Psychosomatic Medicine in the Nineteenth Century

Abstract

General Theoretical SurveyThe history of medicine has always been intimately involved with the philosophic destiny of the ideas about the interrelations of mind and body. The interactions between the conceptual worlds of the medicine of the body and of the medicine of the mind are largely determined by the prevailing cultural preferences for the resolution of the mind-body complex.Thus, at the beginning of the nineteenth century the organization and use of medical knowledge were significantly conditioned by the existing conceptions of mind-body relationships as well as by the general cultural atmosphere in which the medical theory and practice were being developed. Moreover, although the medicine of the body had appreciably liberated itself from theological and moral restrictions in its freedom of investigation and speculation, the medicine of the mind was still considerably handicapped by being largely bound to religion and to philosophy.From philosophy psychological medicine of the early nineteenth century inherited a longstanding conception of the mind as an organization of faculties with a content of ideas related to each other by associations based on similarity, contiguity, or contrast.The mind-body problem, which is a projection of psychosomatic relations to the metaphysical plane, was formulated largely in terms of two philosophical premises, one of From the Department of Psychiatry, Yale University School of Medicine.Read at the 82nd meeting of the Beaumont Medical Club,

Taking time to smell the roses: Accounts of people with chronic fatigue syndrome and their struggle for legitimisation

“…Some argued that the 'stuff of things was ultimately mental, and that this 'primordial element of consciousness' could become condensed into material things. By contrast, and with the rise of scientific knowledge of the external world, anti-metaphysical interpretations led to unifying approaches tied to a mechanistic model of the body, such as those proposed by Willis and Sydenham (Stainbrook, 1965). Since biomédical knowledge was at this time synonymous with observation of bodily structure and function of each element, physiological description led to such theories as nerves being hollow vessels through which brain fluid was transported around the body (Clarke, 1968cited in Rousseau, 1991.…”

German publications on anorexia nervosa in the nineteenth century

“…In the last quarter of the nineteenth century, the "German school of Magenarzte" (gastric specialists) (Stainbrook, 1952) was quite influential. Concerning the interface between gastric and nervous disorders, both the nosological description and etiological conceptualization of the many digestive complaints were strongly influenced by the then popular notion of "nervous weakness."…”

“…Anorexic patients probably were able to mislead their physicians by emphasizing the digestive difficulties (of which, as we noticed, Stichl rightly remarked that they were consequences rather than causes): gastric pain was an acceptable excuse for refusing nourishment (Shorter, 1987). And the doctors readily accepted this explanation because of their nosological bias: anorexia nervosa was conceived as a form of gastric neurosis, more specifically a sensory neurosis, characterized by a deficiency in hunger sensation (Stainbrook, 1952). Hence, the internists categorized the anorexic behavior as one of the many forms of nervous dyspepsia, a term which, despite growing criticism of its too broad application, was as popular among physicians in general as the notion of neurasthenia among psychiatrists.…”

The Contributions of Psychoanalysis and Psychiatry to Psychosomatic Medicine

“…Von Feuchtersleben in his 'Medical Psychology' (1845) and D aniel H ack T uke, in his book 'The Influence of the Mind on the Body', published in 1872, listed many conditions where the influence of emotion seemed of very great significance in the production of bodily symptoms. But Stainbrook (1952) in his study of psychosomatic medicine in the 19th century, has emphasised that the dominant attitude to the mind-body relationship at that time could be described as somatopsychic, the phrase popularised by J acobi. Theories such as that of reflex irritation advanced by Broussais, which postulated that the primary seat of disease lay in the intestines, or in the genitals, or in any bodily system other than the brain; or concepts of nervous activity derived for the laws of thermo-dynamics, all placed the primary disturbance squarely in bodily organisations.…”