶ 94– 118 June 2004 大韓醫史學會 ISSN 1225– 505X

Cultural M orph olo g y of E atin g D i s orde rs

Osamu Kanamori*

psychologist With this important limit what can 1 Destructing solid-like contour of eating I do? disorders For hasty and rough spectators what I can add to this multidimensional model may be just a When we confront with such complicated very subtle and trivial one What I would like to diseases as eating disorders1) the understanding try in this paper is a sort of destruction of according to which we cannot analyze them only solid-like contour of eating disorders contour through the lens of biomedical apparatus without presupposed even in this multidimensional model referring simultaneously to the social and cultural In other words I will try to analyze the state of context is only a point of start and not a affairs in which three judgments like It is conclusion For such diseases the suitable obviously an It may be a case question is not whether or not the social and of eating disorder and It is not an eating cultural factors are also implicated in their disorder overlap one another so as to be etiology but how the social and cultural factors confounded or become indistinguishable in certain are implicated in it So when this multi- moment Quite strange as it may be it will be dimensional model of etiology is almost an my theoretical aim I would say again in another acquired common premise what kind of word that my aim is to assist in bewildering contribution am I able to do in this discourse? moments during which one may be vexed to lose Of course this paper has no clinical aim as I the logical line of research and discourse when am neither a medical doctor nor a clinical one comes across a certain literary text or some

* Graduate School of Education The University of Tokyo 1) There are two principal forms of eating disorders and bulimia In this paper I discuss principally on anorexia nervosa

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extra-medical topics while thinking through an the topics of cultural analysis of disease At eating disorder case or vice versa It is as if I first Sander Gilman s Disease and Re- were assisting in evaporation of eating disorders presentation3)(1988) Gilman seems to be into social sphere itself To say a little bit more wandering around this topic in an untrammeled concretely I will try to cite and analyze certain way Susan Sontag s Illness and Metaphor4) materials that seem to be peripheral or irrelevant (1978) and AIDS and its Metaphor5)(1989) are for the discussion of eating disorders and to take known as interesting essays on tuberculosis cognizance of the fact that these purportedly cancer and AIDS On hysteria I refer to Elain peripheral and circumferential materials can Showalter s The Female Malady 6) (1985) Janet influence what might be called the essence of Oppenheim s Shattered Nerves7)(1991) and Janet eating disorders or our understanding of it This Beizer s Ventriloquized Bodies8)(1994) Paula penchant for perturbation of clear-cut dichotomy Treichler writes a cultural study on AIDS in her of concepts looks like the style often adopted in How to Have Theory in an Epidemic9)(1999) postmodern arguments Well I am conscious of And Patricia McEachern tries to treat exactly this resemblance because I think that the mode eating disorders in her Deprivation and Power 10) of being of this malady is really suitable for (1998) but it seems to me that this essay is not postmodern discursive sphere a great success I am also conscious that this highly theoretical I hope that my essay is able to enrich even setting of problem is not useful for clinical field only a slight level this important topic As a But even for such an awful malady like eating matter of course I use principally historical or disorder human spirit can situate itself with literary documents for my analysis I open certain distance from suffering patients at least for succeeding four files avoiding redundant a while objectify the disease and dissect the commentaries and similar variations of argument elements to understand closely what it is I also obey to this old evil of human spirit2) 2 Caterina File Instead of beginning immediately the work I would like to cite here some books that constitute When we are interested in culture thought

2) Of course saying this does not mean at all that I dont care the suffering of many women under the eating disorders 3) Sander Gilman Disease and Representation Ithaca Cornell University Press 1988 4) Susan Sontag Illness and Metaphor New York Farrar Straus and Giroux 1978 5) Susan Sontag AIDS and its Metaphor New York Farrar Straus and Giroux 1989 6) Elain Showalter The Female Malady New York Pantheon books 1985 7) Janet Oppenheim Shattered Nerves New York Oxford University Press 1991 8) Janet Beizer Ventriloquized Bodies Ithaca Cornell University Press 1994 9) Paula Treichler How to Have Theory in an Epidemic Durham Duke University Press 1999 10) Patricia McEachern Deprivation and Power Westport Greenwood Press 1998

－ 95 － 醫 史 學 제13권 제1호(통권 제24호) 2004년 6월 and history on eating disorders we confront Caterina made up her mind to live for God almost certainly some women in European and forgets every funny things of secular world middle age as historical interesting figures that But the family doesn t want that she give up this is to say certain women who ate almost secular world They fight each other during nothing and respected for their love for God several months But finally the father under- and their religious ascetic practices Their mode stands her wish and tells the other member to of being is called anorexia mirabilis Among this respect her religious conviction kind of women we must not forget one of the About after the age of sixteen years old most famous one named Caterina da Siena Caterina begins to dislike the odor of meat and (1347-80) Using as principal document Rudolph eat nothing but bread raw vegetable and water Bell s Holy Anorexia 11)(1985) I try to sketch She doesn t speak very much flagellates herself succinctly Caterina s life during long time enough that her back begins to bleed And after twenty-one years old Caterina Caterina was born as one of twins in 1347 loses furthermore her appetite and cannot eat only one year before the devastating prevalence of even bread At twenty-five years old she loses Black Death in entire Europe The other one of almost all of her appetite and if she tries to eat twins was named Giovanna When she was six something before people who doubts that she years old she saw a vision but told it to must be a sorcerer she has to vomit what she nobody In twelve years old the family urges eats reluctantly All that she eats since then is her to make up her face for the preparation of some bitter herb and cold water And for this marriage She resisted at first but her elder herb she only masticates for some time and sister Bonaventura said to her that women are disgorges its substance after a while permitted by God to make their toilet for better At the beginning of 1380 Caterina decides to appearance Caterina obeyed to her advice For give up drinking water for its symbolic pre- some time Caterina seems to live like many ciousness of Christ s blood She knows that this other women but the death of beloved decision will take necessarily her life but doesn t Bonaventura in delivery changed everything change her decision After three weeks of trial Caterina blames herself for the death of she stops this of no water but this Bonaventura because she flirts sometimes with a experience damages enormously her already secular world and thus provokes ire of God So weaken body and she will leave this world in Caterina begins to meditate upon God Another the same year unfortunate incident attacks her mind Giovanna This is approximately Caterina s life Think- is dead in 1363 within a year of death of ing on her life we are inclined to pose Bonaventura

11) Rudolph Bell Holy Anorexia Chicago The University of Chicago Press 1985 chap 2

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immediately the next question Was Caterina a women of anorexia mirabilis including Caterina? patient of anorexia nervosa? Joan Brumberg author of important book Shocked with the misfortune of the family and entitled Girls12) (1988) poses also this losing gradually her appetite Caterina fights interesting question13) She expresses certain against her own family during months for her life malaise when she hears English contemporary design In her era being pious is a socially psychiatrist assume that Saint Wilgefortis with her appreciated quality so Caterina is a good girl in hirsuteness must be a patient of anorexia a social sense In this sense she has a social nervosa14) After some hesitation Brumberg portrait of being fundamentally a good and serious concludes that we must not identify ancient girl but she fights with her family for a while women of anorexia mirabilis with patients of since some bitter experiences She must be anorexia nervosa Certainly there are some perfectionist obstinate sensitive and has a resemblances between the two But while it is strong volition All of these qualifications and true to say that ancient women of anorexia profiling fit with the profiling of anorexia nervosa mirabilis didn t eat almost anything what were patient Besides that the fact that she spits out they searching aiming and longing for? As for bitter herb after masticating for some time is also Caterina she didn t eat almost anything but also observed in some patient of this malady and she flagellated herself and silenced for a long known as symptom of chewing time Extremely abstemious diets re- presented for With these observations we are inclined to her only a part of range of religious asceticism qualify Caterina as an anorexia nervosa patient Arguing like that Brumberg considers that the Rudolph Bell himself adopts this point of view identification of anorexia mirabilis with anorexia and not only Caterina but also many other women nervosa is just a version of biological re- that the Roman nominates as ductionism15) saint have in fact many symptoms close to And I agree with Brumberg s opinion anorexia nervosa This kind of interpretation that Observing that Caterina didn t eat almost anything classifies men of old times in some pathological and exercised many kind of ascetic practices categories according to their conducts or thought people in her era felt that her conduct was really has an academic tradition coined as pathography originated from her profound love of God and Then let s pose again the same question using a they respected and stood in awe of her Even her different concept can we adopt this patho- conduct like shutting out of water which was graphical scheme to situate and understand many exactly equivalent of suicide was not considered

12) Joan Jacobs Brumberg Fasting Girls New York Vintage Books 1988 Hereafter FG 13) FG chap 2 14) As is known some patients of anorexia nervosa tend to experience lanugo 15) FG chap 2 p 44-48

－ 97 － 醫 史 學 제13권 제1호(통권 제24호) 2004년 6월 as a psychopathological symptom of self- I don t think that I have enough discussed on destruction and thus became as an object of this important point but let s quit this matter and medical treatment In any sense anorexia continue to multiply the concerning perspectives mirabilis was not a malady and the suffering of on it Caterina was not a pathological symptom Then how must we evaluate the fact that Saint 3 Sarah File Wilgefortis was a hirsute woman? It is true that hirsuteness may result from a long-term diet But When we search for historical documents we this fact proves only the fact that Saint find a no less interesting figure than anorexia Wilgefortis had an identical physiology with us mirabilis in portraits and lives of what they call but doesn t prove that she was a patient of fasting girls Fasting girls emerging between anorexia nervosa about 17th century and 19th century are tardy Please note the next important point Judging and decolorized anorexia mirabilis in that they like this doesn t mean at all that I make little appeared in era when the sensibility on sanctity is account of biomedical researches on this disease gradually evanescent Among many other In relatively a macroscopic view anorexia interesting portraits of fasting girls we can nervosa patient may experience the cessation of enumerate Anne Moore or Mollie Fancher etc menses hypothermia hypotension bradycardia but I would like to present here one of the most lanugos renal insufficiency hepatic insuffi- impressive and tragic cases among them i e ciency parotid gland tumor etc In a micro- the case of Sarah Jacob scopic view anorexia nervosa patient may suffer The Welsh Sarah Jacob was a from hypokalemia and abnormality on hormonal daughter of Mr And Mrs Jacob crofter lived secretion like vasopressin gonadotropin CRH in Wales England Sarah only twelve years old etc These objective knowledge are no doubt girl before menarche in the époque began to fast important contributions and the microscopic since October 1867 In first periods she ate determination of physiological abnormality permits sometimes a piece of apple or so but soon after the doctors to react against the abnormality so as she stopped totally to eat When the family to mitigate it with medical intervention that is talked about food she became excited and got these knowledge are operative knowledge the angry very much when someone showed food to clinical importance of which is very precious But her Father claimed that she excreted neither the point is it is finally insufficient even on feces nor urine since December 1867 The rumors clinical point of view to consider that we can got thicker that Sarah didn t eat anything and grasp the essence of the disease when we doctors and priests began to investigate on her determine its physiological phase for the case The local Anglican vicar Mr Jones extremely multi-determined malady like eating attested that Sarah had a good character and that disorders she attended assiduously Sunday school At the

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beginning of 1869 Jones wrote a letter in which health He heard a gurgling sound in the stomach he believed in her fasting during 16 months and gut which proved that Sarah digested He despite of doctor s disbelief People got interested thought that one must blame on parents rather in her fast still more than Sarah herself With this situation the authority decided to The corps of doctors thought that one couldn t investigate closely on her fast in order to verify leave the case as it was so that they sent in whether her fasting was authentic or not November 1869 four nurses from London to her Between 22nd March and 5th April 1869 two house to examine it more closely Before the men of the region supervised her conduct complete checking of the fast they examined the working on a two-shift basis on entire 24 hours chamber very carefully to find any pieces of These two men regardless of the skeptical edible things and they interdicted her younger attitude at the outset testified that Sarah didn t sister Margaret to sleep with Sarah during the eat anything as far as they noticed Meanwhile night At the beginning of December the Sarah became a famous girl around the entire examination started At first Sarah responded England and many people came to see her with cheerfully with the talk of four nurses but after some presents and talked with her encouraged six days she became faint and weak Four and adored her Her mother decorated the Sarah nurses having mercy on this situation proposed s bed with many flowers ribbons and some to stop the examination so that Sarah could do religious books And she dressed her daughter the same thing as before and eat something if with multicolored ribbons and some lovely goods she did until then Doctor agreed with them and But the corps of doctors didn t like this proposed to give her water and brandy But the circus-like presentation of the case In summer father protested strongly against it and insisted 1869 the doctor Robert Fowler visited her house the examination to be continued After about nine At the first meeting he found that Sarah was a days Sarah felt so cold that the supervisors rather pretty little girl but he noticed that her permitted that Margaret was in bed with her to eyes moved relentlessly which seemed to be a give some warmth But about on tenth days of characteristic of hysteric patients Her mother examination on 17th December 1869 Sarah unaccustomed to modern medical investigation Jacob died of sustained starvation16) didn t like the doctor s application of stetho- We have another good book on cultural history scope to the daughter s body and many other of Walter Vandereycken & Ron van examinations In contrast Fowler strived to Deth s From Fasting Saints to Anorexic achieve this investigation as a good professional Girls 17)(1988) in which we can also find some and recognized that Sarah was relatively in good documents of Sarah s case Using this book with

16) FG chap 3 pp 65-69

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Brumberg s one18) let s present further facts on case with such a profound repentance her and think upon its cultural implications In effect examined from now we have some In this case people began to reproach the difficulty to sympathize with the doctor s course of the case after the death of Sarah zealousness that aimed to unmask the trickery of Doctors confirmed after the dissection of the Sarah s fast Perhaps at first with a childish hope body that Sarah had eaten something People to draw an attention of her parents Sarah began judged that her parents were guilty for almost to feign to fast But as the rumors became bigger child abuse Immediately after her death The and bigger she couldn t avow any more that it Lancet important medical journal qualified was just a fake Perhaps she received some poor Sarah as a miserable victim of her own delusions food from her sister or someone during the and ignorance of adults around her The article midnight and ate it stealthily A poor and sad exhibits some rather rare direct effusion of dinner for a girl in the growth period In lieu of indignation and remorse Why did the team of examining that she ate really nothing they should examination dare to carry out the test for what have praised her for her self-control for satisfying should not have to be tested from the beginning? to take such a poor little food The evaluation of In the same vein The Medical Times and this incident after her death made by the medical Gazette of the 25th December 1869 compared journalism has a well-balanced common sense and the examination of Sarah s fasting to an open test reason- able judgment But it gives all the more of witchcraft that drowned a woman before the bitter aftertaste if we think of the fact that it was public to verify that she was not a witch It was only by sacrificing the life of this little girl that a national dishonor The fact that Sarah ate the corps of doctors attained to this conclusion something surreptitiously was not something to be After only several years of this incident some proved anyway The fact that she refused to doctors defined the pathological entity named admit to eat something proved just that she was a anorexia nervosa which is still now used for patient of hysteria whom one must intervene under-nourishment I will refer to this anecdote with medical treatment And this newspaper more closely later As is easily presumed the accused also people who came to see Sarah gave curious portraits of these fasting girls were more her some present and encouraged her Instead and more subsumed under the scientific and they should have protested that it was unthinkable medical categories like hysteria or anorexia that one could live without nourishment but they nervosa etc instead of becoming an object of didn t The corps of doctors resumed finally this awe and adoration During the rationalization

17) Walter Vandereycken & Ron van Deth From Fasting Saints to Anorexic Girls New York New York University Press 1994 The original book is in Dutch and published in 1988 In this paper I used English translation Hereafter FSAG 18) FSAG chap 4 pp 54-55 pp 69-71 FG chap 3 p 69-70

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process of modern society the medicalization of illusion They were a little bit all of them fasting girls advanced concomitantly For mixed and overlapped instance a famous neurologist of the époque George Beard (1839-89) did not hesitate to 4 Barrie & Nadia File identify these fasting girls at best with poor patients subjected to their own morbid illusions In this file we encounter one writer and one at worst with imposters who sought money and patient in a psychopathological document popular fame At first let s take up the writer named James But on the other side there was a fact worthy M Barrie (1860-1937) famous for giving birth of attention Please remind the aforementioned of Peter Pan Barrie was a novelist and a name of Mollie Fancher who was famous both dramatist After a quite important success of two for fasting and for some parapsychological plays Quality Street (1901) and The Admirable faculties like prophecy and clairvoyance William Crichton (1902) he wrote Peter Pan (1904) a A Hammond (1828-1900) was a doctor who masterpiece in virtue of which his name was attacked Fancher with extreme perseverance for inscribed in the history of English literature fraud but people felt rather embarrassed when Incidentally Barrie wrote between these three his accusation was so obstinate and perseverant successful dramas a small play not so welcomed 19) In the traditional dichotomy of soul and body in his era entitled Little Mary (1903) a comedy fasting could signify that soul succeeded in control in three acts Takashi Abe evaluates in his 20) of body with concentration and stoicism Barrie (1935) that that it is only a second- Therefore if someone refused outrageously to degree trash written for amusement s sake while recognize its possibility this someone could be Denis Mackail in his definitive biography of 2 1) considered as a cynical and materialistic person- Barrie The Story of J M B (1941) presents ality And that happened in the case of Fancher almost the same opinion So we cannot expect and Hammond battle In general we can resume too much of this play But as it has some that fasting girls could represent simultaneously relevance with the subject of this paper I would solitude girls who needed the closer attention of like to write down roughly its argument her parents a sort of medium appeal to An Irish chemist old Reilly makes some spirituality battling against materialistic science cheerful conversation with the Earl of Carlton concrete figures of self-control hysteric patients who comes to receive some medicament and and poor existence addicted to morbid desire and praises very much the excellence of English

19) James Matthew Barrie The Greenwood Hat The Blot on Peter Pan Little Mary New York Charles Scribners Sons 1940 pp 299-407 20) Takashi Abe Barrie (Barrie) Tokyo Kenkyusha 1935 chap 4 pp 114-115 21) Denis Mackail The Story of J M B London Peter Davies 1941 chap 17 pp 340-349

－101－ 醫 史 學 제13권 제1호(통권 제24호) 2004년 6월 aristocrats Reilly adds to his words that it is to is proved to be random the result will be open be regretted that they are often sick Caring to a wider public (The Second Act) nothing of Reilly s reserve Carlton enjoys After a month The Earl of Plumleigh the talking with Reilly s granddaughter Moira and father of Lady Millicent makes public known after a while he is gone away Reilly orders to their quotidian time schedule since a month 6 Moira a girl of twelve years old to read his 30 leap out of bed 7 run a mile walk a opus magnum two volumes of The Medium or mile 7 30 breakfast 8 botany 8 45 How to Cure Our Best People (The First Act) Herodotus 11 run a mile walk a mile 12 After six years Cecil the son of Carlton Latin verse 2 dinner Everybody is astonished speaks about a medium that is in company with to know that they take a dinner at 2 o clock in Loney (She is Moira now grown up to eighteen the afternoon Anyway they want to know how years old) Nobody meets yet this medium but is the recovery of Lady Millicent Meanwhile he knows that her name is Little Mary Cecil the very Millicent appears brimming over with insists that they need actually the supernatural good spirits Surprised they are really intrigued force of the medium because Lady Millicent the by the technique that the medium must use for daughter of the Earl of Plumleigh a friend lives her They ask tenaciously Loney to reveal the with a wheelchair since these two years after secret of this medium and the art of recovery having a shock with the sudden death of her Loney finally approves to reveal it and go to the fiancé So they decide to rely on Loney and her upstairs to take a book before the revelation medium for Lady Millicent When Loney comes Waiting for her Lady Millicent tells them on in Carlton asks her if they met once each other Little Mary of whom Loney said that she was Loney replies him that they met once before six something inside of everybody They make a years Remembering the scene Carlton inquires guess that Little Mary means perhaps a religious Reilly s health and Loney tells him that Reilly sentiment is dead three years ago When people asks Loney Loney comes back with two voluminous books where Little Mary is Loney replies rather given by Reilly Loney reveals the secret as ambiguously that she is already here When follows my grandfather told me that English people asks Loney whether this Little Mary can people ate too much The English upper class cure Lady Millicent Loney guarantees that Little does three times a day what the poor class does Mary can cure her in a month And Loney only once a week a heavy and copious meal predicts that if they are with Lady Millicent the The medium Little Mary is nothing else than our cure force of the medium will influence all of stomach If you care for her appropriately you them Carlton suspicious of her bold prediction will be soon as fit as a fiddle Therefore I is ready to go away but acknowledging that this ordered Lady Millicent to eat well only once a conduct hurts Loney he desists from going day My grandfather discovered the tremendous Carlton gives her a warning that if her prediction truth that what we are depend essentially on what

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we eat Good or bad lovely or malice all these did not be classified as a good piece But at least characters are determined by what people eat If for a while the euphemism of Little Mary to you want someone to love you then you must mean stomach was well known in England so that take care of the meal of this someone Loney some one could say like this My Little Mary is tells thus the secret People feel rather ill at ease not so in good condition today with this speech But Carlton declares that if we In itself Little Mary is not so tempting for don t like this story it is because it is so analysis But the manner of reaction of spectator crudely true and right And as recently can afford us some important cultural information experienced a luckless love affair this middle-age of this era in England The essence of man is aristocrat asks Loney to live with him and to expressed in what he eats This proposition didn take care of his meal during all of reminder of t be deemed highly in the reign of Edward VII his life (The Third Act) reign in which lingers the Victorian atmosphere That s all The Reilly s truth The essence of Regardless of the fact that eating is one of the man is expressed with what the man eats looks most fundamental conditions of survival human really like the famous prank22) of Ludwig culture takes it sometimes as a third-grade Feuerbach (1804-72) According to Abe and painting for evaluation of which only a glance is Mackail this play was not received well by enough We will take up this theme later again spectators and almost nobody was persuaded Here I would rather search for more implicit with a rather abrupt and bizarre confession of meaning of this play being inspired by some love of an old aristocrat to Loney at the final interesting facts that Vandereycken and van Deth phase of the play Though it was put on the presented in their book23) stage during some months since autumn 1903 As an adult Barrie stood only five feet high Little Mary was considered as a second-class and looked always like a very young man low tasted joke When the conundrum of who Sempiternal child Peter Pan was perhaps a Little Mary is was revealed and that she was projection of Barrie himself And we have a just another name of stomach the spectator burst biographical hint in this presumption Barrie had into wry laughter And if it was exactly the first an older brother David David beloved child stage the riddle of who Little Mary is could was unfortunately dead from an accident during a instigate some interest of spectator But after the skating when he was fourteen The lament of the first stage as the riddle is no more a riddle that mother was so profound that she was forced to nobody knows the effect is as if people listened be bedridden almost one year and ate just very to the same bad joking several times Therefore little Barrie was just a boy of seven years old in view of management of theater also this play but he tried to console her sadness So Barrie

22) Der Mensch ist was er isst 23) FSAG chap 11 pp 233-236

－103 － 醫 史 學 제13권 제1호(통권 제24호) 2004년 6월 rested many times in her bedroom and talked English William W Gull (1816-90) and the with her Barrie wanted to be another and living other is a French Charles Lasègue (1816-83)24) David That meant that Barrie remained for the Gull was a very important doctor in his period reminder of his life as a boy of fourteen years and he at first forged the concept of anorexia old like dead David Peter Pan was David or nervosa as an independent pathological entity He Barrie himself who tried to identify with David thought that this malady was not an organic The core of the riddle of Little Mary was a disease and that it was not a sort of madness reduction of quantity of what people eat for their though quite similar with it On the other hand healthier state of body That was a clinical Lasègue called it l anorexie hystérique that is proposal to the England aristocrats Eating less to say Lasègue negated to treat it as an and doing often sports This is a good method of independent and authentic entity and preferred to diet and at the same time this can be the first classify it as one of the forms of upper step towards anorexia nervosa for certain patients categorical entity the hysteria Humble and This play written just before Peter Pan could be prudent personality as he had Lasègue is tend to suggesting to the arriving Peter Pan to take care be hidden behind a showy Jean-Martin Charcot of his Little Mary i e not to eat too much (1825-93) but in fact he was an important and to remain forever as a little child And if psychiatrist in the period and left large and Peter Pan was a concretization of ideal of eternal copious descriptions on spleen catalepsy child Barrie perhaps cured himself through his alcoholism kleptomania exhibi- tionism etc own literary imagination writing Little Mary and Besides that Lasègue developed what he Peter Pan These two plays may be for him a called the theory of three stages of l anorexie sort of clinical activity under the guise of a hystérique In this description Lasègue paid cultural system called literature subtle attention to the familial situation in which * * * the patient and her family exchanged their Though this paper doesn t aim mainly at the conversation and their conduct L anorexie historical description of anorexia nervosa as hystérique emerges through the nexus of desire pathological entity I would like to present here a and fear of patient supplication threat and really rough survey on it After only several years terror of family member Researchers like of Sarah s pitiful death the concept of anorexia Salvador Minuchin or Mara Selvini-Palazzoli etc nervosa was proposed in clinical discourse in 1873 will succeed this kind of relational understanding and 1874 Traditionally they refer in this context of anorexia25) to the two important doctors the one is an Needless to say Sigmund Freud contributed to

24) Cf FSAG chap 8 FG chap 4 pp 109-123 chap 5 25) Salvador Minuchin Bernic L Rosman & Leslie Baker Psychosomatic Families Cambridge Harvard University

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the etiology of anorexia nervosa with his large next theoretical step we must wait about for theoretical frame of dynamic psychiatry but 1960 s curiously enough he didn t pay particular Incidentally in 1903 at the same year of attention to the exact symptom of this entity and publication of Little Mary was published a treated as a sort of neurosis As a major episode voluminous book of Pierre Janet (1859-1947) the in the first half of twentieth century we must not first tome of Les Obsessions et la Psy- forget the theory of a German doctor Morris chasthénie26)(1903-04) Janet was almost as Simmonds (1855-1925) In 1914 Simmonds important psychiatrist as Freud in the era In this discovered during the autopsy of a female volume Janet presents a very impressive case of emaciated patient that she had an atrophy of anorexia nervosa coined often as Nadia Case27) pituitary Though the diagnosis in life remained I resume the essential content of Janet s des- quite uncertain this Simmonds disease became cription as bellow considered as a physiological core of anorexia Nadia twenty-seven years old female patient nervosa during about twenty years after this ate only very little Twice a day of weak potage discovery This theory gave a clear-cut etiology of the yolk of a boiled egg a spoonful of vinegar this mysterious disease of anorexia as a pituitary and a strong tea with squeezed lemon that was deficiency In this context anorexia nervosa all of portion per day that she took Though with patients were treated with some extracts of a small portion of nourishment Nadia was a very pituitary gland Since the end of 1930 s H L active woman dance in the evening long Sheehan demonstrated that the identification of promenade in the afternoon Nadia had a sense of Simmonds disease with anorexia nervosa was hunger or sometimes even a strong feeling of inappropriate But the endocrinological under- starvation In this sense Nadia was not so really standing of this malady was not disappeared an anorexic patient immediately and lingered away in clinical sphere The reason why Nadia refused to eat too much So we can state perhaps quite roughly that there was that an idea guided permanently her conduct were in principal two major trends of treatments Regarded superficially the idea must be a desire for this disease during the first half of twentieth of being slim In effect she was slim and pale century i e endocrinological treatments But the desire for slimness seemed related to originated from Simmonds and psychodynamic some more moral theme For Nadia being fat treatments originated from Freud etc For the meant something of immoral Meanwhile she

Press 1978 Mara Selvini-Palazzoli Self -Starvation London Human Context Books 1974(Its Italian original published in 1963) 26) Pierre Janet Les Obsessions et la Psychasthénie 2 vols Paris Félix Alcan Tome I 1903 3e edition 1919 Tome II avec F Raymond 1904 2e edition 1911 27) Pierre Janet op cit Tome I Première Partie Chap 1 Première Section pp 33-41

－105 － 醫 史 學 제13권 제1호(통권 제24호) 2004년 6월 began to refuse to eat when someone was with Refusing to eat was in effect only an appearance her She wanted to eat alone She refused also of this wish I don t want to grow up I don t that someone hears her eating because she want to be like any other woman I want to be strongly disliked the sound of her own biting forever a little girl ---- That was the idea that Objectively Nadia was a slender and beautiful guided Nadia woman But she thought herself that she was fat This is the description of Nadia by Janet with red face and plenty of acne When Janet Though Janet himself hesitated to qualify Nadia told her that there was no acne on her face she as an anorexic patient in course of analysis I replied that acne existed between her skin and don t want to discuss on it here in detail and I her flesh Nadia was scared to go out on the consider her as a case of anorexia nervosa street So she went out only in dark night The Anyway the notion of guiding idea is very sense of uneasiness with regard to her body important In Janet s schema it is not sufficient started very early When she was four she felt to describe as it was the symptom and conduct of being too big When she was eight she found refusal of food etc but one must identify a core that her legs and arms were too long and idea that makes possible the apparent symptom ridiculous When she was eleven she felt an and conduct And in Nadia s case Janet intolerable sense of shame in miniskirt Of identified it as a refusal of growing up refusal to course these symptoms were getting worse in be an adult woman the age of puberty She became almost frantic in In effect the interpretation that lays stress on menarche When came out pubic hair she refusal of adulthood or on the infant-regressive thought that only she had this kind of savage s inclination at the core of anorexia nervosa ornament so that she relentlessly continued to occupies an important part among many other draw it Around this age Nadia stopped to eat interpretations and etiologies of this malady28) much and began to avoid meeting other persons But as Janet also touched on it we must perhaps With every method she could find Nadia tried distinguish the desire of being sexless from that to hide that she was a woman She dressed of becoming man-like existence Mari Suzuki herself with a gender-neutral style and her contemporary clinician presents a case in which hairstyle was also made in neutral manner That a girl became anorexic after having been shocked didn t mean however that she wanted to be a by an irritant experience When she was walking man If she could she would be without sex in a narrow path in the night a man wreathed Furthermore she would want to have no body suddenly his arms about her She felt that her

28) For instance one of the most important researchers on the domain in Japan Kozo Shimozaka also thinks that it is the psychological core of this disease See Kozo Shimozaka Treatise on Anorexia Nervosa(Anorexia Nervosa Ronko) Tokyo Kongoshuppan 1988 See also Arthur Crisp Anorexia nervosa Let me be London Academic Press 1980 etc

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body was spoiled and thought that she had to growing up a real writer a fictional fairy and experience such a thing because she owned a a real patient cross over each other and weave a female body29) In this case what this vulnerable textile of anorexia in a space of concepts In this woman wanted by being emaciated was to seek textile a thread of biomedical element is so to be an asexual existence On the other hand minor that one may overlook it we must understand in a different way a case such as Annette s one presented by Hilde Bruch 5 Huxley File (1904-84) in her Conversations with Anorexics30) (1994) Annette doesn t hide a strong aversion Let s open the last file Important English against female bodies in general curvilinear and writer Aldous Huxley (1894-1963) published as bleeding body In an advanced age the breast his first novel Crome Yellow3 1) in 1921 Crome hangs down But this disrelish hides something Yellow consists in series of sophisticated important that overflows from a pure phy- conversations between intellectuals and the siological phase It is an indirect expression of leisured class gathered in a mansion at Crome irritation on the present social status of women in countryside The host of the mansion Henry society passive and stagnant mode of being If Wimbush writes a book History of Crome of the emaciated Annette s body becomes similar to a passages of which he reads sometimes before man s body but this does not mean that she sojourners Among the anecdotes that Henry reads finds a male body in itself beautiful and ideal In for guests there is quite an interesting one this case we must take into consideration another relating to his grandfather George and to the scope of analysis more sociological one But I processions of events for his marriage (chap 19) will mention it later again In 1833 George was a young man of twenty-two Barrie who avoided to grow up to remain a years old He had an occasion to meet the dead and beloved child for his mother eternal beautiful Lapith sisters the eldest Georgiana and child Peter Pan that Barrie s imagination created the younger twin Emmeline and Caroline One Little Mary who infiltrated slightly a scent of day he had a dinner with them and remarked anorexia into her strict method of diet and Nadia something curious The next passage is the scene who wanted to remain an asexual existence to of this remark avoid to blossom into a matured woman ---- through the scope of meaning of refusal of He [Georges] noticed with surprise and a

29) Mari Suzuki Girls Heart and Anorexia Nervosa (Otomegokoro to Kyoshokusho) Tokyo Intermedical 1999 chap 1 p 28 30) Danita Czyzewski & Melanie A Suhr eds Hilde Bruch Conversations with Anorexics New York Basic Books 1988 London Jason Aronson 1994 chap 6 pp 119-129 31) Aldous Huxley Crome Yellow London Chatto & Windus 1921 Chicago Dalkey Archive Press 2001

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certain solicitous distress that Miss Emmeline s and frail They ate only a little they were always appetite was poor that it didn t in fact exist pale complained of fever talked very much of Two spoonfuls of soup a morsel of fish no death and frequently swooned Especially bird no meat and three grapes that was her Georgiana was the most ethereal of all of the whole dinner He looked from time to time at three she ate least swooned most often talked her two sisters Georgiana and Caroline seemed most of death and was the palest to be quite as abstemious They waved away whatever was offered them with an expression But this too purified portrait of frail woman of delicate disgust shutting their eyes and had to be almost necessarily counter-balanced by averting their faces from the proffered dish as a disgraceful secret One day George took notice though the lemon sole the duck the loin of of a little maid that went through an veal the trifle were objects revolting to the inconspicuous door with a large covered tray sight and smell George who thought the Soon after the same maid went outside without dinner capital ventured to comment on the this tray Intrigued George dared to open this sisters lack of appetite door and looked at a mysterious staircase After a Pray don t talk to me of eating said bit of hesitation he decided to ascend the Emmeline drooping like a sensitive plant We staircase with a beating heart and some diffidence find it so coarse so unspiritual my sisters and I One can t think of one s soul while one is And when he saw a door he tried to listen the eating noises from inside in vain He peeped from a George agreed one couldn t But one must keyhole and saw nothing but a white wall live he said Determined he opened the door and petrified by Alas! Emmeline sighed One must Death what he saw Inside this room the three Lapiths is very beautiful don t you think? She broke were eating greedily all of good cheers on the a corner off a piece of toast and began to table After a moment of pause he rushed out of nibble at it languidly But since as you say the room and when alone he began to laugh one must live She made a little gesture of During the lunch of the same day the Lapiths resignation Luckily a very little suffices to ate more than ordinary times And when keep one alive She put down her corner of Georgiana caught George s eye she blushed her toast half eaten3 2) face and looked away In the same afternoon when they met in the garden Georgiana implored And since this impressive dinner George him to tell it to nobody George proposed an became to meet them more often He felt sincerely ambiguous condition and finally they married33) that he must protect them from the secular world That s all There are perhaps many different These sisters seemed to him so spiritual delicate

32) Aldous Huxley op cit Dalkey Archive Press chap 19 p 94 33) Aldous Huxley op cit chap 19 pp 94-99

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elements to be well analyzed inside of this funny judge that Health Fragments itself is a frag- anecdote We can consider that this story reflects mentary expression of a social norm functioning in some manner a cultural norm that was living as an important background in Victorian era and since Victorian age until the era of Huxley s adult that Huxley absorbed and succeeded in his own age Avoidance of eating before spectators reminds way this social image of charming woman of us the portrait of Nadia And according to ethereal appetite Of course as we have seen Brumberg34) this act of eating before companions Huxley himself presented this norm with a seems to connote a subtle and special meaning in sarcastic caricature the Lapiths ate avidly when England and U S A during Victorian era no one else was with them It is not astonishing Especially for young girls eating with a keen to see that when somebody who really finds appetite before companions could mean a rather beautiful women with little appetite reads this direct expression of sexual lust or of an absence passage this somebody will feel that Huxley s of self-control In a book entitled Health anecdote has a scent of cynicism and materialism Fragments35)(1875) the authors claimed that a I have some bewildering feeling to know that woman with a rosebud mouth was expected to this Huxley-styled caricature looks a little bit like have an ethereal appetite And Brumberg the mode of conduct of contemporary bulimia continues to cite the passage of Health Fragments patients Incidentally this anecdote was cited in saying Madam von Stein lost Goethe s love by a famous feminist analysis of anorexia entitled gross habits of eating sausages and drinking The Anorexic Experience36) (1984) of Marilyn strong coffee And also Women such as von Lawrence It is highly possible that many women Stein who indulged in the pleasures of the more or less concerning anorexia problem or the appetite were said to develop a certain unspiritual medical staffs working for it know this anecdote or superanimal expression And this resembles So to speak we can assert that many bulimia surprisingly what the Lapiths sisters said in patients continue the norm and the manner of public! The existence of a social norm that asserts Huxley when they binge secretly in their private that eating is animal-like and unspiritual Huxley space at the last decades of twentieth century But s fiction reflects a certain historical social norm in this case also it is quite improbable that these and vice versa Although the probability under bulimia patients are directly influenced by a which Huxley read Health Fragments is not null lecture of Crome Yellow and imitate it This we don t have to limit our manner of thinking kind of mode of explanation which refers to a into a so strict causal linkage And we had better direct causal connection is not appropriate for

34) FG chap 7 p 174-184 35) George & Susan Everett Health Fragments New York 1875 FG chap 7 p 176-177 36) Marilyn Lawrence The Anorexic Experience London The Womens Press 1984 1988 The 3rd edition fully revised and updated 1995 chap 2 p 35-36

－109 － 醫 史 學 제13권 제1호(통권 제24호) 2004년 6월 these social phenomena Vaguely influencing In lieu of beginning immediately to try the social norm a literary fiction and some abnormal closer articulation I would like to present a brief conduct that spoil patients real body overlap or survey on the contemporary discursive topography pass by each other and reverberate themselves on this disease in lingering sound and images Roughly speaking the publication of Hilde I am inclined to assert that the abnormality and Bruch s Eating Disorders37)(1973) was an epoch the deviance in eating conduct existed and still making advent for the history of understanding of exist as a sort of culture when I assist to so this malady Bruch published another book many complicated factors and elements drifting entitled The Golden Cage38) (1978) containing around eating disorders I am inclined to do it evocative images and easy expressions for a even if I am conscious that the term culture is a wider audience But even after the publication of sort of hotchpotch reluctant to trace a clear-cut this second book anorexia nervosa was not a line of understanding or a linear logical causality disease well known in grand public Except for I am inclined to do it even if I am conscious specialists this remained a secret and particular that when I say the proposition that Eating disease Anyway during the first half of 1980 s disorders exist as a sort of culture it can be some books written by authors who had difficult to indicate what I add substantially to the experienced personally this malady were published understanding of this malady Anyway the choice succeedingly for instance Sheila MacLeod s The of the term culture is not an essential one in Art of Starvation39)(1981) Cherry Boone O Neill itself This choice is only a summarizing s Starving f or Attention40) (1983) and Kim expression of my intention of destructing Chernin s The Hungry Self 4 1) (1985) Particularly solid-like contour of eating disorders To The Hungry Self could present clearly the view articulate a little more closely I would have to that eating disorders emerged from the struggle of add some more explanation on what I did in young girls to quest for self-identity with an course of jumping-like analysis of four files And ambivalent sentiment toward her mother (I don t that will be an aim of the last section want to become such an old tired woman Thank you for bring me up etc ) This category of the 6 Eating disorders-ness trapped in first person s confession or confession-like spiders threads of web of meaning analysis is still intermittently published until

37) Hilde Bruch Eating Disorders Houston Basic Books 1973 38) Hilde Bruch The Golden Cage The Enigma of Anorexia Nervosa Cambridge Harvard University Press 1978 39) Sheila MacLeod The Art of Starvation London Virago Press 1981 40) Cherry Boone O Neill Starving f or Attention New York Dell 1983 41) Kim Chernin The Hungry Self New York HarperPerennial 1985 Chernin remains as an important researcher and clinician with her own experience of this disease See also idem The Obsession New York Harper & Row 1981 idem Womansize London The Womens Press 1983

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now42) a form of strike by absenting themselves from Irrefutably the incident of Karen Carpenter in eating at least for a determined period That was 1983 was capital for the wider social recognition a strategy of hunger strike For instance of this particular malady Wonderful singer as she Sylvia Pankhurst (1882-1960) was one of these was Karen had to finish her only thirty-two suffragists In her book The Suff ragette years old life by anorexia nervosa43) The name Movement45)(1931) she recalled a tremendous of this unknown malady appeared bizarre and experience of forced feeding that she had to put terrifying Almost at the same period Jane up with achieved by a group of doctors as Fonda confessed to have suffered from some medical treatment against hunger strike46) binge eating Anorexia and bulimia became Seized by several men she was forced to open suddenly the object of public concern Moreover her mouth and inserted a metal instrument into a novel of Steven Levenkron The Best Little Girl her throat Almost choking with her own violent in the World44)(1979) was broadcasted as a TV palpitation she had to receive some liquid drama at the same period After this series of alimentation For her it was just a sort of oral events and incidents anorexia nervosa became rape I myself had a chance to see some widely known for the public so much so that illustrations of forced feeding against hunger people joked often on it in everyday conversations striker though not of that of Pankhurst herself And already in 1988 Brumberg s Fasting Girls I must confess that I found it atrocious and an excellent history was published horrible And I think that many other people Incidentally though my survey takes matter out must feel like me What doctors poured into their of historical sequence here I would like to call throat was certainly substantial nourishment but attention for the existence of a new form of as far as it was forced against women who fasting originated from totally different context refused to for a political reason it seemed to At the end of the nineteenth century and the represent an injection of the mind of beginning of the twentieth century some women accommodation and compromise Even with the called suffragists who struggled for obtaining the pretext that it was for her own sake this forced same right of suffrage with man began to adopt feeding made extremely opaque the demarcation

42) Among relatively new ones see for example Marianne Apostolides Inner Hunger New York W W Norton 1998 Marya Hornbacher Wasted New York HarperCollins Publishers 1998 And Barbara Kent Lawrence describes calmly in her Bitter Ice (New York William Morrow 1999) how her husbands curious mode of eating destructs the natural manner of quotidian life of her family member He eats predominantly ice and spits out always cold water from his mouth 43) Cf Ray Coleman The Carpenters New York HarperCollins 1994 44) Steven Levenkron The Best Little Girl in the World New York Warner Books 1979 45) Sylvia Pankhurst The Suff ragette Movement London Longmans 1931 46) Cf Maud Ellmann The Hunger Artists London Virago Press 1993 pp 33-34

－111－ 醫 史 學 제13권 제1호(통권 제24호) 2004년 6월 line between medical treatment and police-like the same imposed femininity So this work is control well-balanced social analysis on anorexia nervosa For common sense to understand continuously with a vivid sense of feminism48) the aforementioned hunger strikes and our Sociological stance to analyze eating disorders contemporary eating disorders would be a quite becomes a tradition thereafter A prominent perplexed matter Nevertheless among figure in sociology Anthony Giddens himself sociological or feminist discourses on eating mentions on it during the analysis on disorders there are plenty of assertions that globalization in his Beyond Lef t and Right49) identify voluntarily eating disorders with (1994) According to him the multiplication of manifestations of social resistance against the distributive style of food means for some rich major political trends Lawrence s The Anorexic societies the rapid extension of range of choice Experience (1984) that I mentioned is one of the for food consumption In this situation women earliest of them Here I would like to pay are relentlessly expected to choose a form among attention to Orback s book Susie Orback s many other forms of eating Under the pressure exactly so entitled book Hunger Strike47)(1986) of social norms of femininity and this forced recognizes that there is some resemblance choice women are sometimes bedazzled and lose between the treatment of hysteric patients in themselves to suffer from eating disorders nineteenth century and that of contemporary Incidentally isn t there any contribution of this anorexic patients And she judges that these kind in Japan? As far as I know there is at least treatments are nothing less than violent one book clearly belonging to this theoretical oppressions on women s protestations With concern In her book Why do Women Want to be sustained fasting anorexic patients lose their Thin?50) (1996) Chie Asano argues the curvilinear bodies and menses in order to inappropriateness of limiting the discourse inside de-womanize themselves That means that they physiological and biomedical sphere for this refuse in their way to obey to the predominant matter Asano obtains information through social norms by alienating from expected questionnaires and interviews with patients and femininity At the same time Orback doesn t confirms the tendency that patients regain their adopt a purely accusatorial stance because she health in conscious confrontation with feminist admits that sometimes women take advantage of social concern She defines the recovery of

47) Susie Orback Hunger Strike New York W W Norton 1986 48) See also the next works Morac MacSween Anorexic Bodies London Routledge 1993 Catherine Garrett Beyond Anorexia Cambridge Cambridge University Press 1998 Julie Hepworth The Social Construction of Anorexia Nervosa London Sage 1999 49) Anthony Giddens Beyond Lef t and Right Cambridge Polity Press 1994 chap 3 50) Chie Asano Why do Women Want to be Thin? (Naze onna wa yaseyoto surunoka) Tokyo Keisoshobo 1996

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patients in terms of the reconfirmation of right of Unbearable Weight52) (1993) As I cannot resume self-definition in a few words this rich document I take up In this way the sociological tradition for only an article gathered in it entitled The Body analysis of eating disorders constitutes one and the Reproduction of Femininity 53) In this important branch in discourse sphere But of article Bordo brings forward a thesis that a course that doesn t mean that there is no pathological phenomenon is an exaggerated criticism against it5 1) The description in which expression of a social norm that put restraint on patients are treated as energetic insurgents against an era For example think about hysteric patients dominant social norms like strong hunger strikers in nineteenth century They were qualified often can eclipse a sort of constrainedness that forces as very sensitive narcissistic versatile and patients in unpleasant state from which they egocentric But these mental qualities were cannot flight away even if they want to exaggeration of the social norm of the era for Sociological view makes possibly too strong images of ideal woman And agoraphobia on projection of its own ideal on patients active which they talked sometimes in 1950 s and 1960 s subjectivity and we can judge impartially that it represented also the social norm of an ideal is quite stupid to consider devastating symptoms housewife of the period Woman who dislikes that destroy patients body as a sort of political finding herself in a wide space expressed agenda for a better society To sum up we can somewhat with distortion the ideal image of say that sociological view in itself is not enough housewife who is always waiting in house for her to understand fully this particular disease husband and her child keeps rooms clean and We have thus multicolour range of discourse cooks in the kitchen In the same manner eating such as the first person s confession or disorders are distorted and exaggerated image of confession-like analysis tradition and sociological what a contemporary woman should be woman and feminist tradition by the side of biomedical of slender and svelte body Moreover the medicine and clinical psychology Moreover we control of appetite can link with a spiritual virtue have another subtle tradition that we want to of self-control and stoicism which is regarded categorize as cultural studies or cultural analysis traditionally as masculine And in her house tradition The works of Brumberg and Van- anorexic patient can have a morbid illusion of dereycken & van Deth belong naturally to this superior status in the family when she is category Here I would like to cite another book repeatedly supplicated to eat something The of this category i e Susan Bordo s patient with a semi- masculine skinny body has

51) Cf Richard A Gordon Eating Disorders Anatomy of a Social Epidemic Oxford Blackwell Publishers 1990 2nd edition 2000 chap 2 p 25 Mari Suzuki op cit chap 2 etc 52) Susan Bordo Unbearable Weight Berkeley University of California Press 1993 53) Susan Bordo The Body and the Reproduction of Femininity in Unbearable Weight pp 165-184

－113 － 醫 史 學 제13권 제1호(통권 제24호) 2004년 6월 symbolically a greater power to become like a original pure fictional scene obtains in this man in a misogynous society The patient manner some realistic character even if it does internalizes the social norm fit for man such as so in a critical context Confronted with this positiveness self- controllability or interpersonal critical comment does Matsumoto feel ashamed power etc at the expense of her own body ---- for her lack of real clinical experience or does I think that the cultural analysis of Bordo is one she take delight in seeing that her literary of the most sophisticated discourses on eating imagination reverberates in real hospitals? disorders in that it is elaborated from an adroit Anyway we must take notice once again of the amalgam of different layers of knowledge particular mode of being of eating disorders By the way we had better not ignore that this which goes and comes back between books and malady makes its appearance in literary fictions hospitals between literary images and clinical sometimes In English we can cite for example techniques the aforementioned Steven Levenkron s The Best Well with this too hasty bibliographical Little Girl in the World (1979) Susan Terri s survey the reader must be a little bit stumped Nell s Quilt54) (1987) and Marsha Skrypuch s The with its possible monotony This survey Hunger55)(1999) etc In Japanese there are novels however permits us to confirm more certainly like Yuko Matsumoto s Lingering Dawn f or that eating disorders mobilize an enormous and Bulimic Patient56) (1987) and Otohiko Kaga s disparate range of phase of discourse such as Skater Waltz57)(1987) Interestingly the novel of biomedical psychological historical literal Matsumoto is cited in a treatise written by a philosophical or cultural phases etc Having this clinician and is evaluated by him as if it force of mobilization and having multifaceted happened in a real world Koichi Nakano s clusters of meaning upon each of which we can Psychosomatic Treatment of Eating Disorders58) develop some theory and achieve coherent (2001) takes up the scene of Lingering Dawn in portrayal this malady looks like a twinkling which a doctor asks a bulimic patient quite existence emerging desultorily from different abruptly whether the patient vomits after the nodes or junctions of web of thought made by meal or that the doctor compares the symptom different strata of knowledge This malady looks of the patient with another absent patients With like an ex-centric disease which decentralizes an eye of professional clinician Nakano criticizes itself so ceaselessly and thoroughly that it seems the attitude of the doctor in this scene The to have no essence and no steady core In this

54) Susan Terris Nells Quilt New York Farrar Straus and Giroux 1987 55) Marsha F Skrypuch The Hunger Toronto The Dundurn Group 1999 56) Yuko Matsumoto Lingering Dawn f or Bulimic Patient (Kyoshokusho no akenai yoake) Tokyo Shueisha 1987 57) Otohiko Kaga Skater Waltz (Skater Waltz) Tokyo Chikumashobo 1987 58) Koichi Nakano Psychosomatic Treatment of Eating Disorders (Sesshokushogai no shinshin iryo) Tokyo Shinko Igakushuppannsha 2001 chap 2

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sense it is impossible to frame it totally in the theatrical performance so we cannot diagnose her discursive sphere of biomedicine Necessarily as anorexic On the other hand her eating disorders evade away from purely medical contemporary doctors recognized in her many or clinical gaze in the process of searching symptoms that she was a poor hysteric patient After this confirmation I have to add a little obsessed by a morbid addiction As number of more comments on the contents of our four files doctors adopted the theory that classified anorexia in order to think through once again the relief of nervosa as a subcategory of hysteria Sarah was eating disorders-ness expressed in their anorexic under this theoretical gaze Moreover respective scope and phase Sarah s fasting was founded on her obsessive * * * passion instigated by the relation between Sarah Many fasting Saint women in the medieval and the family between Sarah and the spectators ages including Caterina da Siena must have and between the family and the spectators If we atrophied stomach downy body and low bodily remember in this context the family system theory temperature So even if they tried to eat of Minuchin and this interpersonal enmeshment something they had to vomit almost all of meals that bound Sarah in her fasting Sarah s case quite certainly Moreover if they tried to eat fulfills unmistakably the condition of anorexia something to demonstrate that they were not While eating in secret some poor food perhaps possessed of evil demon they must feel during the midnight under the collaboration of one bewildered and flurried by their impossibility to member of family Sarah was not anorexic But eat correctly when they vomited all of meal In during the daytime when she refused even to this phase all of the phenomena seem fit exactly take a glance at food in front of family and of for the symptoms of eating disorders patients strangers she was a sort of anorexic Thus the Nevertheless these fasting Saint women were not value of existence of eating disorders-ness anorexic The resemblance or even the identity in continues to turn reverse- ly in instant Sarah was physiological process cannot cover totally the anorexic Sarah was not anorexic meaning by which these Saint women themselves The portrait of Nadia should have emerged or people observing them understand their fasting exclusively inside the positivistic discourse sphere What is important is not physiological process as it was originally so in the book of Janet But itself but its meaning in my paper Nadia was presented in a linkage Then was Sarah Jacob anorexic? Sarah ate with Barrie s work in that two of them expressed surreptitiously even from almost all of family in respective manner the refusal of sexual members But she contented herself with only an maturation and adulthood and also in that they extremely small portion for the girls of her age appeared in history almost contemporaneously Certainly Sarah abhorred to look at food before Unless this linkage is purely my subjective fancy family and strangers during the daytime But this once that this linkage assumed the two figures abhorrence was to be considered as rather a remain at least for a while in the web of meaning

－115 － 醫 史 學 제13권 제1호(통권 제24호) 2004년 6월 of eating disorders-ness as a new candidate of Meanwhile I could confirm the important fact node And some scholars familiar with English that eating is not so just physiological literature may link Nadia with another authors or nourishment but polysemous conduct in which another literary works following the chain of are mixed up the theatre-ness ceremonial association with Little Mary s proposal of diet character social and aesthetical normativeness etc or with eternal childhood of Peter Pan etc On Therefore the anecdote of secret binge of the the other hand some scholars familiar with psy- Lapiths of Huxley could occupy a little nod in chopathology or clinical psychology may link the web of eating disorders-ness And I don t Little Mary or Barrie with another cases reported think that I need to argue more tenaciously to in psychopathological works like that of Nadia demonstrate that with such an enormous range of In this way the emergence of a new node connections nobody can present a total landscape influences the entire range of web of meaning of of eating disorders-ness referring simply to eating disorders-ness and gives some slow some mono-phasic plan of knowledge shaking on it In this process of shaking and In the shaking balance of touch and detach of balancing something that seemed totally irrelevant many ideas and imaginations eating disorders or indifferent from eating disorders until then can scatter themselves around in social or cultural appear as a new other candidate of node or spheres junction To tell the truth nobody can predict If many spectres of eating disorders-ness how these new connections will emerge to such as It is almost anorexic It is evidently influence the entire web of eating disorders-ness not anorexic It may be anorexic but not so and where they will occur to modify the total serious one It is a catastrophic and fatal configuration of it And among these movements anorexic etc are scattering around in our of connection and disjunction there is a case of cultural sphere the patients suffering for some final separation from this web such as anorexia period with anorexia or bulimia had better relax mirabilis or a case of iterative touch and detach in their fasting or binging and be more such as Sarah Jacob s case conscious that their eating behaviour cannot come As already in the case of Barrie I became not only from their own origins Many deviant forms at unease with the consideration on the documents of eating being scattering and presenting in so of purely fictive and imaginary discourse in many concrete cultural phenomena the patients search for slight traces of eating disorders-ness behaviour only reflects and repeats the cultural I continued to look for another many documents deviance itself Escaping away from their of literature Sometimes I happened to meat a repeated self-reprobation and from pusillanimous kind of eating disorders-ness in literary fictions valetudinarianism the patients had better throw and I found that their fictitious suffering had their suffering and fear in return against the authentic and proper signification rather than it culture through which their suffering and fear scented only falsehood and fabrication come from In so doing patients and culture can

－116 － Osamu Kanamori∶ Cultural Morphology of Eating Disorders

co-suffer patients and culture can co-recover In add now only few words please relax suffer my ears simple but pregnant words of Mari for some time and come back again to live with Suzuki echo kindly anorexia she says is just us a byway on which some young girls find themselves for a while They can recover from it Key word Anorexia nervosa anorexia mirabilis just naturally as they become in adult age If not fasting girls refusal of growing up eating as disgracefulness impossibility of monopolistic fatal I feel even that I can let the patients do understanding of anorexia under the scope of what they want to do regardless of fasting or biomedicine anorexia as culture binging 59) To these words I would like to

59) Mari Suzuki op cit chap 3 pp 75-76

－117 － 醫 史 學 제13권 제1호(통권 제24호) 2004년 6월

= 초록 =

섭식장애의 문화적 모습

오사무 카나모리*

중세유럽에서 흥미로웠던 anorexia mirabilis 나 17세기에서 19세기에 걸쳐 유럽에 나타났던 단식 하는 소녀들에 대한 많은 사례는 음식을 먹는다는 본질적인 인간행위가 다양한 일탈의 가능성에 노출되어 있음을 말해준다 예를 들어 유명한 단식하는 소녀였던 사라 자콥은 음식을 기피하다가 결국 비극적으로 죽음을 맞았다 제임스 베리의 귀여운 매리 라는 드라마는 피에르 자네가 서술 한 나디아의 사례와 유사한 맥락에 있다 나디아는 가능하면 중성적이고 아이와 같은 사람으로 남 기를 원한다 이러한 만남은 섭식장애가 정확히 과학적 생의학적 정신병리학적 담론의 영역에 만 국한되지 않음을 말해준다 다차원적이고 복합적인 섭식장애를 이해하기 위해서는 생의학적이 고 임상심리학적 담론 뿐 아니라 철학적 문화적 사회학적 페미니스트적 허구적 담론들의 다양 하고 폭넓은 혼합을 받아들여야 한다 이 논문에서 저자는 많은 문화적 영역에 흩어져 있는 섭식 장애의 지극히 다양한 측면이 가지는 복합성을 밝히고자 하였다

색인어∶ 거식증 단식하는 소녀 성장거부 거식증을 생의학적 관점에서만 이해하는 것에 대한 거부 문화 로서의 거식증

* 일본 도쿄대학교 교육학대학원

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