Relationships Between Emotional States and Organic Disease.

Every physician recognizes the existence of symptoms produced by emotional strain. The significance of these symptoms, however, is very differently interpreted by psychiatrist, internist and physiologist. To the psychiatrist, functional symptoms represent an escape mechanism through which the patient finds justification for past failure or reason for withdrawal from future situations which hold for him an element of danger. For the psychiatrist the little boy's stomach-ache in the early school-morning represents a mechanism, unconsciously produced, which if successful eliminates the necessity of school for that day. Its purpose accomplished, the symptom disappears. From this point of view every emotionally produced symptom is an excuse. Although for secondary reasons the type of symptom presented would interest the psychiatrist, his essential emphasis would be laid on the possible advantage to the patient resulting from the symptom. Until recently the physician has in his turn overemphasized the "organic" one might say the "anatomic" aspect of the picture. He has divided his cases into compartments according to the organ chiefly affected, labeling some "nervous stomach," others "nervous heart," etc. Although he has taken some interest in the physiology, and has studied his cases by X-ray, gastric analysis or electrocardiogram, gross defects disproven, his interest has often waned both in the organ under investigation, and, too often, in the patient himself. "There is nothing wrong," he has said; "go away and forget it" (parenthetically he has added "in any case, go away!"). For the past twenty years a few physiologists have been asking themselves whether anything happens to the organs of the body in the presence of emotional tension and have brought evidence to prove