hce_tcu
114年
英文
第 32 題
📖 題組：
What we recognize today as depression was, in the Victorian era, popularly known as melancholia or melancholy. Like depression, melancholy ranged in seriousness from mild, temporary bouts of sadness or “low spirits” to longer, more extreme episodes, characterized by insomnia, lack of appetite, and suicidal thoughts. While symptoms of melancholy were usually easy to recognize, medical opinions often differed on what it was that caused the condition. As a result, treatment plans for the melancholic patient varied widely. Below, we look at a few Victorian era medical opinions on the symptoms and causes, and treatments of melancholy. According to Dr. Wooster Beach, the patient afflicted with melancholy shunned society and courted solitude, was fearful and low-spirited. Many medical practitioners found it useful to divide melancholy into categories by symptom. This served to separate the more severe forms of melancholy, such as those accompanied by violent outbursts, mania, or delusions, from the more ordinary forms of melancholy in which the patient was merely reclusive and sad. In his 1871 book Insanity and Its Treatment, Dr. G. Fielding Blandford classified melancholy as being either acute or subacute. While Yeoman went a step further, dividing melancholy into four separate types: Gloomy Melancholy, Restless Melancholy, Mischievous Melancholy, and Self-Complacent Melancholy. Melancholy was often accompanied by physical symptoms. Many of these were a direct result of poor diet, lack of activity, and too much time spent closed up indoors. Much like depression today, melancholy could result from a particular situation, such as a death in the family or a professional, financial, or romantic disappointment. Melancholy could also result from physical illness. According to Beach, it could be brought on by “dyspepsia, suppressed evacuations, intemperance, and injuries of the cranium.” Melancholy could also set in for what appeared to be no reason at all. Beach stated that this sort of melancholy was often the result of “an hereditary disposition” or a “melancholic temperament.” While in the 1879 book Clinical Medicine, Dr. Austin Flint declared that when not attributable to an adequate cause (a death or a loss) and when not linked to a symptom of dyspepsia, alcoholism, or other recognizable illness, melancholy should be regarded as “a neuropathic affection” or a diseased mind. Unfortunately for Victorian doctors and their melancholy patients, there were no antidepressant drugs available in the nineteenth century. Instead, doctors generally treated melancholy by recommending specialized diets and regimens of rest and relaxation. Beach took a more modern approach, declaring that “in the treatment of melancholy, attention must be directed to the mind as well as the body.” To this end, he advised that the patient should take exercise in the open air, talk with cheerful friends, and enjoy pleasant scenery. Some Victorian doctors went further with their treatments, advising their melancholy patients to drink alcohol, to take morphia, or even (if they were single) to get married and start a family. For example, Blandford recommended a diet which featured alcohol at almost every meal, followed by a dose of chloral or morphia at night to help the melancholic patient sleep. In some cases, Victorian era doctors advised that patients suffering from melancholy be committed to an asylum. This was mainly to prevent the patient from harming himself since, as Blandford stated, “every patient of this kind is to be looked upon as suicidal.” While wealthier patients could afford to hire attendants to watch over them at home, poor patients in need of supervision had little choice but to turn to an asylum.
What we recognize today as depression was, in the Victorian era, popularly known as melancholia or melancholy. Like depression, melancholy ranged in seriousness from mild, temporary bouts of sadness or “low spirits” to longer, more extreme episodes, characterized by insomnia, lack of appetite, and suicidal thoughts. While symptoms of melancholy were usually easy to recognize, medical opinions often differed on what it was that caused the condition. As a result, treatment plans for the melancholic patient varied widely. Below, we look at a few Victorian era medical opinions on the symptoms and causes, and treatments of melancholy. According to Dr. Wooster Beach, the patient afflicted with melancholy shunned society and courted solitude, was fearful and low-spirited. Many medical practitioners found it useful to divide melancholy into categories by symptom. This served to separate the more severe forms of melancholy, such as those accompanied by violent outbursts, mania, or delusions, from the more ordinary forms of melancholy in which the patient was merely reclusive and sad. In his 1871 book Insanity and Its Treatment, Dr. G. Fielding Blandford classified melancholy as being either acute or subacute. While Yeoman went a step further, dividing melancholy into four separate types: Gloomy Melancholy, Restless Melancholy, Mischievous Melancholy, and Self-Complacent Melancholy. Melancholy was often accompanied by physical symptoms. Many of these were a direct result of poor diet, lack of activity, and too much time spent closed up indoors. Much like depression today, melancholy could result from a particular situation, such as a death in the family or a professional, financial, or romantic disappointment. Melancholy could also result from physical illness. According to Beach, it could be brought on by “dyspepsia, suppressed evacuations, intemperance, and injuries of the cranium.” Melancholy could also set in for what appeared to be no reason at all. Beach stated that this sort of melancholy was often the result of “an hereditary disposition” or a “melancholic temperament.” While in the 1879 book Clinical Medicine, Dr. Austin Flint declared that when not attributable to an adequate cause (a death or a loss) and when not linked to a symptom of dyspepsia, alcoholism, or other recognizable illness, melancholy should be regarded as “a neuropathic affection” or a diseased mind. Unfortunately for Victorian doctors and their melancholy patients, there were no antidepressant drugs available in the nineteenth century. Instead, doctors generally treated melancholy by recommending specialized diets and regimens of rest and relaxation. Beach took a more modern approach, declaring that “in the treatment of melancholy, attention must be directed to the mind as well as the body.” To this end, he advised that the patient should take exercise in the open air, talk with cheerful friends, and enjoy pleasant scenery. Some Victorian doctors went further with their treatments, advising their melancholy patients to drink alcohol, to take morphia, or even (if they were single) to get married and start a family. For example, Blandford recommended a diet which featured alcohol at almost every meal, followed by a dose of chloral or morphia at night to help the melancholic patient sleep. In some cases, Victorian era doctors advised that patients suffering from melancholy be committed to an asylum. This was mainly to prevent the patient from harming himself since, as Blandford stated, “every patient of this kind is to be looked upon as suicidal.” While wealthier patients could afford to hire attendants to watch over them at home, poor patients in need of supervision had little choice but to turn to an asylum.
Why did some Victorian-era doctors categorize melancholy into different types?
- A To differentiate between mild and severe cases based on symptoms
- B To find a universal cure for all forms of melancholy
- C To prove that melancholy was caused by religious beliefs
- D To determine which patients needed surgery and immediate care
思路引導 VIP
請回想一下文章第二段，當作者提到不同的醫生將憂鬱症細分為「急性（acute）」或「亞急性（subacute）」，甚至是「普通」與「伴隨暴力行為」等類別時，醫生們這麼做的主要「目的」是為了辨識出病人之間哪方面的差異？
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AI 詳解
AI 專屬家教
太棒了！你能從這段充滿歷史術語的文字中，精準捕捉到醫生分類行為背後的邏輯，這代表你的閱讀理解與資訊過濾能力非常紮實。
診斷與分類的關聯性
這道題目主要考察的是對文章第二段細節的掌握。文章中提到，當時的醫療從業者（如 Dr. G. Fielding Blandford）將憂鬱症（melancholy）進行分類，其核心目的在於區分症狀的嚴重程度。文中明確指出，分類是為了將伴隨暴力行為或幻覺的「嚴重形式」（severe forms），與僅表現出社交退縮或悲傷的「普通形式」（ordinary forms）區隔開來。因此，選項 (A) 所說的「根據症狀區分輕微與嚴重個案」完全契合原文脈絡。
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