Target Health Blog


July 2, 2018

History of Medicine

The Crying Boy, by Italian painter, Giovanni Bragolin
Source: Fair use,
The original Angel of Grief in Rome, a 1894 sculpture by William Wetmore Story which serves as the grave stone of the artist and his wife Emelyn at the Protestant Cemetery, Rome. Photo credit: LuciusCommons, Public domain. I, the copyright holder of this work, release this work into the public domain. This applies worldwide. I grant anyone the right to use this work for any purpose, without any conditions, unless such conditions are required by law.

Angel of Grief or the Weeping Angel is an 1894 sculpture by William Wetmore Story for the grave of his wife Emelyn Story at the Protestant Cemetery in Rome. Its full title bestowed by the creator was The Angel of Grief Weeping Over the Dismantled Altar of Life. This was Story's last major work prior to his death, which happened one year after his wife. The statue's creation was documented in an 1896 issue of Cosmopolitan Magazine: according to this account, his wife's death so devastated Story that he lost interest in sculpture but was inspired to create the monument by his children, who recommended it as a means of memorializing the woman. Unlike the typical angelic grave art, “this dramatic life-size winged figure speaks more of the pain of those left behind“ by appearing “collapsed, weeping and draped over the tomb.“ The term is now used to describe multiple grave stones throughout the world erected in the style of the Story stone. A feature in The Guardian called the design “one of the most copied images in the world“. Story himself wrote that “It represents the angel of Grief, in utter abandonment, throwing herself with drooping wings and hidden face over a funeral altar. It represents what I feel. It represents Prostration. Yet to do it helps me.“

Humans are the only living creature that weeps.

In Hippocratic and medieval medicine, tears were associated with the bodily humors, and crying was seen as purgation of excess humors from the brain. William James thought of emotions as reflexes prior to rational thought, believing that the physiological response, as if to stress or irritation, is a precondition to cognitively becoming aware of emotions such as fear or anger. This connection between weeping and excretion was common in Europe in 1586, when the English clergyman and physician Timothie Bright wrote an influential Treatise of Melancholie, whose many readers probably included Shakespeare, which described tears as a ?kinde of excrement not much unlike' urine. In a poem called ?A Lady Who P-st at the Tragedy of Cato', Alexander Pope lampooned Joseph Addison's celebrated play, Cato: A Tragedy (1712) by describing a woman who responds to the drama with copious urine rather than the expected tears:

While maudlin Whigs deplor'd their Cato's Fate,

Still with dry Eyes the Tory Celia sate,

But while her Pride forbids her Tears to flow,

The gushing Waters find a Vent below:

Tho' secret, yet with copious Grief she mourns,

Like twenty River-Gods with all their Urns.

Let others screw their Hypocritick Face,

She shews her Grief in a sincerer Place;

There Nature reigns, and Passion void of Art,

For that Road leads directly to the Heart.

This old idea has been reinforced by modern science in the last century and a half. In recent decades, the most widely quoted theorist of tears has been the American biochemist William H Frey II who, since the 1980s, has been arguing that the metaphor of weeping as excretion should be taken quite literally. In an interview with The New York Times in 1982, Frey claimed that crying is ?an exocrine process' which, ?like exhaling, urinating, defecating and sweating' releases toxic substances from the body - in this case, so-called ?stress hormones'.

An anonymous British pamphlet from 1755, Man: A Paper for Ennobling the Species, proposed a number of ideas for human improvement, and among them was the idea that something called “moral weeping“ would help:

We may properly distinguish weeping into two general kinds, genuine and counterfeit; or into physical crying and moral weeping. Physical crying, while there are no real corresponding ideas in the mind, nor any genuine sentimental feeling of the heart to produce it, depends upon the mechanism of the body: but moral weeping proceeds from, and is always attended with, such real sentiments of the mind, and feeling of the heart, as do honour to human nature; which false crying always debases.

In his “Confessions,“ St. Augustine implored God to explain “why weeping is sweet to the miserable.“ Religious traditions honor the gift of tears and have found ways to ritualize it. During the Passover Seder, when Jews remember their escape from Egypt, they bring salt water to their lips to symbolize the tears of bondage. In ancient times, when a person died, mourners put their tears in bottles and sometimes even wore them around their necks. Over the ages, the weeping of tears has been a sign of the mystical experiences of saints and repentant sinners. These transcendent moments go beyond what the mind can comprehend; tears are a response of the heart. The question had never been asked in quite that way. Charles Darwin, in “The Expression of the Emotions in Man and Animals“ (1872), speculated that we weep in times of mental distress because of an accidental mechanical relationship between the act of squalling and the production of tears. When an infant wails, Darwin argued, it causes such an engorgement of blood vessels and general pressure around the eye that the lachrymal glands are affected “by reflex action.“ Several millennia's worth of babies later, “it has come to pass that suffering readily causes the secretion of tears, without being necessarily accompanied by any other action.“ Though Darwin was aware that emotional weeping produces a sense of solace, he believed the tears themselves to be “an incidental result; purposeless.“ Darwin noted that tears could not be neatly associated with any single kind of mental state. They can be secreted ?in sufficient abundance to roll down the cheeks', he wrote, ?under the most opposite emotions, and under no emotion at all'. A tear on its own means nothing. A tear shed in a particular mental, social, and narrative context, can mean anything. ?Tears, idle tears,' wrote the English poet, Alfred Tennyson, ?I know not what they mean.' Yet he, and we, continue to feel compelled to interpret them, to try to distil their meaning. The intellectual climate was not conducive to further inquiry. Crying was, at least in part, a social behavior; and according to prevailing notions of cultural relativism then in vogue, it was therefore a matter of social conditioning. “One weeps,“ wrote French sociologist Emile Durkheim in 1915, “not simply because he is sad but because he is forced to weep. It is a ritual attitude he is forced to adopt out of respect for custom.“

There have been many attempts to differentiate between the two distinct types of crying: positive and negative. Different perspectives have been broken down into three dimensions to examine the emotions being felt and also to grasp the contrast between the two types. Spatial perspective explains sad crying as reaching out to be “there“, such as at home or with a person who may have just died. In contrast, joyful crying is acknowledging being “here.“ It emphasized the intense awareness of one's location, such as at a relative's wedding. Temporal perspective explains crying slightly differently. In temporal perspective, sorrowful crying is due to looking to the past with regret or to the future with dread. This illustrated crying as a result of losing someone and regretting not spending more time with them or being nervous about an upcoming event. Crying as a result of happiness would then be a response to a moment as if it is eternal; the person is frozen in a blissful, immortalized present. The last dimension is known as the public-private perspective. This describes two types of crying as ways to imply details about the self as known privately or one's public identity. For example, crying due to a loss is a message to the outside world that pleads for help with coping with internal sufferings. Or, as Arthur Schopenhauer suggested, sorrowful crying is a method of self-pity or self-regard, a way one comforts oneself. Joyful crying, in contrast, is in recognition of beauty, glory, or wonderfulness.

Anthropologist Ashley Montagu found such explanations inadequate. As for Darwin's squeeze-reflex theory, he wrote in 1959, the same evolutionary outcome “might have occurred in any number of other species possessing the necessary lacrimal and orbicular muscles. How, then, has it come about that weeping occurs in man alone?“ Montagu noted that “as is well known, human infants do not usually cry with tears until they are about six weeks of age. Weeping, then, would appear to be both phylogenetically and ontogenetically a late development in the human species“ -- that is, it came about as late in our evolution as a species as it does in each individual's growth. (Though well before laughter, which arrives at about five months.) That timing suggested that weeping was somehow an adaptive trait. Working from Darwin's own notion of natural selection, Montagu then postulated an evolutionary argument: We cry now because our ancient forebears tended to live longer the more abundantly they wept. Babies breathe heavily when they cry, Montagu argued, and consequently “even a short session of tearless crying in a young infant is likely to dry out the mucous membranes of the nose and throat, rendering the child vulnerable to the invasion of harmful bacteria and, probably, viruses.“

Tears, however, contain an enzyme called lysozyme (discovered by Alexander Fleming in 1922), which within five or 10 minutes will destroy the cell walls of as much as 95% of those bacteria. And thanks to an intricate plumbing scheme, the liquid drains directly onto the imperiled membranes: From the glands under the upper eyelid, down into the canal at the inside corner of the eye, and thence into the nasolacrimal duct which empties into the nasal cavity. Thus, Montagu argued, those primordial infants who were least able to produce tears would have been the most prone to infection and early death, and therefore the least likely to pass on their genetic characteristics-leaving “the perpetuation of the species increasingly to those who could weep.“ Biochemist, William H. Frey PhD, who is director of the Dry Eye and Tear Research Center at the St. Paul-Ramsey Medical Center, first began studying tears in the 1980s. When he came across Montagu's explanation, he wondered: If emotional weeping serves such an essential life-sustaining purpose, then “why hasn't nature provided this protection during the first critical days and weeks of life?“ In addition, how would one explain the fact that humans frequently cry without an increase in breathing rate? Or that tears customarily precede gasping or sobbing? Frey had been intrigued by stress researcher Hans Selye's notion of homeostasis -- the process whereby the body attempts to maintain an internal biochemical equilibrium in the face of disruptive stimuli and hostile shocks. Might not tears serve this purpose by purging certain chemicals produced by emotional stress? In 1959, psychiatrist, Thomas Szasz MD postulated that weeping represented an unconscious regression to the prenatal state in which the body is bathed in amniotic fluid. Weeping, then, was a regressive fantasy of return to the saline wetness of the womb.

Emotional tears were chemically different, containing 21% more protein, among other substances. Since then, research has concentrated on three of them: Leucine-enkephalin, a brain chemical of the family called endorphines, which are thought to affect pain sensations; a pituitary hormone known as ACTH; and another pituitary hormone, prolactin, which stimulates milk production in mammals. Tears may also serve a therapeutic role, though researchers say the supposedly cathartic role of “a good cry“ has been overstated. Thirty years ago, biochemist Frey found that emotional tears carried more protein than non-emotional tears (say, from chopping an onion). The implication was that when you cry for emotional reasons, you are involved in a healing process.

The inability to cry:

Psychologists have also gleaned new insights into people who can't produce tears at all - either emotional or the basal tears that keep eyes lubricated. Some say that ophthalmologists have typically treated ?dry eye' as a medical issue, completely missing the fact that emotional communication is impaired when you lack tears. Patients with Sjogren's syndrome, for example, have great difficulty producing tears. A study found that 22% of patients with the syndrome had significantly more difficulty identifying their own feelings than control participants did.

Sources: http://www.apa.orgwww.washingtonpost.com;; Wikipedia

For our readers:

For your listening pleasure, a work of pure brilliance:

An artist, beyond genius, enabling the mysteries of the universe to become manifest in glorious music, and through us, the listeners, complete a circuit, still not explained by neuroscience.

W.A. Mozart: Requim, Lacrimosa

Full Requiem Mozart REQUIEM KV 626 conducted by Leonard Bernstein in Salzburg, Germany

David Garrett, violin version - Lacrimosa

Mozart, Lacrimosa, Organ

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