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Every clinician knows that organic diseases often occur under circumstances that make it seem as if the disease served some psychological purposes for the patient. I do not refer to the secondary capitalization of the illness by the patient, with which we are all familiar, seen particularly in the neuroses. Rather I refer to those cases where the illness seems to be, in part, a reaction to a certain event even though the nature of the illness precludes the possibility that such an event alone could have brought on the illness. We know that sore throat is caused by an irritation, usually bacterial; but when a woman who is not subject to them develops a severe sore throat immediately after an episode in which she has maligned the character of a friend, or immediately after a relative has swallowed carbolic acid, or immediately after a fellatio experience, we have reason to suspect a connection which psychoanalytic research may substantiate.
Much work has already been done in this field through the pioneering courage of Smith Ely Jelliffe in this country, and by Felix Deutsch, Georg Groddeck, and others in Europe. In this brief communication I shall not attempt to review the literature. I shall only mention Groddeck's hypothesis, which is that the libido in some way or other pervades the entire body so that the body may accept or reject an infection in accordance with some instinctive demand. Even though this is not entirely scientific it is, at least, stimulating and fruitful because it reconciles the bacteriological theories of resistance and immunity with the psychological theories of self protection and self destruction.
Where should one expect to find more abundant evidence concerning the nature of these unconscious factors in physical disease than in that most prevalent of all infections, the common cold? We do not know how it is caused, how it is communicated, or how it can be cured. We all know its symptoms very well, both subjectively and objectively, but what a