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Section I: Features, Factors, and Characteristics History

Michael Zupancic Peretz Lavie

Charles Dickens' character Joe, from The Pickwick Papers (1835) (3), is described as "a wonderfully fat boy" who falls asleep easily and against his will (Fig. 2). When we first meet Joe, he is standing up asleep after knocking vigorously on a door. When asked why he knocked relentlessly, Joe explains it is to prevent himself from falling asleep. Dickens' description of Joe caught the eye of several physicians who independently coined the term "Pickwickian syndrome." Of these physicians, the most cited is Sir William Osier (4) (Fig. 3). In the eighth edition of his celebrated textbook Principles and Practice of Medicine, published in 1914, he used the term "Pickwickian syndrome" to describe obese and sleepy patients, in homage to Dickens' character Joe.