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DELIRIUM: A HISTORICAL NOTE
Delirium is often unrecognized because its defining feature?a disturbance of
consciousness?is overlooked. The patient’s difficulty in sustaining and directing attention may be attributed to benign causes, such as fatigue or lack of sleep, or it may be overshadowed by more dramatic phenomena, such as hallucinations or agitation. Whenever a patient has a change in mental state or behavior, the physician should consider delirium, not only because it is common but also because it is serious. If the physician thinks of delirium and examines her patient accordingly, psychiatric consultation may not be necessary.
A historical note-Medical writers in ancient Greece and Rome knew that febrile and toxic illnesses could be accompanied by abnormalities in cognition, perception, behavior, and mood. Two patterns of abnormality were identified: phrenitis, marked by excitement and insomnia; and lethargus, marked by torpor and sleepiness. Although both could occur in the course of a single illness, they were regarded as separate conditions for some two thousand years. It was only in the nineteenth century that phrenitis and lethargus came to be seen as variants of a single
disorder?delirium?whose hallmark was a disturbance in consciousness produced by
dysfunction of the brain.
*8/172/2*

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