In DSM-III-R, pica, with anorexia nervosa, bulimia nervosa and rumination disorder of infancy, is accorded the status of a separate eating disorder. However, in the Draft of ICD-10, only anorexia nervosa and bulimia nervosa are listed under eating disorders. Pica in children, and feeding disorder in infancy and childhood, are incorporated with enuresis, encopresis, and feeding, movement and speech disorders in a separate "heterogeneous group of disorders". Extensive research on the history and terminology of eating disorders from the 16th to the 20th century suggests that, historically, pica was regarded as a symptom of other disorders rather than a separate entity. This paper aimed to locate and assess chronologically significant definitions and accounts of pica, to provide a fuller clinical description of a condition which, despite its current relevance, has received little detailed historical examination, and to give some consideration to the multiple aetiological theories which have been put forward. The historical findings are related to the descriptive criteria for pica in DSM-III-R and Draft ICD-10.

SynopsisPost-traumatic stress disorder was first recognized as a diagnostic category embracing reactions in response to overwhelming environmental stress ‘outside the range of usual human experience’ in DSM-III (APA, 1980). Such abnormal stressors are by no means a product of the twentieth century but have featured, sporadically, in all societies from the earliest civilizations. Longitudinal investigations of traumatic stress have rarely gone further back than the nineteenth century, and have been concerned, almost exclusively, with adverse effects following railway accidents and military combat. The present study, utilizing a mid-eighteenth century medical source, presents an analysis of the impact of a natural disaster on members of a peasant family trapped in an avalanche in the Italian Alps in 1755.

SynopsisPagophagia, or the excessive consumption of ice or iced drinks, is popularly regarded as a novel manifestation of pica, which has emerged, predominantly in the USA, over the last 30 years. However, a sampling of historical sources reveals that not only are there warnings in the writings of both Hippocrates and Aristotle concerning the dangers of excessive intake of cold or iced water, but a series of medical works, from the sixteenth century on, incorporate discussion and illustrative case histories about the detrimental effect of immoderate usage of cold water, ice and snow, frequently in the context of disordered eating.

The etymology of the ancient term bulimia is explored, and variant forms are presented from a range of printed works dating from the fifteenth to the eighteenth century. Twelve cases, reported from the seventeenth to the nineteenth century, are described, analyzed, and discussed in terms of symptomatology, theories of causation, and treatment. Evidence is provided that bulimia, in the form of pathological voracity, has been described consistently for centuries. The historical findings are considered in relation to the form and status of the modern syndrome of bulimia nervosa. It is concluded that, for centuries, the symptom of bulimia has been occurring in conjunction with a variety of other symptoms and signs, forming putative syndromes, whose interpretation has been influenced by contemporary social and cultural factors and by developing medical knowledge.