Historical Analyses of Disordered Handwriting

Handwritten texts carry significant information, extending beyond the meaning of their words. Modern neurology, for example, benefits from the interpretation of the graphic features of writing and drawing for the diagnosis and monitoring of diseases and disorders. This article examines how handwriting analysis can be used, and has been used historically, as a methodological tool for the assessment of medical conditions and how this enhances our understanding of historical contexts of writing. We analyze handwritten material, writing tests and letters, from patients in an early 20th-century psychiatric hospital in southern Germany (Irsee/Kaufbeuren). In this institution, early psychiatrists assessed handwriting features, providing us novel insights into the earliest practices of psychiatric handwriting analysis, which can be connected to Berkenkotter’s research on medical admission records. We finally consider the degree to which historical handwriting bears semiotic potential to explain the psychological state and personality of a writer, and how future research in written communication should approach these sources

A Petition Written by Ricardus Franciscus

This article identifies Ricardus Franciscus as the scribe of Kew, The National Archives, C 49/30/19, a petition seeking the exoneration of the late Duke Humphrey of Gloucester. (d. 1447). The authors provide a palaeographical analysis of the "flamboyant, spiky script" of the well-known scribe Franciscus in this document, which support the identification, as well as the linguistic features. The authors situate the petition within what is known about this scribe's life, patrons, and his written output. The article sheds more light on the scribes of medieval petitions which had hitherto been lacking

A History of Dystonia: Ancient to Modern

Before 1911, when Hermann Oppenheim introduced the term dystonia, this movement disorder lacked a unifying descriptor. While words like epilepsy, apoplexy, and palsy have had their meanings since antiquity, references to dystonia are much harder to identify in historical documents. Torticollis is an exception, although there is difficulty distinguishing dystonic torticollis from congenital muscular torticollis. There are, nevertheless, possible representations of dystonia in literature and visual art from the pre-modern world. Eighteenth century systematic nosologists such as Linnaeus, de Sauvages, and Cullen had attempted to classify some spasmodic conditions, including torticollis. But only after Charcot's contributions to clinical neuroscience were the various forms of generalized and focal dystonia clearly delineated. They were categorized as névroses: Charcot's term for conditions without an identifiable neuroanatomical cause. For a time thereafter, psychoanalytic models of dystonia based on Freud's ideas about unconscious conflicts transduced into physical symptoms were ascendant, although there was always a dissenting “organic” school. With the rise of subspecialization in movement disorders during the 1970s, the pendulum swung strongly back toward organic causation. David Marsden's clinical and electrophysiological research on the adult-onset focal dystonias was particularly important in establishing a physical basis for these disorders. We are still in a period of “living history” of dystonia, with much yet to be understood about pathophysiology. Rigidly dualistic models have crumbled in the face of evidence of electrophysiological and psychopathological overlap between organic and functional dystonia. More flexible biopsychosocial frameworks may address the demand for new diagnostic and therapeutic rationales

How to use pen and paper tasks to aid tremor diagnosis in the clinic

When a patient presents with tremor, it can be useful to perform a few simple pen and paper tests. In this article, we explain how to maximise the value of handwriting and of drawing Archimedes spirals and straight lines as clinical assessments. These tasks take a matter of seconds to complete but provide a wealth of information that supplements the standard physical examination. They aid the diagnosis of a tremor disorder and can contribute to its longitudinal monitoring. Watching the patient’s upper limb while they write and draw may reveal abnormalities such as bradykinesia, dystonic posturing and distractibility. The finished script and drawings can then be evaluated for frequency, amplitude, direction and symmetry of oscillatory pen movements and for overall scale of penmanship. Essential, dystonic, functional and parkinsonian tremor each has a characteristic pattern of abnormality on these pen and paper tests

Chapter 9 “Nonsense Rides Piggyback on Sensible Things”

“Nonsense rides piggyback on sensible things”, declares professional sceptic and questioned-document analyst Joe Nickell concerning graphology. This chapter examines graphology’s enduring allure and reach, despite its controversies, and considers its relationship with other types of handwriting analysis. It first asks: is it possible to metaphorically “dissect” the page of handwritten texts, to scrutinize writing as a “medical paratext” rich in information about the writer’s state of health? It then interrogates the nature of the connection between physical and mental states and handwriting. It demonstrates how academics are going “back to basics” with their enquiries into individual difference and handwriting features, and how digital methodologies are contributing to this. Thus, this chapter is an updated study of graphology, providing a wider understanding of the concept of the paratext by considering the information captured in handwriting in the context of a digital age

Health at the writing desk of John Ruskin: a study of handwriting and illness

Though John Ruskin (1819 – 1900) is remembered principally for his work as a theorist, art critic, and historian of visual culture, he wrote exhaustively about his health in his correspondence and diaries. Ruskin was prone to recurring depressive and hypochondriacal feelings in his youth and adulthood. In 1871, at the age of 52, he developed an illness with relapsing psychiatric and neurological features. He had a series of attacks of brain disturbance, and a deterioration of his mental faculties affected his writing for years before curtailing his career a decade before he died. Previous writers have suggested he had a psychiatric malady, perhaps schizophrenia or schizo-affective disorder. But the more obvious conclusion from a close medical reading of Ruskin’s descriptions of his illness is he had some sort of ‘organic’ brain illness. This paper aims to give insight into the relationship between Ruskin’s state of wellbeing and the features of his writing through a palaeographical study of his letters and diary entries. We examine the handwriting for physical traces of Ruskin’s major brain illness, guided by the historical narrative of the illness. We also examine Ruskin’s recording of his experiences for what they reveal about the failure of his health and its impact on his work. Ruskin’s handwriting does not have clear-cut pathological features before around 1885, though suggestions of subtle writing deficits were present as early as 1876. After 1887, Ruskin’s handwriting shows fixed pathological signs—tremor, disturbed letter formation and features that reflect a slow and laborious process of writing. These observations are more than could be explained by normal ageing, and suggest the presence of a neurological deficit affecting writing control. Our findings are consistent with conclusions that we drew from the historical record—that John Ruskin had an organic neurological disorder with cognitive, behavioural, psychiatric, and motor effects

Heated Words : The Politics and Poetics of Work in 'A Complaint against Blacksmiths'

‘A Complaint against Blacksmiths’, unique to BL, MS Arundel 292, may gesture towards fourteenth-century legislation against night-time work, yet is underpinned by delight in the sights and sounds of the forge. The smith’s smoke-smattered visage is simultaneously disgraceful and inspiring to its medieval audience. Many of us experience a different kind of unease in the digital age, as hours are converted into immaterial goods. For many, the clamour of physical labour has been replaced by the noise of automation. Looking back into the forge, the modern urban worker may yearn for its sonic landscape, with clattering hammers, grunting mouths, and hissing waters

‘I Haue Ben Crised and Besy’ : Illness and Resilience in the Fifteenth-Century Stonor Letters

The modern and medieval meanings of words reporting ill health often bear little resemblance to one another. This article compares the use of ‘diseased’ and ‘sick’ in the fifteenth-century Stonor family letters. It examines the word ‘crased’, which implies physical ill health most directly, but also suggests emotional, psychological, or spiritual distress in female family members especially. The article then turns to the practical implications of poor health, asking how and why it affected the day-to-day concerns of the Stonors and their associates. It uncovers compelling evidence for resilience in the face of many and competing calls of duty. Finally, the article presents unique palaeographical evidence for the impact of illness, where a correspondent is so ‘seke’ that he can scarcely hold his pen

Adaptation of the Lateral Distal Femur DXA Scan Technique to Adults With Disabilities

AbstractThe technique that best addresses the challenges of assessing bone mineral density in children with neuromuscular impairments is a dual-energy X-ray absorptiometry (DXA) scan of the lateral distal femur. The purpose of this study was to adapt this technique to adults with neuromuscular impairments and to assess the reproducibility of these measurements. Thirty-one adults with cerebral palsy had both distal femurs scanned twice, with the subject removed and then repositioned between each scan (62 distal femurs, 124 scans). Each scan was independently analyzed twice by 3 different technologists of varying experience with DXA (744 analyses). Precision of duplicate analyses of the same scan was good (range: 0.4%–2.3%) and depended on both the specific region of interest and the experience of the technologist. Precision was reduced when comparing duplicate scans, ranging from 7% in the metaphyseal (cancellous) region to 2.5% in the diaphyseal (cortical) region. The least significant change was determined as recommended by the International Society for Clinical Densitometry for each technologist and each region of interest. Obtaining reliable, reproducible, and clinically relevant assessments of bone mineral density in adults with neuromuscular impairments can be challenging. The technique of obtaining DXA scans of the lateral distal femur can be successfully applied to this population but requires a commitment to developing the necessary expertise

Autism spectrum disorders in boys at a major UK hemophilia center: prevalence and risk factors

Background: Autism spectrum disorders (ASDs) are diagnosed by social communication difficulties strong, narrow interests, and repetitive stereotyped behavior. An apparently-elevated prevalence of ASD at a major UK hemophilia center warranted investigation. Objectives: To screen boys with hemophilia for difficulties in social communication and executive function and identify the prevalence and risk factors for ASD. Methods: Parents of boys with hemophilia aged 5 to 16 years completed the Social Communication Questionnaire, Children’s Communication Checklist, and the Behavior Rating Inventory of executive function. Prevalence and potential risk factors for ASD were evaluated. Boys with an existing diagnosis of ASD did not complete questionnaires, but were included in the prevalence analysis. Results: Negative scores on all 3 questionnaires were observed for 60 of 79 boys. Positive scores on 1, 2, and 3 questionnaires were seen in 12 of 79, 3 of 79, and 4 of 79 boys, respectively. In addition to the 11 of 214 boys with a prior ASD diagnosis, 3 further boys were diagnosed with ASD, yielding a prevalence of 14 (6.5%) of 214, greater than that of boys in the UK general population. Premature birth was linked to having ASD, but did not fully explain the increased prevalence with more boys born <37 weeks scoring positively on the Social Communications Questionnaire and Children’s Communication Checklist compared with those born at term. Conclusion: This study identified an increased prevalence of ASD at 1 UK hemophilia center. Prematurity was identified as a risk factor but did not fully explain the higher prevalence of ASD. Further investigation in the wider national/global hemophilia communities is warranted to determine whether this is an isolated finding