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Penicillin
From Wikipedia, the free encyclopedia
Penicillin core structure, where "R" is the variable group.
Penicillin (sometimes abbreviated PCN or pen) is a group of antibiotics derived from
Penicillium fungi,[1] including penicillin G (intravenous use), penicillin V (oral use), procaine
penicillin, and benzathine penicillin (intramuscular use).
Penicillin antibiotics were among the first drugs to be effective against many previously serious
diseases, such as bacterial infections caused by staphylococci and streptococci. Penicillins are
still widely used today, though misuse has now made many types of bacteria resistant. All
penicillins are β-lactam antibiotics and are used in the treatment of bacterial infections caused by
susceptible, usually Gram-positive, organisms.
Several enhanced penicillin families also exist, effective against additional bacteria: these
include the antistaphylococcal penicillins, aminopenicillins and the more-powerful
antipseudomonal penicillins.
Medical uses
The term "penicillin" is often used generically to refer to benzylpenicillin (penicillin G, the
original penicillin found in 1928), procaine benzylpenicillin (procaine penicillin), benzathine
benzylpenicillin (benzathine penicillin), and phenoxymethylpenicillin (penicillin V). Procaine
penicillin and benzathine penicillin have the same antibacterial activity as benzylpenicillin but
act for a longer period of time. Phenoxymethylpenicillin is less active against gram-negative
bacteria than benzylpenicillin.[2][3] Benzylpenicillin, procaine penicillin and benzathine penicillin
are given by injection (parenterally), but phenoxymethylpenicillin is given orally.
Susceptibility
Despite the expanding number of penicillin resistant bacteria, penicillin can still be used to treat
a wide range of infections caused by certain susceptible bacteria. Some of these bacteria include
Streptococci, Staphylococci, Clostridium, and Listeria genera. The following list illustrates
minimum inhibitory concentration susceptibility data for a few medically significant bacteria:[4][5]

Listeria monocytogenes: from less than or equal to 0.06 μg/ml to 0.25 μg/ml
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

Neisseria meningitidis: from less than or equal to 0.03 μg/ml to 0.5 μg/ml
Staphylococcus aureus: from less than or equal to 0.015 μg/ml to more than 32 μg/ml
Adverse effects
Main article: Penicillin drug reaction
Common adverse drug reactions (≥ 1% of patients) associated with use of the penicillins include
diarrhoea, hypersensitivity, nausea, rash, neurotoxicity, urticaria, and superinfection (including
candidiasis). Infrequent adverse effects (0.1–1% of patients) include fever, vomiting, erythema,
dermatitis, angioedema, seizures (especially in people with epilepsy), and pseudomembranous
colitis.[6]
History
Discovery
Main article: History of penicillin
Alexander Fleming, who is credited with discovering penicillin in 1928.
Sample of penicillium mould presented by Alexander Fleming to Douglas Macleod, 1935
In 1897 a French physician, Ernest Duchesne at École du Service de Santé Militaire in Lyons,
published a medical thesis entitled Contribution à l’étude de la concurrence vitale chez les
micro-organismes : antagonisme entre les moisissures et les microbes (Contribution to the study
in vital competition in microorganisms: antagonism between molds and microbes) in which he
specifically studied the interaction between Escherichia coli and Penicillium glaucum. He
independently discovered healing properties of P. glaucum, even curing infected guinea pigs
from typhoid. His dissertation[16] was ignored by the Institut Pasteur. Although he is the precursor
to antibiotic-mediated therapy and penicillin in particular, his works were subsequently
forgotten.[17]
The discovery of penicillin is attributed to Scottish scientist and Nobel laureate Alexander
Fleming in 1928.[18] He showed that, if Penicillium rubens[19] were grown in the appropriate
substrate, it would exude a substance with antibiotic properties, which he dubbed penicillin. This
serendipitous observation began the modern era of antibiotic discovery. The development of
penicillin for use as a medicine is attributed to the Australian Nobel laureate Howard Walter
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Florey, together with the German Nobel laureate Ernst Chain and the English biochemist
Norman Heatley.[20]
Fleming recounted that the date of his discovery of penicillin was on the morning of Friday,
September 28, 1928.[21] The traditional version of this story describes the discovery as a fortuitous
accident: in his laboratory in the basement of St Mary's Hospital in London (now part of Imperial
College), Fleming noticed a Petri dish containing Staphylococcus that had been mistakenly left
open, was contaminated by blue-green mould from an open window, which formed a visible
growth.[22] There was a halo of inhibited bacterial growth around the mould. Fleming concluded
that the mould released a substance that repressed the growth and caused lysing of the bacteria.[20]
Scientists now suspect that Fleming’s story of the initial discovery of the antibacterial properties
of the penicillium mould is inaccurate. With a modern understanding of how the bacteria and the
mould interact, scientists know that if bacteria were already present on the petri dish they would
have inhibited the growth of the mould and Fleming would not have noticed any mould on the
plate at all. A more likely story is that a spore from a laboratory one floor below, run by C. J. La
Touche, was transferred to Fleming's petri dish before the bacteria were added. At the time of the
initial discovery La Touche was working with the same mould found in Fleming's petri dish.[22]
Once Fleming made his discovery he grew a pure culture and discovered it was a Penicillium
mould, now known to be Penicillium notatum. Fleming coined the term "penicillin" to describe
the filtrate of a broth culture of the Penicillium mould. Fleming asked C. J. La Touche to help
identify the mould, which he incorrectly identified as Penicillium rubrum (later corrected by
Charles Thom). He expressed initial optimism that penicillin would be a useful disinfectant,
because of its high potency and minimal toxicity in comparison to antiseptics of the day, and
noted its laboratory value in the isolation of Bacillus influenzae (now called Haemophilus
influenzae).[23][22]
Fleming was a famously poor communicator and orator, which meant his findings were not
initially given much attention.[22] He was unable to convince a true chemist to help him extract
and stabilize the antibacterial compound found in the broth filtrate. Despite the lack of a true
chemist, he remained interested in the potential use of penicillin and presented a paper entitled
"A Medium for the Isolation of Pfeiffer’s Bacillus" to the medical research club of London,
which was met with little interest and even less enthusiasm by his peers. Had Fleming been more
successful at making other scientists interested in his work, penicillin for medicinal use would
possibly have been developed years earlier.[22]
Despite the lack of interest of his fellow scientists, he did conduct several experiments on the
antibiotic substance he discovered. The most important result proved it was nontoxic in humans
by first performing toxicity tests in animals and then on humans. His following experiments on
penicillin's response to heat and pH allowed Fleming to increase the stability of the compound.[23]
The one test that modern scientists would find missing from his work was the test of penicillin
on an infected animal, the results of which would likely have sparked great interest in penicillin
and sped its development by almost a decade.[22]
Medical application
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Florey (pictured), Fleming and Chain shared a Nobel Prize in 1945 for their work on penicillin.
In 1930, Cecil George Paine, a pathologist at the Royal Infirmary in Sheffield, attempted to use
penicillin to treat sycosis barbae, eruptions in beard follicles, but was unsuccessful. Moving on to
ophthalmia neonatorum, a gonococcal infection in infants, he achieved the first recorded cure
with penicillin, on November 25, 1930. He then cured four additional patients (one adult and
three infants) of eye infections, and failed to cure a fifth.[24][25][26]
In 1939, Australian scientist Howard Florey (later Baron Florey) and a team of researchers (Ernst
Boris Chain, Arthur Duncan Gardner, Norman Heatley, M. Jennings, J. Orr-Ewing and G.
Sanders) at the Sir William Dunn School of Pathology, University of Oxford made progress in
showing the in vivo bactericidal action of penicillin. In 1940 they showed that penicillin
effectively cured bacterial infection in mice.[27][28] In 1941 they treated a policeman, Albert
Alexander, with a severe face infection; his condition improved, but then supplies of penicillin
ran out and he died. Subsequently, several other patients were treated successfully.[29]
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Sulfonamide (medicine)
From Wikipedia, the free encyclopedia
Sulfonamide functional group
Hydrochlorothiazide is a sulfonamide and a thiazide.
Furosemide is a sulfonamide, but not a thiazide.
Sulfamethoxazole is a antibacterial sulfonamide
Sulfonamide or sulphonamide is the basis of several groups of drugs. The original antibacterial
sulfonamides (sometimes called sulfa drugs or sulpha drugs) are synthetic antimicrobial agents
that contain the sulfonamide group. Some sulfonamides are also devoid of antibacterial activity,
e.g., the anticonvulsant sultiame. The sulfonylureas and thiazide diuretics are newer drug groups
based on the antibacterial sulfonamides.[1][2]
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Allergies to sulfonamide are common,[3] hence medications containing sulfonamides are
prescribed carefully. It is important to make a distinction between sulfa drugs and other sulfurcontaining drugs and additives, such as sulfates and sulfites, which are chemically unrelated to
the sulfonamide group, and do not cause the same hypersensitivity reactions seen in the
sulfonamides.
Because sulfonamides displace bilirubin from albumin, kernicterus (brain damage due to excess
bilirubin) is an important potential side effect of sulfonamide use.
Function
Antimicrobial
Main article: Dihydropteroate synthetase inhibitor
In bacteria, antibacterial sulfonamides act as competitive inhibitors of the enzyme
dihydropteroate synthetase (DHPS), an enzyme involved in folate synthesis. Sulfonamides are
therefore bacteriostatic and inhibit growth and multiplication of bacteria, but do not kill them.
Humans, in contrast to bacteria, acquire folate (vitamin B9) through the diet.[4]
Structural similarity between sulfonamide (left) and PABA (center) is the basis for the inhibitory
activity of sulfa drugs on dihydrofolate (right) biosynthesis
Other uses
The sulfonamide chemical moiety is also present in other medications that are not antimicrobials,
including thiazide diuretics (including hydrochlorothiazide, metolazone, and indapamide, among
others), loop diuretics (including furosemide, bumetanide, and torsemide), acetazolamide,
sulfonylureas (including glipizide, glyburide, among others), and some COX-2 inhibitors (e.g.,
celecoxib).
Sulfasalazine, in addition to its use as an antibiotic, is also used in the treatment of inflammatory
bowel disease.
History
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Sulfonamide drugs were the first antibiotics to be used systemically, and paved the way for the
antibiotic revolution in medicine. The first sulfonamide, trade-named Prontosil, was a prodrug.
Experiments with Prontosil began in 1932 in the laboratories of Bayer AG, at that time a
component of the huge German chemical trust IG Farben. The Bayer team believed that coal-tar
dyes which are able to bind preferentially to bacteria and parasites might be used to attack
harmful organisms in the body. After years of fruitless trial-and-error work on hundreds of dyes,
a team led by physician/researcher Gerhard Domagk[5] (working under the general direction of
Farben executive Heinrich Hörlein) finally found one that worked: a red dye synthesized by
Bayer chemist Josef Klarer that had remarkable effects on stopping some bacterial infections in
mice.[6] The first official communication about the breakthrough discovery was not published
until 1935, more than two years after the drug was patented by Klarer and his research partner
Fritz Mietzsch.
Prontosil, as Bayer named the new drug, was the first medicine ever discovered that could
effectively treat a range of bacterial infections inside the body. It had a strong protective action
against infections caused by streptococci, including blood infections, childbed fever, and
erysipelas, and a lesser effect on infections caused by other cocci. However, it had no effect at all
in the test tube, exerting its antibacterial action only in live animals. Later, it was discovered by
Bovet,[7] Federico Nitti and J. and Th. Jacques Tréfouël, a French research team led by Ernest
Fourneau at the Pasteur Institute, that the drug was metabolized into two pieces inside the body,
releasing from the inactive dye portion a smaller, colorless, active compound called
sulfanilamide.[8] The discovery helped establish the concept of "bioactivation" and dashed the
German corporation's dreams of enormous profit; the active molecule sulfanilamide (or sulfa)
had first been synthesized in 1906 and was widely used in the dye-making industry; its patent
had since expired and the drug was available to anyone.[9]
The result was a sulfa craze.[10] For several years in the late 1930s, hundreds of manufacturers
produced tens of thousands of tons of myriad forms of sulfa. This and nonexistent testing
requirements led to the elixir sulfanilamide disaster in the fall of 1937, during which at least 100
people were poisoned with diethylene glycol. This led to the passage of the Federal Food, Drug,
and Cosmetic Act in 1938 in the United States. As the first and only effective antibiotic available
in the years before penicillin, sulfa drugs continued to thrive through the early years of World
War II.[11] They are credited with saving the lives of tens of thousands of patients, including
Franklin Delano Roosevelt, Jr. (son of US President Franklin Delano Roosevelt) and Winston
Churchill. Sulfa had a central role in preventing wound infections during the war. American
soldiers were issued a first-aid kit containing sulfa pills and powder, and were told to sprinkle it
on any open wound.
The sulfanilamide compound is more active in the protonated form. The drug has very low
solubility and sometimes can crystallize in the kidneys, due to its first pKa of around 10. This is a
very painful experience, so patients are told to take the medication with copious amounts of
water. Newer analogous compounds prevent this complication because they have a lower pKa,
around 5–6,[citation needed] making them more likely to remain in a soluble form.
Many thousands of molecules containing the sulfanilamide structure have been created since its
discovery (by one account, over 5,400 permutations by 1945), yielding improved formulations
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with greater effectiveness and less toxicity. Sulfa drugs are still widely used for conditions such
as acne and urinary tract infections, and are receiving renewed interest for the treatment of
infections caused by bacteria resistant to other antibiotics.
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World Health Organization
From Wikipedia, the free encyclopedia
World Health Organization
Flag of the World Health Organization
Abbreviation
Formation
Type
WHO
OMS
7 April 1948
Specialized agency of the United
Nations
Legal status
Active
Headquarters
Geneva, Switzerland
Head
Margaret Chan
Parent
organization
United Nations Economic and Social
Website
www.who.int
Council (ECOSOC)
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The World Health Organization (WHO; /huː/) is a specialized agency of the United Nations
(UN) that is concerned with international public health. It was established on 7 April 1948,
headquartered in Geneva, Switzerland. The WHO is a member of the United Nations
Development Group. Its predecessor, the Health Organization, was an agency of the League of
Nations. The constitution of the World Health Organization had been signed by 61 countries on
22 July 1946, with the first meeting of the World Health Assembly finishing on 24 July 1948. It
incorporated the Office International d'Hygiène Publique and the League of Nations Health
Organization. Since its creation, it has played a leading role in the eradication of smallpox. Its
current priorities include communicable diseases, in particular HIV/AIDS, Ebola, malaria and
tuberculosis; the mitigation of the effects of non-communicable diseases; sexual and
reproductive health, development, and aging; nutrition, food security and healthy eating;
occupational health; substance abuse; and driving the development of reporting, publications,
and networking. The WHO is responsible for the World Health Report, a leading international
publication on health, the worldwide World Health Survey, and World Health Day (7 April of
every year). The head of WHO is Margaret Chan.
The 2014/2015 proposed budget of the WHO is about US$4 billion.[1] About US$930 million is
to be provided by member states with a further US$3 billion to be from voluntary contributions.[1]
History
Establishment
During the 1945 United Nations Conference on International Organization, Dr. Szeming Sze, a
delegate from China, conferred with Norwegian and Brazilian delegates on creating an
international health organization under the auspices of the new United Nations. After failing to
get a resolution passed on the subject, Alger Hiss, the Secretary General of the conference,
recommended using a declaration to establish such an organization. Dr. Sze and other delegates
lobbied and a declaration passed calling for an international conference on health.[2] The use of
the word "world", rather than "international",emphasized the truly global nature of what the
organization was seeking to achieve.[3] The constitution of the World Health Organization was
signed by all 51 countries of the United Nations, and by 10 other countries, on 22 July 1946.[4] It
thus became the first specialised agency of the United Nations to which every member
subscribed.[5] Its constitution formally came into force on the first World Health Day on 7 April
1948, when it was ratified by the 26th member state.[6] The first meeting of the World Health
Assembly finished on 24 July 1948, having secured a budget of US$5 million (then
GBP£1,250,000) for the 1949 year. Andrija Stampar was the Assembly's first president, and G.
Brock Chisholm was appointed Director-General of WHO, having served as Executive Secretary
during the planning stages.[3] Its first priorities were to control the spread of malaria, tuberculosis
and sexually transmitted infections, and to improve maternal and child health, nutrition and
environmental hygiene. Its first legislative act was concerning the compilation of accurate
statistics on the spread and morbidity of disease.[3] The logo of the World Health Organization
features the Rod of Asclepius as a symbol for healing.[7]
Operational history
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Three former directors of the Global Smallpox Eradication Programme read the news that
smallpox had been globally eradicated, 1980
WHO established an epidemiological information service via telex in 1947, and by 1950 a mass
tuberculosis inoculation drive (using the BCG vaccine) was under way. In 1955, the malaria
eradication programme was launched, although it was later altered in objective. 1965 saw the
first report on diabetes mellitus and the creation of the International Agency for Research on
Cancer. WHO moved into its headquarters building in 1966. The Expanded Programme on
Immunization was started in 1974, as was the control programme into onchocerciasis – an
important partnership between the Food and Agriculture Organization (FAO), the United Nations
Development Programme (UNDP), and World Bank. In the following year, the Special
Programme for Research and Training in Tropical Diseases was also launched. In 1976, the
World Health Assembly voted to enact a resolution on Disability Prevention and Rehabilitation,
with a focus on community-driven care. The first list of essential medicines was drawn up in
1977, and a year later the ambitious goal of "health for all" was declared. In 1986, WHO started
its global programme on the growing problem of HIV/AIDS, followed two years later by
additional attention on preventing discrimination against sufferers and UNAIDS was formed in
1996. The Global Polio Eradication Initiative was established in 1988.[8]
In 1958, Viktor Zhdanov, Deputy Minister of Health for the USSR, called on the World Health
Assembly to undertake a global initiative to eradicate smallpox, resulting in Resolution
WHA11.54.[9] At this point, 2 million people were dying from smallpox every year. In 1967, the
World Health Organization intensified the global smallpox eradication by contributing $2.4
million annually to the effort and adopted a new disease surveillance method.[10][11] The initial
problem the WHO team faced was inadequate reporting of smallpox cases. WHO established a
network of consultants who assisted countries in setting up surveillance and containment
activities.[12] The WHO also helped contain the last European outbreak in Yugoslavia in 1972.[13]
After over two decades of fighting smallpox, the WHO declared in 1979 that the disease had
been eradicated – the first disease in history to be eliminated by human effort.[14]
In 1998, WHO's Director General highlighted gains in child survival, reduced infant mortality,
raised life expectancy and reduced rates of "scourges" such as smallpox and polio on the fiftieth
anniversary of WHO's founding. He, did, however, accept that more had to be done to assist
maternal health and that progress in this area had been slow.[15] Cholera and malaria have
remained problems since WHO's founding, although in decline for a large part of that period.[16]
In the twenty-first century, the Stop TB Partnership was created in 2000, along with the UN's
formulation of the Millennium Development Goals. The Measles initiative was formed in 2001,
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and credited with reducing global deaths from the disease by 68% by 2007. In 2002, The Global
Fund to Fight AIDS, Tuberculosis and Malaria was drawn up to improve the resources
available.[8] In 2006, the organization endorsed the world's first official HIV/AIDS Toolkit for
Zimbabwe, which formed the basis for a global prevention, treatment and support plan to fight
the AIDS pandemic.[17]
Overall focus
The WHO's Constitution states that its objective "is the attainment by all people of the highest
possible level of health".[18]
WHO fulfils its objective through its functions as defined in its Constitution: (a) to act as the
directing and co-ordinating authority on international health work; (b) to establish and maintain
effective collaboration with the United Nations, specialized agencies, governmental health
administrations, professional groups and such other organizations as may be deemed appropriate;
(c) to assist Governments, upon request, in strengthening health services; (d) to furnish
appropriate technical assistance and, in emergencies, necessary aid upon the request or
acceptance of Governments; (e) to provide or assist in providing, upon the request of the United
Nations, health services and facilities to special groups, such as the peoples of trust territories; (f)
to establish and maintain such administrative and technical services as may be required,
including epidemiological and statistical services; (g) to stimulate and advance work to eradicate
epidemic, endemic and other diseases; (h) to promote, in co-operation with other specialized
agencies where necessary, the prevention of accidental injuries; (i) to promote, in co-operation
with other specialized agencies where necessary, the improvement of nutrition, housing,
sanitation, recreation, economic or working conditions and other aspects of environmental
hygiene; (j) to promote co-operation among scientific and professional groups which contribute
to the advancement of health; (k) to propose conventions, agreements and regulations, and make
recommendations with respect to international health matters and to perform.
WHO currently defines its role in public health as follows:[19]






providing leadership on matters critical to health and engaging in partnerships where joint
action is needed;
shaping the research agenda and stimulating the generation, translation and dissemination
of valuable knowledge;
setting norms and standards and promoting and monitoring their implementation;
articulating ethical and evidence-based policy options;
providing technical support, catalyzing change, and building sustainable institutional
capacity; and
monitoring the health situation and assessing health trends.
Communicable diseases
The 2012–2013 WHO budget identified 13 areas among which funding was distributed.[20] Two
of those thirteen areas related to communicable diseases: the first, to reduce the "health, social
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and economic burden" of communicable diseases in general; the second to combat HIV/AIDS,
malaria and tuberculosis in particular.[20]
In terms of HIV/AIDS, WHO works within the UNAIDS network and considers it important that
it works in alignment with UNAIDS objectives and strategies. It also strives to involve sections
of society other than health to help deal with the economic and social effects of the disease.[21] In
line with UNAIDS, WHO has set itself the interim task between 2009 and 2015 of reducing the
number of those aged 15–24 years who are infected by 50%; reducing new HIV infections in
children by 90%; and reducing HIV-related deaths by 25%.[22]
Although WHO dropped its commitment to a global malaria eradication campaign in the 1970s
as too ambitious, it retains a strong commitment to malaria control. WHO's Global Malaria
Programme works to keep track of malaria cases, and future problems in malaria control
schemes. WHO is to report, likely in 2015, as to whether RTS,S/AS01, currently in research, is a
viable malaria vaccine. For the time being, insecticide-treated mosquito nets and insecticide
sprays are used to prevent the spread of malaria, as are antimalarial drugs – particularly to
vulnerable people such as pregnant women and young children.[23]
WHO's help has contributed to a 40% fall in the number of deaths from tuberculosis between
1990 and 2010, and since 2005, it claims that over 46 million people have been treated and an
estimated 7 million lives saved through practices advocated by WHO. These include engaging
national governments and their financing, early diagnosis, standardising treatment, monitoring of
the spread and impact of tuberculosis and stabilising the drug supply. It has also recognised the
vulnerability of victims of HIV/AIDS to tuberculosis.[24]
WHO aims to eradicate polio. It has also been successful in helping to reduce cases by 99% since
the Global Polio Eradication Initiative was launched in 1988, which partnered WHO with Rotary
International, the US Centers for Disease Control and Prevention (CDC) and the United Nations
Children's Fund (UNICEF), as well as smaller organizations. It works to immunize young
children and prevent the re-emergence of cases in countries declared "polio-free".[25]
Non-communicable diseases, mental health and injuries
Another of the thirteen WHO priority areas is aimed at the prevention and reduction of "disease,
disability and premature deaths from chronic noncommunicable diseases, mental disorders,
violence and injuries, and visual impairment".[20][26]
For example, the WHO promotes road safety as a means to reduce traffic-related injuries.[27]
WHO has also worked on global initiatives in surgery, including emergency and essential
surgical care,[28] trauma care,[29] and safe surgery.[30] The WHO Surgical Safety Checklist is in
current use worldwide in the effort to improve patient safety.[31]
Life course and life style
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WHO works to "reduce morbidity and mortality and improve health during key stages of life,
including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve
sexual and reproductive health and promote active and healthy aging for all individuals".[20][32]
It also tries to prevent or reduce risk factors for "health conditions associated with use of
tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets and physical
inactivity and unsafe sex".[20][33][34]
WHO works to improve nutrition, food safety and food security and to ensure this has a positive
effect on public health and sustainable development.[20]
Emergency work
When any sort of disaster or emergency occurs, it is WHO's stated objective to reduce any
consequences the event may have on world health and its social and economic implications.[20]
On 5 May 2014, WHO announced that the spread of polio is a world health emergency –
outbreaks of the disease in Asia, Africa and the Middle East are considered "extraordinary".[35][36]
On 8 August 2014, WHO declared that the spread of Ebola is a public health emergency; an
outbreak which is believed to have started in Guinea, has spread to other nearby countries such
as Liberia and Sierra Leone. The situation in West Africa is considered very serious.[37]
Health policy
WHO addresses government health policy with two aims: firstly, "to address the underlying
social and economic determinants of health through policies and programmes that enhance health
equity and integrate pro-poor, gender-responsive, and human rights-based approaches" and
secondly "to promote a healthier environment, intensify primary prevention and influence public
policies in all sectors so as to address the root causes of environmental threats to health".[20]
The organization develops and promotes the use of evidence-based tools, norms and standards to
support member states to inform health policy options. It oversees the implementation of the
International Health Regulations, and publishes a series of medical classifications; of these, three
are overreaching "reference classifications": the International Statistical Classification of
Diseases (ICD), the International Classification of Functioning, Disability and Health (ICF) and
the International Classification of Health Interventions (ICHI).[38] Other international policy
frameworks produced by WHO include the International Code of Marketing of Breast-milk
Substitutes (adopted in 1981),[39] Framework Convention on Tobacco Control (adopted in
2003)[40] and the Global Code of Practice on the International Recruitment of Health Personnel
(adopted in 2010).[41]
In terms of health services, WHO looks to improve "governance, financing, staffing and
management" and the availability and quality of evidence and research to guide policy making. It
also strives to "ensure improved access, quality and use of medical products and technologies".[20]
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Governance and support
The remaining two of WHO's thirteen identified policy areas relate to the role of WHO itself:[20]


"to provide leadership, strengthen governance and foster partnership and collaboration
with countries, the United Nations system, and other stakeholders in order to fulfill the
mandate of WHO in advancing the global health agenda"; and
"to develop and sustain WHO as a flexible, learning organization, enabling it to carry out
its mandate more efficiently and effectively".
Partnerships
The WHO along with the World Bank constitute the core team responsible for administering the
International Health Partnership (IHP+). The IHP+ is a group of partner governments,
development agencies, civil society and others committed to improving the health of citizens in
developing countries. Partners work together to put international principles for aid effectiveness
and development cooperation into practice in the health sector.[42]
The organization relies on contributions from renowned scientists and professionals to inform its
work, such as the WHO Expert Committee on Biological Standardization,[43] the WHO Expert
Committee on Leprosy,[44] and the WHO Study Group on Interprofessional Education &
Collaborative Practice.[45]
WHO runs the Alliance for Health Policy and Systems Research, targeted at improving health
policy and systems.[46]
WHO also aims to improve access to health research and literature in developing countries such
as through the HINARI network.[47]
Public health education and action
Each year, the organization marks World Health Day and other observances focusing on a
specific health promotion topic. World Health Day falls on 7 April each year, timed to match the
anniversary of WHO's founding. Recent themes have been vector-borne diseases (2014), healthy
ageing (2012) and drug resistance (2011).[48]
The other official global public health campaigns marked by WHO are World Tuberculosis Day,
World Immunization Week, World Malaria Day, World No Tobacco Day, World Blood Donor
Day, World Hepatitis Day, and World AIDS Day.
As part of the United Nations, the World Health Organization supports work towards the
Millennium Development Goals.[49] Of the eight Millennium Development Goals, three –
reducing child mortality by two-thirds, to reduce maternal deaths by three-quarters, and to halt
and begin to reduce the spread of HIV/AIDS – relate directly to WHO's scope; the other five
inter-relate and have an impact on world health.[50]
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Structure
The World Health Organization is a member of the United Nations Development Group.[67]
Membership
Countries by World Health Organization membership status
As of 2013, the WHO has 194 member states: all Member States of the United Nations except
Liechtenstein, as well as the Cook Islands and Niue.[68] (A state becomes a full member of WHO
by ratifying the treaty known as the Constitution of the World Health Organization.) As of 2013,
it also had two associate members, Puerto Rico and Tokelau.[69] Several other entities have been
granted observer status. Palestine is an observer as a "national liberation movement" recognised
by the League of Arab States under United Nations Resolution 3118. The Holy See also attends
as an observer, as does the Order of Malta.[70] In 2010, Taiwan was invited under the name of
"Chinese Taipei".[71]
WHO Member States appoint delegations to the World Health Assembly, WHO's supreme
decision-making body. All UN Member States are eligible for WHO membership, and,
according to the WHO web site, "other countries may be admitted as members when their
application has been approved by a simple majority vote of the World Health Assembly".[68]
In addition, the UN observer organizations International Committee of the Red Cross and
International Federation of Red Cross and Red Crescent Societies have entered into "official
relations" with WHO and are invited as observers. In the World Health Assembly they are seated
alongside the other NGOs.[70]
Page 16 of 52
International Federation of Red Cross and Red Crescent Societies
(IFRC)
History
The Formation of the IFRC
The International Federation of Red Cross and Red Crescent Societies (IFRC) was founded in
1919 in Paris in the aftermath of World War I. The war had shown a need for close cooperation
between Red Cross Societies, which, through their humanitarian activities on behalf of prisoners
of war and combatants, had attracted millions of volunteers and built a large body of expertise. A
devastated Europe could not afford to lose such a resource.
It was Henry Davison, president of the American Red Cross War Committee, who proposed
forming a federation of these National Societies. An international medical conference initiated
by Davison resulted in the birth of the League of Red Cross Societies, which was renamed in
October 1983 to the League of Red Cross and Red Crescent Societies, and then in November
1991 to become the International Federation of Red Cross and Red Crescent Societies.
The first objective of the IFRC was to improve the health of people in countries that had suffered
greatly during the four years of war. Its goals were "to strengthen and unite, for health activities,
already-existing Red Cross Societies and to promote the creation of new Societies"
There were five founding member Societies: Britain, France, Italy, Japan and the United States.
This number has grown over the years and there are now 189 recognized National Societies - one
in almost every country in the world.
The Birth of an Idea
Page 17 of 52
The Red Cross idea was born in 1859, when Henry Dunant, a young Swiss man, came upon the
scene of a bloody battle in Solferino, Italy, between the armies of imperial Austria and the
Franco-Sardinian alliance. Some 40,000 men lay dead or dying on the battlefield and the
wounded were lacking medical attention.
Dunant organized local people to bind the soldiers' wounds and to feed and comfort them. On his
return, he called for the creation of national relief societies to assist those wounded in war, and
pointed the way to the future Geneva Conventions.
"Would there not be some means, during a period of peace and calm, of forming relief societies
whose object would be to have the wounded cared for in time of war by enthusiastic, devoted
volunteers, fully qualified for the task?" he wrote.
The Red Cross was born in 1863 when five Geneva men, including Dunant, set up the
International Committee for Relief to the Wounded, later to become the International Committee
of the Red Cross. Its emblem was a red cross on a white background: the inverse of the Swiss
flag. The following year, 12 governments adopted the first Geneva Convention; a milestone in
the history of humanity, offering care for the wounded, and defining medical services as
"neutral" on the battlefield.
90 years of improving the lives of the most vulnerable
The idea of pooling the skills and resources of Red Cross Societies to provide
humanitarian assistance in peacetime,and not just to prepare for relief in times
of war, goes back to the founder of the Movement, Geneva businessman Henry
Dunant.
Henry Dunant - the destiny of the Red Cross
Jean-Henry Dunant was born on 8 May 1828 in Geneva to a middle-class
Calvinist family. His early initiatives included participating in the creation of
the Young Men’s Christian Association (YMCA) in 1852 and the World
Alliance of YMCAs in 1855.
Further details on the history of the International Red Cross and Red Crescent Movement can be
found on the Movement's own web site.
Our vision and mission
Page 18 of 52


The International Federation of Red Cross and Red Crescent Societies (IFRC) is the world's
largest humanitarian organization, providing assistance without discrimination as to nationality,
race, religious beliefs, class or political opinions.
Founded in 1919, the IFRC comprises 189 member Red Cross and Red Crescent National
Societies, a secretariat in Geneva and more than 60 delegations strategically located to support
activities around the world. There are more societies in formation. The Red Crescent is used in
place of the Red Cross in many Islamic countries.
The IFRC vision: To inspire, encourage, facilitate and promote at all times all forms of
humanitarian activities by National Societies, with a view to preventing and alleviating
human suffering, and thereby contributing to the maintenance and promotion of human
dignity and peace in the world.
The role of the IFRC
The IFRC carries out relief operations to assist victims of disasters, and combines this with
development work to strengthen the capacities of its member National Societies. The IFRC's
Page 19 of 52
work focuses on four core areas: promoting humanitarian values, disaster response, disaster
preparedness, and health and community care. Further details of this work can be found in the
What we do section.
The unique network of National Societies - which cover almost every country in the world - is
the IFRC's principal strength. Cooperation between National Societies gives the IFRC greater
potential to develop capacities and assist those most in need. At a local level, the network
enables the IFRC to reach individual communities.
The role of the secretariat in Geneva is to coordinate and mobilize relief assistance for
international emergencies, promote cooperation between National Societies and represent these
National Societies in the international field.
The role of the field delegations is to assist and advise National Societies with relief operations
and development programmes, and encourage regional cooperation.
The IFRC, together with National Societies and the International Committee of the Red Cross,
make up the International Red Cross and Red Crescent Movement.
Page 20 of 52
History of poliomyelitis
From Wikipedia, the free encyclopedia
An Egyptian stele thought to represent a Polio victim. 18th Dynasty (1403 - 1365 BC).
Main article: Poliomyelitis
The history of poliomyelitis (polio) infections extends into prehistory. Although major polio
epidemics were unknown before the 20th century,[1] the disease has caused paralysis and death
for much of human history. Over millennia, polio survived quietly as an endemic pathogen until
the 1900s when major epidemics began to occur in Europe;[1] soon after, widespread epidemics
appeared in the United States. By 1910, frequent epidemics became regular events throughout
the developed world, primarily in cities during the summer months. At its peak in the 1940s and
1950s, polio would paralyze or kill over half a million people worldwide every year.[2]
The fear and the collective response to these epidemics would give rise to extraordinary public
reaction and mobilization; spurring the development of new methods to prevent and treat the
disease, and revolutionizing medical philanthropy. Although the development of two polio
vaccines has eradicated poliomyelitis in all but four countries, the legacy of poliomyelitis
remains, in the development of modern rehabilitation therapy, and in the rise of disability rights
movements worldwide.
Early history
Ancient Egyptian paintings and carvings depict otherwise healthy people with withered limbs,
and children walking with canes at a young age.[3] It is theorized that the Roman Emperor
Claudius was stricken as a child, and this caused him to walk with a limp for the rest of his life.[4]
Perhaps the earliest recorded case of poliomyelitis is that of Sir Walter Scott. In 1773 Scott was
said to have developed "a severe teething fever which deprived him of the power of his right
Page 21 of 52
leg."[5] At the time, polio was not known to medicine. A retrospective diagnosis of polio is
considered to be strong due to the detailed account Scott later made,[6] and the resultant lameness
of his left leg had an important effect on his life and writing.[7]
The symptoms of poliomyelitis have been described by many names. In the early nineteenth
century the disease was known variously as: Dental Paralysis, Infantile Spinal Paralysis,
Essential Paralysis of Children, Regressive Paralysis, Myelitis of the Anterior Horns,
Tephromyelitis (from the Greek tephros, meaning "ash-gray") and Paralysis of the Morning.[8] In
1789 the first clinical description of poliomyelitis was provided by the British physician Michael
Underwood—he refers to polio as "a debility of the lower extremities".[9] The first medical report
on poliomyelitis was by Jakob Heine, in 1840; he called the disease Lähmungszustände der
unteren Extremitäten.[10] Karl Oskar Medin was the first to empirically study a poliomyelitis
epidemic in 1890.[11] This work, and the prior classification by Heine, led to the disease being
known as Heine-Medin disease.
Epidemics
Major polio epidemics were unknown before the 20th century; localized paralytic polio
epidemics began to appear in Europe and the United States around 1900.[1] The first report of
multiple polio cases was published in 1843 and described an 1841 outbreak in Louisiana. A fiftyyear gap occurs before the next U.S. report—a cluster of 26 cases in Boston in 1893.[1] The first
recognized U.S. polio epidemic occurred the following year in Vermont with 132 total cases (18
deaths), including several cases in adults.[11] Numerous epidemics of varying magnitude began to
appear throughout the country; by 1907 approximately 2,500 cases of poliomyelitis were
reported in New York City.[12]
This cardboard placard was placed in windows of residences where patients were quarantined
due to poliomyelitis. Violating the quarantine order or removing the placard was punishable by a
fine of up to US$100 in 1909.
On Saturday, June 17, 1916 an official announcement of the existence of an epidemic polio
infection was made in Brooklyn, New York. That year, there were over 27,000 cases and more
than 6,000 deaths due to polio in the United States, with over 2,000 deaths in New York City
alone.[13] The names and addresses of individuals with confirmed polio cases were published
daily in the press, their houses were identified with placards, and their families were
quarantined.[14] Dr. Hiram M. Hiller, Jr., was one of the physicians in several cities who realized
Page 22 of 52
what they were dealing with, but the nature of the disease remained largely a mystery. The 1916
epidemic caused widespread panic and thousands fled the city to nearby mountain resorts; movie
theaters were closed, meetings were canceled, public gatherings were almost nonexistent, and
children were warned not to drink from water fountains, and told to avoid amusement parks,
swimming pools, and beaches.[13] From 1916 onward, a polio epidemic appeared each summer in
at least one part of the country, with the most serious occurring in the 1940s and 1950s.[1] In the
epidemic of 1949, 2,720 deaths from the disease occurred in the United States and 42,173 cases
were reported and Canada and the United Kingdom were also affected.[15][16]
Prior to the 20th century polio infections were rarely seen in infants before 6 months of age and
most cases occurred in children 6 months to 4 years of age.[17] Young children who contract polio
generally suffer only mild symptoms, but as a result they become permanently immune to the
disease.[18] In developed countries during the late 19th and early 20th centuries, improvements
were being made in community sanitation, including improved sewage disposal and clean water
supplies. Better hygiene meant that infants and young children had fewer opportunities to
encounter and develop immunity to polio. Exposure to poliovirus was therefore delayed until late
childhood or adult life, when it was more likely to take the paralytic form.[17]
In children, paralysis due to polio occurs in 1/1000 cases, while in adults, paralysis occurs in
1/75 cases.[19] By 1950, the peak age incidence of paralytic poliomyelitis in the United States had
shifted from infants to children aged 5 to 9 years; about one-third of the cases were reported in
persons over 15 years of age.[20] Accordingly, the rate of paralysis and death due to polio
infection also increased during this time.[1] In the United States, the 1952 polio epidemic would
be the worst outbreak in the nation's history, and is credited with heightening parents’ fears of
the disease and focusing public awareness on the need for a vaccine.[21] Of the 57,628 cases
reported that year 3,145 died and 21,269 were left with mild to disabling paralysis.[21][22]
Historical treatments
In the early 20th century—in the absence of proven treatments—a number of odd and potentially
dangerous polio treatments were suggested. In John Haven Emerson's A Monograph on the
Epidemic of Poliomyelitis (Infantile Paralysis) in New York City in 1916[23] one suggested
remedy reads:
“
Give oxygen through the lower extremities, by positive electricity. Frequent baths
using almond meal, or oxidising the water. Applications of poultices of Roman
chamomile, slippery elm, arnica, mustard, cantharis, amygdalae dulcis oil, and of
special merit, spikenard oil and Xanthoxolinum. Internally use caffeine, Fl. Kola,
dry muriate of quinine, elixir of cinchone, radium water, chloride of gold, liquor
calcis and wine of pepsin.[24]
”
Following the 1916 epidemics and having experienced little success in treating polio patients,
researchers set out to find new and better treatments for the disease. Between 1917 and the early
1950s several therapies were explored in an effort to prevent deformities including hydrotherapy
and electrotherapy. In 1935 Claus Jungeblut reported that vitamin C treatment enhanced
Page 23 of 52
resistance to poliomyelitis in monkeys.[25] However follow up experiments reported by Albert
Sabin and Jungeblut himself were unable to confirm the initially promising results.[26][27] Later,
Fred Klenner published his own clinical experience with vitamin C in the treatment of
polio,[28][29][30][31] however his work was not well received and no large clinical trials were ever
performed.
Surgical treatments such as nerve grafting, tendon lengthening, tendon transfers, and limb
lengthening and shortening were used extensively during this time.[32][33] Patients with residual
paralysis were treated with braces and taught to compensate for lost function with the help of
calipers, crutches and wheelchairs. The use of devices such as rigid braces and body casts, which
tended to cause muscle atrophy due to the limited movement of the user, were also touted as
effective treatments.[34] Massage and passive motion exercises were also used to treat polio
victims.[33] Most of these treatments proved to be of little therapeutic value, however several
effective supportive measures for the treatment of polio did emerge during these decades
including the iron lung, an anti-polio antibody serum, and a treatment regimen developed by
Sister Elizabeth Kenny.[35]
Iron lung
This iron lung was donated to the CDC by the family of Mr. Barton Hebert of Covington,
Louisiana, who had used the device from the late 1950s until his death in 2003.
The first iron lung used in the treatment of polio victims was invented by Philip Drinker, Louis
Agassiz Shaw, and James Wilson at Harvard, and tested October 12, 1928 at Children's Hospital,
Boston.[36] The original Drinker iron lung was powered by an electric motor attached to two
vacuum cleaners, and worked by changing the pressure inside the machine. When the pressure is
lowered, the chest cavity expands, trying to fill this partial vacuum. When the pressure is raised
the chest cavity contracts. This expansion and contraction mimics the physiology of normal
breathing. The design of the iron lung was subsequently improved by using a bellows attached
directly to the machine, and John Haven Emerson modified the design to make production less
expensive.[36] The Emerson Iron Lung was produced until 1970.[37] Other respiratory aids, such as
the "rocking bed" were used in patients with less critical breathing difficulties.[32]
During the polio epidemics, the iron lung saved many thousands of lives, but the machine was
large, cumbersome and very expensive:[38] in the 1930s, an iron lung cost about $1,500 - about
the same price as the average home.[39] The cost of running the machine was also prohibitive, as
patients were encased in the metal chambers for months, years and sometimes for life:[37] even
with an iron lung the fatality rate for patients with bulbar polio exceeded 90%.[40]
Page 24 of 52
These drawbacks led to the development of more modern positive-pressure ventilators and the
use of positive-pressure ventilation by tracheostomy. Positive pressure ventilators reduced
mortality in bulbar patients from 90% to 20%.[41] In the Copenhagen epidemic of 1952, large
numbers of patients were ventilated by hand ("bagged") by medical students and anyone else on
hand, because of the large number of bulbar polio patients and the small number of ventilators
available.[42]
Passive immunotherapy
In 1950 William Hammon at the University of Pittsburgh isolated serum, containing antibodies
against poliovirus, from the blood of polio survivors.[35] The serum, Hammon believed, would
prevent the spread of polio and to reduce the severity of disease in polio patients.[43] Between
September 1951 and July 1952 nearly 55,000 children were involved in a clinical trial of the
anti-polio serum.[44] The results of the trial were promising; the serum was shown to be about
80% effective in preventing the development of paralytic poliomyelitis, and protection was
shown to last for 5 weeks if given under tightly controlled circumstances.[45] The serum was also
shown to reduce the severity of the disease in patients who developed polio.[35]
The large-scale use of antibody serum to prevent and treat polio had a number of drawbacks,
however, including the observation that the immunity provided by the serum did not last long,
and the protection offered by the antibody was incomplete, that re-injection was required during
each epidemic outbreak, and that the optimal time frame for administration was unknown.[43] The
antibody serum was widely administered, but obtaining the serum was an expensive and timeconsuming process, and the focus of the medical community soon shifted to the development of
a polio vaccine.[46]
Kenny regimen
Early management practices for paralyzed muscles emphasized the need to rest the affected
muscles and suggested that the application of splints would prevent tightening of muscle,
tendons, ligaments, or skin that would prevent normal movement. Many paralyzed polio patients
lay in plaster body casts for months at a time. This prolonged casting often resulted in atrophy of
both affected and unaffected muscles.[3]
In 1940, Sister Elizabeth Kenny, an Australian bush nurse, arrived in North America and
challenged this approach to treatment. In treating polio cases in rural Australia between 1928 and
1940, Kenny had developed a form of physical therapy that - instead of immobilizing afflicted
limbs - aimed to relieve pain and spasms in polio patients through the use of hot, moist packs to
relieve muscle spasm, and the advocated early activity and exercise to maximize the strength of
unaffected muscle fibers and promote the neuroplastic recruitment of remaining nerve cells that
had not been killed by the virus.[34] Sister Kenny later settled in Minnesota where she established
the Sister Kenny Rehabilitation Institute, beginning a world-wide crusade to advocate her system
of treatment. Slowly, Kenny's ideas won acceptance, and by the mid-20th century had become
the hallmark for the treatment of paralytic polio.[32] In combination with antispasmodic
medications to reduce muscular contractions, Kenny's therapy is still used in the treatment of
paralytic poliomyelitis.
Page 25 of 52
Vaccine development
Main article: Polio vaccine
People in Columbus, Georgia awaiting polio vaccination during the early days of the National
Polio Immunization Program.
In 1935 Maurice Brodie, a research assistant at New York University, attempted to produce a
polio vaccine, procured from virus in ground up monkey spinal cords, and killed by
formaldehyde. Brodie first tested the vaccine on himself and several of his assistants. He then
gave the vaccine to three thousand children. Many developed allergic reactions, but none of the
children developed an immunity to polio.[47] During the late 1940s and early 1950s, a research
group, headed by John Enders at the Boston Children's Hospital, successfully cultivated the
poliovirus in human tissue. This significant breakthrough ultimately allowed for the development
of the polio vaccines. Enders and his colleagues, Thomas H. Weller and Frederick C. Robbins,
were recognized for their labors with the Nobel Prize in 1954.[48]
Two vaccines are used throughout the world to combat polio. The first was developed by Jonas
Salk, first tested in 1952, and announced to the world by Salk on April 12, 1955.[46] The Salk
vaccine, or inactivated poliovirus vaccine (IPV), consists of an injected dose of killed poliovirus.
In 1954, the vaccine was tested for its ability to prevent polio; the field trials involving the Salk
vaccine would grow to be the largest medical experiment in history. Immediately following
licensing, vaccination campaigns were launched, by 1957, following mass immunizations
promoted by the March of Dimes the annual number of polio cases in the United States would be
dramatically reduced, from a peak of nearly 58,000 cases, to just 5,600 cases.[11]
Eight years after Salk's success, Albert Sabin developed an oral polio vaccine (OPV) using live
but weakened (attenuated) virus.[49] Human trials of Sabin's vaccine began in 1957 and it was
licensed in 1962. Following the development of oral polio vaccine, a second wave of mass
immunizations would lead to a further decline in the number of cases: by 1961, only 161 cases
were recorded in the United States.[50] The last cases of paralytic poliomyelitis caused by endemic
transmission of poliovirus in the United States were in 1979, when an outbreak occurred among
the Amish in several Midwestern states.[51]
Legacy
Page 26 of 52
Early in the 20th century polio would become the world's most feared disease. The disease hit
without warning, tended to strike white, affluent individuals, required long quarantine periods
during which parents were separated from children: it was impossible to tell who would get the
disease and who would be spared.[11] The consequences of the disease left polio victims marked
for life, leaving behind vivid images of wheelchairs, crutches, leg braces, breathing devices, and
deformed limbs. However, polio changed not only the lives of those who survived it, but also
effected profound cultural changes: the emergence of grassroots fund-raising campaigns that
would revolutionize medical philanthropy, the rise of rehabilitation therapy and, through
campaigns for the social and civil rights of the disabled, polio survivors helped to spur the
modern disability rights movement.
In addition, the occurrence of polio epidemics led to a number of public health innovations. One
of the most widespread was the proliferation of "no spitting" ordinances in the United States and
Rehabilitation therapy
A physical therapist assists two polio-stricken children while they exercise their lower limbs.
Prior to the polio scares of the 20th century, most rehabilitation therapy was focused on treating
injured soldiers returning from war. The crippling effects of polio led to heightened awareness
and public support of physical rehabilitation, and in response a number of rehabilitation centers
specifically aimed at treating polio patients were opened, with the task of restoring and building
the remaining strength of polio victims and teaching new, compensatory skills to large numbers
of newly paralyzed individuals.[38]
In 1926, Franklin Roosevelt, convinced of the benefits of hydrotherapy, bought a resort at Warm
Springs, Georgia, where he founded the first modern rehabilitation center for treatment of polio
patients which still operates as the Roosevelt Warm Springs Institute for Rehabilitation.[56]
The cost of polio rehabilitation was often more than the average family could afford, and more
than 80% of the nation's polio patients would receive funding through the March of Dimes.[53]
Some families also received support through philanthropic organizations such as the Ancient
Arabic Order of the Nobles of the Mystic Shrine fraternity, which established a network of
pediatric hospitals in 1919, the Shriners Hospitals for Children, to provide care free of charge for
children with polio.[57]
Page 27 of 52
Disability rights movement
As thousands of polio survivors with varying degrees of paralysis left the rehabilitation hospitals
and went home, to school and to work, many were frustrated by a lack of accessibility and
discrimination they experienced in their communities. In the early 20th century the use of a
wheelchair at home or out in public was a daunting prospect as no public transportation system
accommodated wheelchairs and most public buildings including schools, were inaccessible to
those with disabilities. Many children left disabled by polio were forced to attend separate
institutions for "crippled children" or had to be carried up and down stairs.[56]
As people who had been paralyzed by polio matured, they began to demand the right to
participate in the mainstream of society. Polio survivors were often in the forefront of the
disability rights movement that emerged in the United States during the 1970s, and pushed
legislation such as the Rehabilitation Act of 1973 which protected qualified individuals from
discrimination based on their disability, and the Americans with Disabilities Act of 1990.[56][58]
Other political movements led by polio survivors include the Independent Living and Universal
design movements of the 1960s and 1970s.[59]
Polio survivors are one of the largest disabled groups in the world. The World Health
Organization estimates that there are 10 to 20 million polio survivors worldwide.[60] In 1977, the
National Health Interview Survey reported that there were 254,000 persons living in the United
States who had been paralyzed by polio.[61] According to local polio support groups and doctors,
some 40,000 polio survivors with varying degrees of paralysis live in Germany, 30,000 in Japan,
24,000 in France, 16,000 in Australia, 12,000 in Canada and 12,000 in the United Kingdom.[60]
Page 28 of 52
Sigmund Freud
From Wikipedia, the free encyclopedia
"Freud" redirects here. For other uses, see Freud (disambiguation).
Sigmund Freud
Freud by Max Halberstadt, 1921
Sigismund Schlomo Freud
6 May 1856
Freiberg in Mähren, Moravia, Austrian
Born
Empire
(now Příbor, Czech Republic)
23 September 1939 (aged 83)
Died
London, England
Austrian
Nationality
Fields
Institutions



Neurology
Psychotherapy
Psychoanalysis
University of Vienna
Page 29 of 52
University of Vienna (MD, 1881)
Alma mater
Academic
advisors



Psychoanalysis
Known for

Notable awards
Spouse
Franz Brentano
Ernst Brücke
Carl Claus
Goethe Prize (1930)
Foreign Member of the Royal Society[1]
Martha Bernays (m. 1886–1939, his
death)
Signature
Sigmund Freud (/frɔɪd/;[2] German pronunciation: [ˈziːkmʊnt ˈfʁɔʏ̯t]; born Sigismund Schlomo
Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist, psychologist and
philosopher, now known as the father of psychoanalysis.
Freud qualified as a doctor of medicine at the University of Vienna in 1881,[3] and then carried
out research into cerebral palsy, aphasia and microscopic neuroanatomy at the Vienna General
Hospital.[4] Upon completing his habilitation in 1895, he was appointed a docent in
neuropathology in the same year and became an affiliated professor (professor extraordinarius)
in 1902.[5][6]
In creating psychoanalysis, a clinical method for treating psychopathology through dialogue
between a patient and a psychoanalyst,[7] Freud developed therapeutic techniques such as the use
of free association and discovered transference, establishing its central role in the analytic
process. Freud's redefinition of sexuality to include its infantile forms led him to formulate the
Oedipus complex as the central tenet of psychoanalytical theory. His analysis of dreams as wishfulfillments provided him with models for the clinical analysis of symptom formation and the
mechanisms of repression as well as for elaboration of his theory of the unconscious as an
agency disruptive of conscious states of mind.[8] Freud postulated the existence of libido, an
energy with which mental processes and structures are invested and which generates erotic
attachments, and a death drive, the source of repetition, hate, aggression and neurotic guilt.[9] In
his later work Freud developed a wide-ranging interpretation and critique of religion and culture.
Psychoanalysis remains influential within psychotherapy, within some areas of psychiatry, and
across the humanities. As such, it continues to generate extensive and highly contested debate
with regard to its therapeutic efficacy, its scientific status, and whether it advances or is
detrimental to the feminist cause.[10] Nonetheless, Freud's work has suffused contemporary
Western thought and popular culture. In the words of W. H. Auden's poetic tribute, by the time
of Freud's death in 1939, he had become "a whole climate of opinion / under whom we conduct
our different lives".[11]
Page 30 of 52
Biography
Development of psychoanalysis
André Brouillet's 1887 A Clinical Lesson at the Salpêtrière depicting a Charcot demonstration.
Freud had a lithograph of this painting placed over the couch in his consulting rooms.[34]
In October 1885, Freud went to Paris on a fellowship to study with Jean-Martin Charcot, a
renowned neurologist who was conducting scientific research into hypnosis. He was later to
recall the experience of this stay as catalytic in turning him toward the practice of medical
psychopathology and away from a less financially promising career in neurology research.[35]
Charcot specialized in the study of hysteria and susceptibility to hypnosis, which he frequently
demonstrated with patients on stage in front of an audience.
Once he had set up in private practice in 1886, Freud began using hypnosis in his clinical work.
He adopted the approach of his friend and collaborator, Josef Breuer, in a use of hypnosis which
was different from the French methods he had studied in that it did not use suggestion. The
treatment of one particular patient of Breuer's proved to be transformative for Freud's clinical
practice. Described as Anna O, she was invited to talk about her symptoms while under hypnosis
(she would coin the phrase "talking cure" for her treatment). In the course of talking in this way,
these symptoms became reduced in severity as she retrieved memories of traumatic incidents
associated with their onset.
This led Freud to eventually establish in the course of his clinical practice that a more consistent
and effective pattern of symptom relief could be achieved, without recourse to hypnosis, by
encouraging patients to talk freely about whatever ideas or memories occurred to them. In
addition to this procedure, which he called "free association", Freud found that patients' dreams
could be fruitfully analyzed to reveal the complex structuring of unconscious material and to
demonstrate the psychic action of repression which underlay symptom formation. By 1896,
Freud had abandoned hypnosis and was using the term "psychoanalysis" to refer to his new
clinical method and the theories on which it was based.[36]
Freud's development of these new theories took place during a period in which he experienced
heart irregularities, disturbing dreams and periods of depression, a "neurasthenia" which he
linked to the death of his father in 1896[37] and which prompted a "self-analysis" of his own
dreams and memories of childhood. His explorations of his feelings of hostility to his father and
rivalrous jealousy over his mother’s affections led him to a fundamental revision of his theory of
the origin of the neuroses.
Page 31 of 52
On the basis of his early clinical work, Freud had postulated that unconscious memories of
sexual molestation in early childhood were a necessary precondition for the psychoneuroses
(hysteria and obsessional neurosis), a formulation now known as Freud's seduction theory.[38] In
the light of his self-analysis, Freud abandoned the theory that every neurosis can be traced back
to the effects of infantile sexual abuse, now arguing that infantile sexual scenarios still had a
causative function, but it did not matter whether they were real or imagined and that in either
case they became pathogenic only when acting as repressed memories.[39]
This transition from the theory of infantile sexual trauma as a general explanation of how all
neuroses originate to one that presupposes an autonomous infantile sexuality provided the basis
for Freud's subsequent formulation of the theory of the Oedipus complex.[40]
Freud described the evolution of his clinical method and set out his theory of the psychogenetic
origins of hysteria, demonstrated in a number of case histories, in Studies on Hysteria published
in 1895 (co-authored with Josef Breuer). In 1899 he published The Interpretation of Dreams in
which, following a critical review of existing theory, Freud gives detailed interpretations of his
own and his patients' dreams in terms of wish-fulfillments made subject to the repression and
censorship of the “dream work”. He then sets out the theoretical model of mental structure (the
unconscious, pre-conscious and conscious) on which this account is based. An abridged version,
On Dreams, was published in 1901. In works which would win him a more general readership,
Freud applied his theories outside the clinical setting in The Psychopathology of Everyday Life
(1901) and Jokes and their Relation to the Unconscious (1905).[41] In Three Essays on the Theory
of Sexuality, published in 1905, Freud elaborates his theory of infantile sexuality, describing its
"polymorphous perverse" forms and the functioning of the “drives”, to which it gives rise, in the
formation of sexual identity.[42] The same year he published ‘Fragment of an Analysis of a Case
of Hysteria (Dora)’ which became one of his more famous and controversial case studies.[43]
Ideas
Early work
Freud began his study of medicine at the University of Vienna in 1873.[93] He took almost nine
years to complete his studies, due to his interest in neurophysiological research, specifically
investigation of the sexual anatomy of eels and the physiology of the fish nervous system, and
because of his interest in studying philosophy with Franz Brentano. He entered private practice
in neurology for financial reasons, receiving his M.D. degree in 1881 at the age of 25.[94]
Amongst his principal concerns in the 1880s was the anatomy of the brain, specifically the
medulla oblongata. He intervened in the important debates about aphasia with his monograph of
1891, Zur Auffassung der Aphasien, in which he coined the term agnosia and counselled against
a too locationist view of the explanation of neurological deficits. Like his contemporary Eugen
Bleuler, he emphasized brain function rather than brain structure.
Freud also an early researcher in the field of cerebral palsy, which was then known as "cerebral
paralysis". He published several medical papers on the topic, and showed that the disease existed
long before other researchers of the period began to notice and study it. He also suggested that
William Little, the man who first identified cerebral palsy, was wrong about lack of oxygen
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during birth being a cause. Instead, he suggested that complications in birth were only a
symptom. Freud hoped that his research would provide a solid scientific basis for his therapeutic
technique. The goal of Freudian therapy, or psychoanalysis, was to bring repressed thoughts and
feelings into consciousness in order to free the patient from suffering repetitive distorted
emotions.
Classically, the bringing of unconscious thoughts and feelings to consciousness is brought about
by encouraging a patient to talk about dreams and engage in free association, in which patients
report their thoughts without reservation and make no attempt to concentrate while doing so.[95]
Another important element of psychoanalysis is transference, the process by which patients
displace onto their analysts feelings and ideas which derive from previous figures in their lives.
Transference was first seen as a regrettable phenomenon that interfered with the recovery of
repressed memories and disturbed patients' objectivity, but by 1912, Freud had come to see it as
an essential part of the therapeutic process.[96]
The origin of Freud's early work with psychoanalysis can be linked to Josef Breuer. Freud
credited Breuer with opening the way to the discovery of the psychoanalytical method by his
treatment of the case of Anna O. In November 1880, Breuer was called in to treat a highly
intelligent 21-year-old woman (Bertha Pappenheim) for a persistent cough that he diagnosed as
hysterical. He found that while nursing her dying father, she had developed a number of
transitory symptoms, including visual disorders and paralysis and contractures of limbs, which
he also diagnosed as hysterical. Breuer began to see his patient almost every day as the
symptoms increased and became more persistent, and observed that she entered states of
absence. He found that when, with his encouragement, she told fantasy stories in her evening
states of absence her condition improved, and most of her symptoms had disappeared by April
1881. Following the death of her father in that month her condition deteriorated again. Breuer
recorded that some of the symptoms eventually remitted spontaneously, and that full recovery
was achieved by inducing her to recall events that had precipitated the occurrence of a specific
symptom.[97] In the years immediately following Breuer's treatment, Anna O. spent three short
periods in sanatoria with the diagnosis "hysteria" with "somatic symptoms",[98] and some authors
have challenged Breuer's published account of a cure.[99][100][101] Richard Skues rejects this
interpretation, which he sees as stemming from both Freudian and anti-psychoanalytical
revisionism, that regards both Breuer's narrative of the case as unreliable and his treatment of
Anna O. as a failure.[102]
The Unconscious
Main article: Unconscious mind
The concept of the unconscious was central to Freud's account of the mind. Freud believed that
while poets and thinkers had long known of the existence of the unconscious, he had ensured that
it received scientific recognition in the field of psychology. The concept made an informal
appearance in Freud's writings.
The unconscious was first introduced in connection with the phenomenon of repression, to
explain what happens to ideas that are repressed. Freud stated explicitly that the concept of the
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unconscious was based on the theory of repression. He postulated a cycle in which ideas are
repressed, but remain in the mind, removed from consciousness yet operative, then reappear in
consciousness under certain circumstances. The postulate was based upon the investigation of
cases of traumatic hysteria, which revealed cases where the behavior of patients could not be
explained without reference to ideas or thoughts of which they had no awareness. This fact,
combined with the observation that such behavior could be artificially induced by hypnosis, in
which ideas were inserted into people's minds, suggested that ideas were operative in the original
cases, even though their subjects knew nothing of them.
Freud, like Josef Breuer, found the hypothesis that hysterical manifestations were generated by
ideas to be not only warranted, but given in observation. Disagreement between them arose when
they attempted to give causal explanations of their data: Breuer favored a hypothesis of hypnoid
states, while Freud postulated the mechanism of defense. Richard Wollheim comments that
given the close correspondence between hysteria and the results of hypnosis, Breuer's hypothesis
appears more plausible, and that it is only when repression is taken into account that Freud's
hypothesis becomes preferable.[119]
Freud originally allowed that repression might be a conscious process, but by the time he wrote
his second paper on the "Neuro-Psychoses of Defence" (1896), he apparently believed that
repression, which he referred to as "the psychical mechanism of (unconscious) defense",
occurred on an unconscious level. Freud further developed his theories about the unconscious in
The Interpretation of Dreams (1899) and in Jokes and Their Relation to the Unconscious (1905),
where he dealt with condensation and displacement as inherent characteristics of unconscious
mental activity. Freud presented his first systematic statement of his hypotheses about
unconscious mental processes in 1912, in response to an invitation from the London Society of
Psychical Research to contribute to its Proceedings. In 1915, Freud expanded that statement into
a more ambitious metapsychological paper, entitled "The Unconscious". In both these papers,
when Freud tried to distinguish between his conception of the unconscious and those that
predated psychoanalysis, he found it in his postulation of ideas that are simultaneously latent and
operative.[119]
Dreams
Main article: Dream
Freud believed that the function of dreams is to preserve sleep by representing as fulfilled wishes
that would otherwise awaken the dreamer.[120]
In Freud's theory dreams are instigated by the daily occurrences and thoughts of everyday life.
His claim that they function as wish fulfillments is based on an account of the “dreamwork” in
terms of a transformation of "secondary process" thought, governed by the rules of language and
the reality principle, into the "primary process" of unconscious thought governed by the pleasure
principle, wish gratification and the repressed sexual scenarios of childhood.[121]
In order to preserve sleep the dreamwork disguises the repressed or “latent” content of the dream
in an interplay of words and images which Freud describes in terms of condensation,
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displacement and distortion. This produces the "manifest content" of the dream as recounted in
the dream narrative. For Freud an unpleasant manifest content may still represent the fulfilment
of a wish on the level of the latent content. In the clinical setting Freud encouraged free
association to the dream's manifest content in order to facilitate access to its latent content. Freud
believed interpreting dreams in this way could provide important insights into the formation of
neurotic symptoms and contribute to the mitigation of their pathological effects.[122]
Id, ego and super-ego
Main article: Id, ego and super-ego
Freud proposed that the human psyche could be divided into three parts: Id, ego and super-ego.
Freud discussed this model in the 1920 essay Beyond the Pleasure Principle, and fully
elaborated upon it in The Ego and the Id (1923), in which he developed it as an alternative to his
previous topographic schema (i.e., conscious, unconscious and preconscious). The id is the
completely unconscious, impulsive, childlike portion of the psyche that operates on the "pleasure
principle" and is the source of basic impulses and drives; it seeks immediate pleasure and
gratification.[127]
Freud acknowledged that his use of the term Id (das Es, "the It") derives from the writings of
Georg Groddeck.[128] The super-ego is the moral component of the psyche, which takes into
account no special circumstances in which the morally right thing may not be right for a given
situation. The rational ego attempts to exact a balance between the impractical hedonism of the
id and the equally impractical moralism of the super-ego; it is the part of the psyche that is
usually reflected most directly in a person's actions. When overburdened or threatened by its
tasks, it may employ defence mechanisms including denial, repression, undoing, rationalization,
and displacement. This concept is usually represented by the "Iceberg Model".[129] This model
represents the roles the Id, Ego, and Super Ego play in relation to conscious and unconscious
thought.
Freud compared the relationship between the ego and the id to that between a charioteer and his
horses: the horses provide the energy and drive, while the charioteer provides direction.[127]
Life and death drives[edit]
Main articles: Libido and Death drive
Freud believed that people are driven by two conflicting central desires: the life drive (libido or
Eros) (survival, propagation, hunger, thirst, and sex) and the death drive. The death drive was
also termed "Thanatos", although Freud did not use that term; "Thanatos" was introduced in this
context by Paul Federn.[130] Freud hypothesized that libido is a form of mental energy with which
processes, structures and object-representations are invested.[131] Prior to the war, Freud believes,
fiction had constituted a different mode of relation to death, a place of compensation in which
"the condition for reconciling ourselves to death is fulfilled, namely, if beneath all vicissitudes of
life a permanent life still remains to us".[132]
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In Beyond the Pleasure Principle, Freud inferred the existence of the death instinct. Its premise
was a regulatory principle that has been described as "the principle of psychic inertia", "the
Nirvana principle", and "the conservatism of instinct". Its background was Freud's earlier Project
for a Scientific Psychology, where he had defined the principle governing the mental apparatus
as its tendency to divest itself of quantity or to reduce tension to zero. Freud had been obliged to
abandon that definition, since it proved adequate only to the most rudimentary kinds of mental
functioning, and replaced the idea that the apparatus tends toward a level of zero tension with the
idea that it tends toward a minimum level of tension.[133]
Freud in effect readopted the original definition in Beyond the Pleasure Principle, this time
applying it to a different principle. He asserted that on certain occasions the mind acts as though
it could eliminate tension entirely, or in effect to reduce itself to a state of extinction; his key
evidence for this was the existence of the compulsion to repeat. Examples of such repetition
included the dream life of traumatic neurotics and children's play. In the phenomenon of
repetition, Freud saw a psychic trend to work over earlier impressions, to master them and derive
pleasure from them, a trend was prior to the pleasure principle but not opposed to it. In addition
to that trend, there was also a principle at work that was opposed to, and thus "beyond" the
pleasure principle. If repetition is a necessary element in the binding of energy or adaptation,
when carried to inordinate lengths it becomes a means of abandoning adaptations and reinstating
earlier or less evolved psychic positions. By combining this idea with the hypothesis that all
repetition is a form of discharge, Freud reached the conclusion that the compulsion to repeat is
an effort to restore a state that is both historically primitive and marked by the total draining of
energy: death.[133]
Legacy
Psychotherapy
Though not the first methodology in the practice of individual verbal psychotherapy,[150] Freud's
psychoanalytic system came to dominate the field from early in the twentieth century, forming
the basis for many later variants. While these systems have adopted different theories and
techniques, all have followed Freud by attempting to effect behavioral change through having
patients talk about their difficulties.[7] Psychoanalysis itself has, according to psychoanalyst Joel
Kovel, declined as a distinct therapeutic practice, despite its pervasive influence on
psychotherapy.[151]
Science
Research projects designed to test Freud's theories empirically have led to a vast literature on the
topic.[156] Seymour Fisher and Roger P. Greenberg concluded in 1977 that some of Freud's
concepts were supported by empirical evidence. Their analysis of research literature supported
Freud's concepts of oral and anal personality constellations, his account of the role of Oedipal
factors in certain aspects of male personality functioning, his formulations about the relatively
greater concern about loss of love in women's as compared to men's personality economy, and
his views about the instigating effects of homosexual anxieties on the formation of paranoid
delusions. They also found limited and equivocal support for Freud's theories about the
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development of homosexuality. They found that several of Freud's other theories, including his
portrayal of dreams as primarily containers of secret, unconscious wishes, as well as some of his
views about the psychodynamics of women, were either not supported or contradicted by
research. Reviewing the issues again in 1996, they concluded that much experimental data
relevant to Freud's work exists, and supports some of his major ideas and theories.[157] Fisher and
Greenberg's similar conclusions in their more extensive earlier volume on experimental
studies[158] have been strongly criticised for alleged methodological deficiencies by Paul Kline,
who writes that they "accept results at their face value with almost no consideration of
methodological adequacy",[159] and by Edward Erwin.[160]
Philosophy
Psychoanalysis has been interpreted as both radical and conservative. By the 1940s, it had come
to be seen as conservative by the European and American intellectual community. Critics outside
the psychoanalytic movement, whether on the political left or right, saw Freud as a conservative.
Fromm had argued that several aspects of psychoanalytic theory served the interests of political
reaction in his The Fear of Freedom (1942), an assessment confirmed by sympathetic writers on
the right. Philip Rieff's Freud: The Mind of the Moralist (1959) portrayed Freud as a man who
urged men to make the best of an inevitably unhappy fate, and admirable for that reason. Three
books published in the 1950s challenged the then prevailing interpretation of Freud as a
conservative: Herbert Marcuse's Eros and Civilization (1955), Lionel Trilling's Freud and the
Crisis of Our Culture, and Norman O. Brown's Life Against Death (1959).[182] Eros and
Civilization helped make the idea that Freud and Marx were addressing similar questions from
different perspectives credible to the left. Marcuse criticized neo-Freudian revisionism for
discarding seemingly pessimistic theories such as the death instinct, arguing that they could be
turned in a utopian direction. Freud's theories also influenced the Frankfurt School and critical
theory as a whole.[183]
Freud has been compared to Marx by Reich, who saw Freud's importance for psychiatry as
parallel to that of Marx for economics,[184] and by Paul Robinson, who sees Freud as a
revolutionary whose contributions to twentieth century thought are comparable in importance to
Marx's contributions to nineteenth century thought.[185] Fromm calls Freud, Marx and Einstein the
"architects of the modern age", but rejects the idea that Marx and Freud were equally significant,
arguing that Marx was both far more historically important and a finer thinker. Fromm
nevertheless credits Freud with permanently changing the way human nature is understood.[186]
Gilles Deleuze and Félix Guattari write in Anti-Oedipus (1972) that psychoanalysis resembles
the Russian Revolution in that it became corrupted almost from the beginning. They believe this
began with Freud's development of the theory of the Oedipus complex, which they see as
idealist.[187]
Jean-Paul Sartre critiques Freud's theory of the unconscious in Being and Nothingness, claiming
that consciousness is essentially self-conscious. Sartre also attempts to adapt some of Freud's
ideas to his own account of human life, and thereby develop an "existential psychoanalysis" in
which causal categories are replaced by teleological categories.[188] Maurice Merleau-Ponty
considers Freud to be one of the anticipators of phenomenology,[189] while Theodor W. Adorno
considers Edmund Husserl, the founder of phenomenology, to be Freud's philosophical opposite,
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writing that Husserl's polemic against psychologism could have been directed against
psychoanalysis.[190] Paul Ricœur sees Freud as a master of the "school of suspicion", alongside
Marx and Nietzsche.[191] Ricœur and Jürgen Habermas have helped create a "hermeneutic version
of Freud", one which "claimed him as the most significant progenitor of the shift from an
objectifying, empiricist understanding of the human realm to one stressing subjectivity and
interpretation."[192] Louis Althusser drew on Freud's concept of overdetermination for his
reinterpretation of Marx's Capital.[193] Jean-François Lyotard developed a theory of the
unconscious that reverses Freud's account of the dream-work: for Lyotard, the unconscious is a
force whose intensity is manifest via disfiguration rather than condensation.[194] Jacques Derrida
finds Freud to be both a late figure in the history of western metaphysics and, with Nietzsche and
Heidegger, a precursor of his own brand of radicalism.[195]
Several scholars see Freud as parallel to Plato, writing that they hold nearly the same theory of
dreams and have similar theories of the tripartite structure of the human soul or personality, even
if the hierarchy between the parts of the soul is almost reversed.[196][197] Ernest Gellner argues that
Freud's theories are an inversion of Plato's. Whereas Plato saw a hierarchy inherent in the nature
of reality, and relied upon it to validate norms, Freud was a naturalist who could not follow such
an approach. Both men's theories drew a parallel between the structure of the human mind and
that of society, but while Plato wanted to strengthen the super-ego, which corresponded to the
aristocracy, Freud wanted to strengthen the ego, which corresponded to the middle class.[198]
Michel Foucault writes that Plato and Freud meant different things when they claimed that
dreams fulfill desires, since the meaning of a statement depends on its relation to other
propositions.[199]
Paul Vitz compares Freudian psychoanalysis to Thomism, noting St. Thomas's belief in the
existence of an "unconscious consciousness" and his "frequent use of the word and concept
'libido' - sometimes in a more specific sense than Freud, but always in a manner in agreement
with the Freudian use." Vitz suggests that Freud may have been unaware that his theory of the
unconscious was reminiscent of Aquinas.[27] Bernard Williams writes that there has been hope
that some psychoanalytical theories may "support some ethical conception as a necessary part of
human happiness", but that in some cases the theories appear to support such hopes because they
themselves involve ethical thought. In his view, while such theories may be better as channels of
individual help because of their ethical basis, it disqualifies them from providing a basis for
ethics.[200]
Escape from Nazism[edit]
In 1930 Freud was awarded the Goethe Prize in recognition of his contributions to psychology
and to German literary culture. In January 1933, the Nazis took control of Germany, and Freud's
books were prominent among those they burned and destroyed. Freud quipped: "What progress
we are making. In the Middle Ages they would have burned me. Now, they are content with
burning my books."[79]
Freud continued to maintain his optimistic underestimation of the growing Nazi threat and
remained determined to stay in Vienna, even following the Anschluss of 13 March 1938 in
which Nazi Germany annexed Austria, and the outbursts of violent anti-Semitism that ensued.[80]
Page 38 of 52
Ernest Jones, the then president of the International Psychoanalytic Association (IPA), flew into
Vienna from London via Prague on 15 March determined to get Freud to change his mind and
seek exile in Britain. This prospect and the shock of the detention and interrogation of Anna
Freud by the Gestapo finally convinced Freud it was time to leave Austria.[80] Jones left for
London the following week with a list provided by Freud of the party of émigrés for whom
immigration permits would be required. Back in London, Jones used his personal acquaintance
with the Home Secretary, Sir Samuel Hoare to expedite the granting of permits. There were
seventeen in all and work permits were provided where relevant. Jones also used his influence in
scientific circles, persuading the president of the Royal Society,[1] Sir William Bragg, to write to
the Foreign Secretary Lord Halifax, requesting to good effect that diplomatic pressure be applied
in Berlin and Vienna on Freud's behalf. Freud also had support from American diplomats,
notably his ex-patient and American ambassador to France, William Bullitt.[81]
The departure from Vienna began in stages throughout April and May 1938. Freud's grandson
Ernst Halberstadt and Freud's son Martin's wife and children left for Paris in April. Freud's sisterin-law, Minna Bernays, left for London on 5 May, Martin Freud the following week and Freud's
daughter Mathilde and her husband, Robert Hollitscher, on 24 May.[82]
By the end of the month, arrangements for Freud's own departure for London had become
stalled, mired in a legally tortuous and financially extortionate process of negotiation with the
Nazi authorities. The Nazi-appointed Kommissar put in charge of his assets and those of the IPA
proved to be sympathetic to Freud's plight. Anton Sauerwald had studied chemistry at Vienna
University under Professor Josef Herzig, an old friend of Freud's, and evidently retained,
notwithstanding his Nazi Party allegiance, a respect for Freud's professional standing. Expected
to disclose details of all Freud's bank accounts to his superiors and to follow their instructions to
destroy the historic library of books housed in the offices of the IPA, in the event Sauerwald did
neither, removing evidence of Freud's foreign bank accounts to his own safe-keeping and
arranging the storage of the IPA library in the Austrian National Library where they remained
until the end of the war.[83]
Though Sauerwald's intervention lessened the financial burden of the "flight" tax on Freud's
declared assets, other substantial charges were levied in relation to the debts of the IPA and the
valuable collection of antiquities Freud possessed. Unable to access his own accounts, Freud
turned to Princess Marie Bonaparte, the most eminent and wealthy of his French followers, who
had travelled to Vienna to offer her support and it was she who made the necessary funds
available.[84] This allowed Sauerwald to sign the necessary exit visas for Freud, his wife Martha
and daughter Anna. They left Vienna on the Orient Express on 4 June, accompanied by their
household staff and a doctor, arriving in Paris the following day where they stayed as guests of
Princess Bonaparte before travelling overnight to London arriving at Victoria Station on 6 June.
Many famous names were soon to call on Freud to pay their respects, notably Salvador Dalí,
Stefan Zweig, Leonard Woolf, Virginia Woolf and H.G. Wells. Representatives of the Royal
Society[1] called with the Society's Charter for Freud to sign himself into membership. Princess
Bonaparte arrived towards the end of June to discuss the fate of Freud's four elderly sisters left
behind in Vienna. Her subsequent attempts to get them exit visas failed and they would all die in
Nazi concentration camps.[85]
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In early 1939 Anton Sauerwald arrived to see Freud, ostensibly to discuss matters relating to the
assets of the IPA. He was able to do Freud one last favour. He returned to Vienna to drive
Freud's Viennese cancer specialist, Hans Pichler, to London to operate on the worsening
condition of Freud's cancerous jaw.[86]
Sauerwald was tried and imprisoned in 1945 by an Austrian court for his activities as a Nazi
Party official. Responding to a plea from his wife, Anna Freud wrote to confirm that Sauerwald
"used his office as our appointed commissar in such a manner as to protect my father". Her
intervention helped secure his release from jail in 1947.[87]
In the Freuds' new home – 20 Maresfield Gardens, Hampstead, North London – Freud's Vienna
consulting room was recreated in faithful detail. He continued to see patients there until the
terminal stages of his illness. He also worked on his last books, Moses and Monotheism,
published in German in 1938 and in English the following year[88] and the uncompleted Outline of
Psychoanalysis which was published posthumously.
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Carl Jung
From Wikipedia, the free encyclopedia
Carl Jung
Jung in 1910
Carl Gustav Jung
Born
26 July 1875
Kesswil, Thurgau, Switzerland
Died
Residence
6 June 1961 (aged 85)
Küsnacht, Zürich, Switzerland
Switzerland
Page 41 of 52
Citizenship
Swiss
Nationality
Swiss
Fields
Institutions
Alma mater
Doctoral
advisor
Psychiatry, psychology, psychotherapy,
analytical psychology
Burghölzli, Swiss Army (as a
commissioned officer in World War I)
University of Basel
Eugen Bleuler
Analytical psychology, typology, the
Known for
collective unconscious, the
psychoanalytical complex, the archetype,
anima and animus, synchronicity
Influences
Influenced
Spouse
Eugen Bleuler, Freud, Nietzsche,[1]
Schopenhauer,[1]
Joseph Campbell, Hermann Hesse, Erich
Neumann, Ross Nichols
Emma Jung
Signature
Carl Gustav Jung (/jʊŋ/; German: [ˈkarl ˈɡʊstaf jʊŋ]; 26 July 1875 – 6 June 1961), often referred
to as C. G. Jung, was a Swiss psychiatrist and psychotherapist who founded analytical
psychology.[2] His work has been influential not only in psychiatry but also in philosophy,
Page 42 of 52
anthropology, archaeology, literature, and religious studies. He was a prolific writer, though
many of his works were not published until after his death.
The central concept of analytical psychology is individuation—the psychological process of
integrating the opposites, including the conscious with the unconscious, while still maintaining
their relative autonomy.[3] Jung considered individuation to be the central process of human
development.[4]
Jung created some of the best known psychological concepts, including the archetype, the
collective unconscious, the complex, and extraversion and introversion.
The Myers-Briggs Type Indicator (MBTI), a popular psychometric instrument, and the concepts
of socionics were developed from Jung's theory of psychological types.
Jung saw the human psyche as "by nature religious"[5] and made this religiousness the focus of
his explorations.[6] Jung is one of the best known contemporary contributors to dream analysis
and symbolization.
Though he was a practising clinician and considered himself to be a scientist,[7] much of his life's
work was spent exploring tangential areas such as Eastern and Western philosophy, alchemy,
astrology, and sociology, as well as literature and the arts. Jung's interest in philosophy and the
occult led many to view him as a mystic, although his ambition was to be seen as a man of
science.[7] His influence on popular psychology, the "psychologization of religion",[8] spirituality
and the New Age movement has been immense.[9]
University studies and early career
Jung did not plan to study psychiatry since it was not considered prestigious at the time. But,
studying a psychiatric textbook, he became very excited when he discovered that psychoses are
personality diseases. His interest was immediately captured—it combined the biological and the
spiritual, exactly what he was searching for.[20] In 1895 Jung studied medicine at the University of
Basel.
In 1900 Jung began working at the Burghölzli psychiatric hospital in Zürich with Eugen Bleuler.
Bleuler was already in communication with the Austrian neurologist Sigmund Freud. Jung's
dissertation, published in 1903, was titled On the Psychology and Pathology of So-Called Occult
Phenomena. In 1906 he published Studies in Word Association, and later sent a copy of this book
to Freud.
Eventually a close friendship and a strong professional association developed between the elder
Freud and Jung, which left a sizeable trove of correspondence. For six years they cooperated in
their work.[21] In 1912, however, Jung published Wandlungen und Symbole der Libido (known in
English as Psychology of the Unconscious), which made manifest the developing theoretical
divergence between the two. Consequently their personal and professional relationship
fractured—each stating that the other was unable to admit he could possibly be wrong. After the
culminating break in 1913, Jung went through a difficult and pivotal psychological
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transformation, exacerbated by the outbreak of the First World War. Henri Ellenberger called
Jung's intense experience a "creative illness" and compared it favorably to Freud's own period of
what he called neurasthenia and hysteria.
Wartime army service
During World War I Jung was drafted as an army doctor and soon made commandant of an
internment camp for British officers and soldiers (Swiss neutrality obliged the Swiss to intern
personnel from either side of the conflict who crossed their frontier to evade capture). Jung
worked to improve the conditions of soldiers stranded in neutral territory and encouraged them to
attend university courses.[22]
Freud
Meeting Freud
Jung was thirty when he sent his Studies in Word Association to Sigmund Freud in Vienna in
1906. The two men met for the first time the following year and Jung recalled the discussion
between himself and Freud as interminable. He recalled that they talked almost unceasingly for
thirteen hours.[25] Six months later the then 50-year-old Freud sent a collection of his latest
published essays to Jung in Zurich. This marked the beginning of an intense correspondence and
collaboration that lasted six years and ended in May 1913.[citation needed] At this time Jung resigned as
the chairman of the International Psychoanalytical Association where he had been elected with
Freud's support.
Jung and Freud influenced each other during the intellectually formative years of Jung's life.
Freud called Jung "his adopted eldest son, his crown prince and successor". In 1906 psychology
as a science was still in its early stages. Jung, who had become interested in psychiatry as a
student by reading Psychopathia Sexualis by Richard von Krafft-Ebing, a professor in Vienna,
by then worked as a doctor under the psychiatrist Eugen Bleuler in Burghölzli. He became
familiar with Freud's idea of the unconscious through reading Freud's The Interpretation of
Dreams (1899). He became a proponent of the new "psycho-analysis." At the time, Freud needed
collaborators and pupils to validate and spread his ideas. Burghölzli was a renowned psychiatric
clinic in Zurich and Jung's research had already gained him international recognition.
Jung de-emphasized the importance of sexual development and focused on the collective
unconscious: the part of unconscious that contains memories and ideas that he believed were
inherited from ancestors. While he did think that libido was an important source for personal
growth, unlike Freud, Jung did not believe that libido alone was responsible for the formation of
the core personality.[26]
Last meetings with Freud
In November 1912, Jung and Freud met in Munich for a meeting among prominent colleagues to
discuss psychoanalytical journals.[28] At a talk about a new psychoanalytic essay on Amenhotep
Page 44 of 52
IV, Jung expressed his views on how it related to actual conflicts in the psychoanalytic
movement. While Jung spoke, Freud suddenly fainted and Jung carried him to a couch.
Jung and Freud personally met for the last time in September 1913 for the Fourth International
Psychoanalytical Congress in Munich. Jung gave a talk on psychological types, the introverted
and extraverted type in analytical psychology. This constituted the introduction of some of the
key concepts which came to distinguish Jung's work from Freud's in the next half century.
Midlife isolation
Carl Gustav Jung
Isolation[edit]
It was the publication of Jung's book "Psychology of the Unconscious" in 1912, that led to the
break with Freud. Letters they exchanged show Freud's refusal to consider Jung's ideas. This
rejection caused what Jung described in his autobiography Memories, Dreams, Reflections, as a
"resounding censure." Everyone he knew dropped away except for two of his colleagues. Jung
described his book as "... an attempt, only partially successful, to create a wider setting for
medical psychology and to bring the whole of the psychic phenomena within its purview." (The
book was later revised and retitled, "Symbols of Transformation", in 1922).
Red Book
In 1913, at the age of thirty-eight, Jung experienced a horrible "confrontation with the
unconscious". He saw visions and heard voices. He worried at times that he was "menaced by a
psychosis" or was "doing a schizophrenia". He decided that it was valuable experience and, in
private, he induced hallucinations or, in his words, "active imaginations". He recorded
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everything he felt in small journals. Jung began to transcribe his notes into a large red leatherbound book, on which he worked intermittently for sixteen years.[13]
Jung left no posthumous instructions about the final disposition of what he called the "Red
Book". His family eventually moved it into a bank vault in 1984. Sonu Shamdasani, a historian
from London, for three years tried to persuade Jung's heirs to have it published, to which they
declined every hint of inquiry. As of mid-September 2009, fewer than two dozen people had
seen it. Ulrich Hoerni, Jung's grandson who manages the Jung archives, decided to publish it to
raise the additional funds needed when the Philemon Foundation was founded.[13]
In 2007, two technicians for DigitalFusion, working with the publisher, W. W. Norton &
Company, scanned the manuscript with a 10,200-pixel scanner. It was published on 7 October
2009, in German with "separate English translation along with Shamdasani's introduction and
footnotes" at the back of the book, according to Sara Corbett for The New York Times. She
wrote, "The book is bombastic, baroque and like so much else about Carl Jung, a willful oddity,
synched with an antediluvian and mystical reality."[13]
The Rubin Museum of Art in New York City displayed the original Red Book journal, as well as
some of Jung's original small journals, from 7 October 2009, to 15 February 2010.[30] According
to them, "During the period in which he worked on this book Jung developed his principal
theories of archetypes, collective unconscious, and the process of individuation." Two-thirds of
the pages bear Jung's illuminations of the text.[30]
Theories
His theories include:




The concept of introversion and extraversion (although he did not define these terms as
they are popularly defined today).[39]
The concept of the complex, a grouping of interrelated unconscious elements.
The concept of the collective unconscious, the primordial realm of archetypes, which
manifests in all people.
Synchronicity as a mode of relationship that is not causal, an idea that has influenced
Wolfgang Pauli (with whom he developed the notion of unus mundus in connection with
the notion of non-locality) and some other physicists.[40]
Introversion and extraversion
In Jung’s Psychological Types, he theorizes that each person falls into one of two categories, the
introvert and the extravert. These two psychological types Jung compares to the ancient
archetypes, Apollo and Dionysus.
The introvert is likened with Apollo, who shines light on understanding. The introvert is focused
on the internal world of reflection, dreaming and vision. Thoughtful and insightful, the introvert
can sometime be uninterested in joining the activities of others.
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The extravert is associated with Dionysus, interested in joining the activities of the world. The
extravert is focused on the outside world of objects, sensory perception and action. Energetic and
lively, the extrovert may lose their sense of self in the intoxication of Dionysian pursuits.[41]
Divergence from Freud
Jung's primary disagreement with Freud stemmed from their differing concepts of the
unconscious.[42] Jung saw Freud's theory of the unconscious as incomplete and unnecessarily
negative. According to Jung, Freud conceived the unconscious solely as a repository of repressed
emotions and desires. Jung agreed with Freud's model of the unconscious, what Jung called the
"personal unconscious", but he also proposed the existence of a second, deeper form of the
unconscious underlying the personal one. This was the collective unconscious, where the
archetypes themselves resided, represented in mythology by a lake or other body of water, and in
some cases a jug or other container. Freud had actually mentioned a collective level of psychic
functioning but saw it primarily as an appendix to the rest of the psyche.
Individuation
Jung considered individuation, a psychological process of integrating the opposites including the
conscious with the unconscious while still maintaining their relative autonomy, necessary for a
person to become whole.[4]
Individuation is a process of transformation whereby the personal and collective unconscious is
brought into consciousness (by means of dreams, active imagination or free association to take
some examples) to be assimilated into the whole personality. It is a completely natural process
necessary for the integration of the psyche to take place.[43]
Besides achieving physical and mental health,[43] people who have advanced towards
individuation tend to be harmonious, mature and responsible. They embody humane values such
as freedom and justice and have a good understanding about the workings of human nature and
the universe.[4]
Persona
In his psychological theory – which is not necessarily linked to a particular theory of social
structure – the persona appears as a consciously created personality or identity fashioned out of
part of the collective psyche through socialization, acculturation and experience.[44] Jung applied
the term persona, explicitly because, in Latin, it means both personality and the masks worn by
Roman actors of the classical period, expressive of the individual roles played.
The persona, he argues, is a mask for the "collective psyche", a mask that 'pretends'
individuality, so that both self and others believe in that identity, even if it is really no more than
a well-played role through which the collective psyche is expressed. Jung regarded the "personamask" as a complicated system which mediates between individual consciousness and the social
community: it is "a compromise between the individual and society as to what a man should
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appear to be".[45] But he also makes it quite explicit that it is, in substance, a character mask in
the classical sense known to theatre, with its double function: both intended to make a certain
impression to others, and to hide (part of) the true nature of the individual.[46] The therapist then
aims to assist the individuation process through which the client (re-)gains his "own self" – by
liberating the self, both from the deceptive cover of the persona, and from the power of
unconscious impulses.
Jung's theory has become enormously influential in management theory; not just because
managers and executives have to create an appropriate "management persona" (a corporate
mask) and a persuasive identity,[47] but also because they have to evaluate what sort of people the
workers are, in order to manage them (for example, using personality tests and peer reviews).[48]
Spirituality
Jung's work on himself and his patients convinced him that life has a spiritual purpose beyond
material goals. Our main task, he believed, is to discover and fulfill our deep innate potential.
Based on his study of Christianity, Hinduism, Buddhism, Gnosticism, Taoism, and other
traditions, Jung believed that this journey of transformation, which he called individuation, is at
the mystical heart of all religions. It is a journey to meet the self and at the same time to meet the
Divine. Unlike Freud's objectivist worldview, Jung's pantheism may have led him to believe that
spiritual experience was essential to our well-being, as he specifically identifies individual
human life with the universe as a whole.[49][50] Jung's ideas on religion gave a counterbalance to
the Freudian scepticism of religion. Jung's idea of religion as a practical road to individuation has
been quite popular, and is still treated in modern textbooks on the psychology of religion, though
his ideas have also been criticized.[51]
Alchemy
The work and writings of Jung from the 1940s onwards focused on alchemy.
In 1944 Jung published Psychology and Alchemy, where he analyzed the alchemical symbols and
showed a direct relationship to the psychoanalytical process.[b] He argued that the alchemical
process was the transformation of the impure soul (lead) to perfected soul (gold), and a metaphor
for the individuation process.[20]
In 1963 Mysterium Coniunctionis first appeared in English as part of in The Collected Works of
C. G. Jung. Mysterium Coniunctionis was Jung's last book and focused on the "Mysterium
Coniunctionis" archetype, known as the sacred marriage between sun and moon. Jung argued
that the stages of the alchemists, the blackening, the whitening, the reddening and the yellowing,
could be taken as symbolic of individuation — his favourite term for personal growth (75).
Alcoholics Anonymous
Jung recommended spirituality as a cure for alcoholism and he is considered to have had an
indirect role in establishing Alcoholics Anonymous.[52] Jung once treated an American patient
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(Rowland Hazard III), suffering from chronic alcoholism. After working with the patient for
some time and achieving no significant progress, Jung told the man that his alcoholic condition
was near to hopeless, save only the possibility of a spiritual experience. Jung noted that
occasionally such experiences had been known to reform alcoholics where all else had failed.
Hazard took Jung's advice seriously and set about seeking a personal spiritual experience. He
returned home to the United States and joined a First-Century Christian evangelical movement
known as the Oxford Group (later known as Moral Re-Armament). He also told other alcoholics
what Jung had told him about the importance of a spiritual experience. One of the alcoholics he
brought into the Oxford Group was Ebby Thacher, a long-time friend and drinking buddy of Bill
Wilson, later co-founder of Alcoholics Anonymous (AA). Thacher told Wilson about the Oxford
Group, and through them Wilson became aware of Hazard's experience with Jung. The influence
of Jung thus indirectly found its way into the formation of Alcoholics Anonymous, the original
twelve-step program, and from there into the whole twelve-step recovery movement, although
AA as a whole is not Jungian and Jung had no role in the formation of that approach or the
twelve steps.
The above claims are documented in the letters of Jung and Bill Wilson, excerpts of which can
be found in Pass It On, published by Alcoholics Anonymous.[53] Although the detail of this story
is disputed by some historians, Jung himself discussed an Oxford Group member, who may have
been the same person, in talks given around 1940. The remarks were distributed privately in
transcript form, from shorthand taken by an attender (Jung reportedly approved the transcript),
and later recorded in Volume 18 of his Collected Works, The Symbolic Life ("For instance, when
a member of the Oxford Group comes to me in order to get treatment, I say, 'You are in the
Oxford Group; so long as you are there, you settle your affair with the Oxford Group. I can't do it
better than Jesus.'" Jung goes on to state that he has seen similar cures among Roman
Catholics).[54]
Art therapy
Jung proposed that art can be used to alleviate or contain feelings of trauma, fear, or anxiety and
also to repair, restore and heal.[16] In his work with patients and in his own personal explorations,
Jung wrote that art expression and images found in dreams could be helpful in recovering from
trauma and emotional distress. He often drew, painted, or made objects and constructions at
times of emotional distress, which he recognized as more than recreational.[16]
Political views
Views on the state
Jung stressed the importance of individual rights in a person's relation to the state and society. He
saw that the state was treated as "a quasi-animate personality from whom everything is expected"
but that this personality was "only camouflage for those individuals who know how to
manipulate it",[55] and referred to the state as a form of slavery.[56][57][58][59] He also thought that the
state "swallowed up [people's] religious forces",[60] and therefore that the state had "taken the
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place of God"—making it comparable to a religion in which "state slavery is a form of
worship".[58] Jung observed that "stage acts of [the] state" are comparable to religious displays:
"Brass bands, flags, banners, parades and monster demonstrations are no different in principle
from ecclesiastical processions, cannonades and fire to scare off demons".[61] From Jung's
perspective, this replacement of God with the state in a mass society led to the dislocation of the
religious drive and resulted in the same fanaticism of the church-states of the Dark Ages—
wherein the more the state is 'worshipped', the more freedom and morality are suppressed;[62] this
ultimately leaves the individual psychically undeveloped with extreme feelings of
marginalization.[63]
Germany, 1933 to 1939
Jung had many friends and respected colleagues who were Jewish and he maintained relations
with them through the 1930s when anti-semitism in Germany and other European nations was on
the rise. However, until 1939, he also maintained professional relations with psychotherapists in
Germany who had declared their support for the Nazi regime and there were allegations that he
himself was a Nazi sympathizer.
In 1933, after the Nazis gained power in Germany, Jung took part in restructuring of the General
Medical Society for Psychotherapy (Allgemeine Ärztliche Gesellschaft für Psychotherapie), a
German-based professional body with an international membership. The society was reorganized
into two distinct bodies:
1. A strictly German body, the Deutsche Allgemeine Ärztliche Gesellschaft für
Psychotherapie, led by Matthias Göring, an Adlerian psychotherapist[64] and a cousin of
the prominent Nazi Hermann Göring;
2. International General Medical Society for Psychotherapy, led by Jung. The German body
was to be affiliated to the international society, as were new national societies being set
up in Switzerland and elsewhere.[65]
C. G. Jung Institute, Küsnacht, Switzerland
The International Society's constitution permitted individual doctors to join it directly, rather
than through one of the national affiliated societies, a provision to which Jung drew attention in a
circular in 1934.[66] This implied that German Jewish doctors could maintain their professional
status as individual members of the international body, even though they were excluded from the
German affiliate, as well as from other German medical societies operating under the Nazis.[67]
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As leader of the international body, Jung assumed overall responsibility for its publication, the
Zentralblatt für Psychotherapie. In 1933, this journal published a statement endorsing Nazi
positions[68] and Hitler's book Mein Kampf.[69] In 1934, Jung wrote in a Swiss publication, the
Neue Zürcher Zeitung, that he experienced "great surprise and disappointment"[70] when the
Zentralblatt associated his name with the pro-Nazi statement.
Jung went on to say "the main point is to get a young and insecure science into a place of safety
during an earthquake".[71] He did not end his relationship with the Zentralblatt at this time, but he
did arrange the appointment of a new managing editor, Carl Alfred Meier of Switzerland. For the
next few years, the Zentralblatt under Jung and Meier maintained a position distinct from that of
the Nazis, in that it continued to acknowledge contributions of Jewish doctors to
psychotherapy.[72]
In the face of energetic German attempts to Nazify the international body, Jung resigned from its
presidency in 1939,[72] the year the Second World War started.
Response to Nazism
Jung's interest in European mythology and folk psychology has led to accusations of Nazi
sympathies, since they shared the same interest.[73][74][75] He became, however, aware of the
negative impact of these similarities:
Jung clearly identifies himself with the spirit of German Volkstumsbewegung throughout this
period and well into the 1920s and 1930s, until the horrors of Nazism finally compelled him to
reframe these neopagan metaphors in a negative light in his 1936 essay on Wotan.[76]
There are writings showing that Jung's sympathies were against, rather than for, Nazism.[c] In his
1936 essay "Wotan", Jung described the influence of Hitler on Germany as "one man who is
obviously 'possessed' has infected a whole nation to such an extent that everything is set in
motion and has started rolling on its course towards perdition."[77][78]
Jung would later say that:
Hitler seemed like the 'double' of a real person, as if Hitler the man might be hiding inside like an
appendix, and deliberately so concealed in order not to disturb the mechanism ... You know you
could never talk to this man; because there is nobody there ... It is not an individual; it is an
entire nation.[79]
In an interview with Carol Baumann in 1948, Jung denied rumors regarding any sympathy for
the Nazi movement, saying:
It must be clear to anyone who has read any of my books that I have never been a Nazi
sympathizer and I never have been anti-Semitic, and no amount of misquotation, mistranslation,
or rearrangement of what I have written can alter the record of my true point of view. Nearly
every one of these passages has been tampered with, either by malice or by ignorance.
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Furthermore, my friendly relations with a large group of Jewish colleagues and patients over a
period of many years in itself disproves the charge of anti-Semitism.[80][d]
Evidence contrary to Jung’s denials has been adduced with reference to his writings,
correspondence and public utterances of the 1930s.[81] His remarks on the superiority of the
"Aryan unconscious" and the “corrosive character” of Freud’s “Jewish gospel” have been cited
as evidence of an anti-semitism “fundamental to the structure of Jung’s thought”.[82]
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