[The scotomas as a metaphor in the work of Oliver Sacks]

INTRODUCTION

The use of medical metaphors is common in the social discourse and in the media. However, the use by physicians themselves to define different concepts to the original meaning of the medical word is rare.

AIM

To analyze the term «scotoma» in its metaphorical sense in the works of the neurologist and writer Oliver Sacks.

DEVELOPMENT

Sacks used scotoma metaphorically in two works, in the autobiographical book A leg to stand on and in an essay Scotoma: forgetting and neglect in science. In the first case, he used it to define the sensorial loss of his leg after an accident, which could be interpreted as a «mental scotoma». In the second case, Sacks analyzed the process and the reasons of forgetting the works of some early scientific discoverers and discussed why this happened. In this case, Sacks made an analogy with the process suffered by scientific discoveries and the reasons why some of them are largely ignored, in a situation that he called «historical» or «social scotoma».

CONCLUSIONS

Sacks does not use the term «scotoma» uniformly. When used to describe the sensorial loss of his leg, it might be considered that scotoma is there a second, although minor but accepted, meaning of the word. However, its use in the definition of historical neglect of early discoveries can be clearly defined as a medical metaphor in full sense.

Phaeohyphomycosis in El Salvador caused by Exophiala spinifera

We identified Exophiala spinifera as the causal agent in a case of subcutaneous phaeohyphomycosis in El Salvador. Identification was based on the morphology of the fungus in tissue and the microscopic features of the culture obtained from the biopsy material. This case is the first of this type to be documented from Central America.