Concerning the Psychogenesis of Somatic Disease: Physiological and Neurological Correlations with the Psychological Theory

The validity of the concept implied in the title of this paper must eventually be established or destroyed by the patient accumulation of clinical facts, painstakingly correlated with deep psychological data, and carefully controlled by the study of normal subjects. It is, however, justified, and, we think, valuable, to scrutinize the material already available at this time, and to try to construct from it a consistent theoretical basis for such a concept. We are in this brief essay not so much interested in the part of personality in the total disease reaction6, or the struggle of the personality with disease, concepts which receive increasing and merited recognition, but with the possible rôle of psychic disorder as a major ætiological agent. Such an effort, though it be brief and sketchy of necessity, requires a high degree of freedom in establishing psychical and physiological correlations, and a considerable freedom in interpretation of the scientific work of others, upon which it is almost entirely based. It is, furthermore, inevitable that such an effort include some constructive speculation. Nor is such an effort novel. In recent works on psychopathology, 2, 3 one may find summaries of the opinions of many early and distinguished theorists from which the following paragraphs may not always differ in gross essentials. The neurological approach to the psyche has recently received detailed attention in the work of Smith and Campion.4 The general problem of the psyche, the vegetative nervous system, and somatic disease has recently received abundant thought and