'The voice of the stomach': the mind, hypochondriasis and theories of dyspepsia in the nineteenth century.

Physicians and surgeons during the nineteenth century were eager to explore the causes of stomach and intestinal illnesses. Theories abounded that there was a sympathy between the mind and the body, especially in the case of the dyspepsia. The body was thought to have physical symptoms from the reactions of the mind, especially in the case of hypochondriasis. Digestive problems had a mental component, but mental anguish could also result from physical problems. Dissertations from aspiring as well as established physicians probed the mental causes of irritable bowel diseases and other diseases in the medical literature. Healing was thought to come from contextualizing the link between the problems of the mind and the resulting physical problems of the body.

Noddle Pox: Syphilis and the Conception of Nosomania/Nosophobia (c. 1665-c. 1965).

Hypochondriac or phobic reactions to venereal disease, specifically syphilis, have invited over three centuries of medical reification and nosological reframing. This bibliographic overview establishes that the early specification and psychiatricization of early modern concepts of melancholy and hypochondriasis, imaginary syphilis or syphilophobia, animated the early respective territorializations of venereology, infectiology more broadly, neurology, and mental medicine. Together with mercuriophobia and a wider emergent clinical sensitivity to sexual angst, the diagnosis, while evidently only sporadically made, functioned as a durable soundboard in the confrontation of emergent medical rationale with various confounders and contenders: medically literate and increasingly mobile but possibly deluded patients; charlatans and putative malpractitioners; self-referral laboratory serology (after 1906); and eventually, through psychoanalysis, the patient's unconscious. Requiring medical psychology early on, syphilology became and remained self-conscious and circumspect, attentive to the casualties of overdiagnosis, overtreatment, and iatrogenesis. Finally, patient apprehension led to makeshift forms of "moral treatment," including fear-instilling and placebos.

Authenticity and Fashionable Disease in Eighteenth-Century Britain.

Throughout the eighteenth century the issue of authenticity shaped portrayals of fashionable diseases. From the very beginning of the century, writers satirized the behavior of elite invalids who paraded their delicacy as a sign of their status. As disorders such as the spleen came to be regarded as "fashionable," the legitimacy of patients' claims to suffer from distinguished diseases was called further into question, with some observers questioning the validity of the disease categories themselves. During the early and middle decades of the century, criticism was largely confined to periodicals, plays, and poetry, while medical writers wrote in defense of the authenticity of such conditions. The adoption of fashionable ailments and nervous sensibility grew increasingly popular, however, and from the 1770s onwards practitioners and novelists increasingly suggested that such diseases should not be trusted as signifiers of personal qualities or social status.

The real malady of Marcel Proust and what it reveals about diagnostic errors in medicine.

Marcel Proust, author of À La Recherche du Temps Perdu, was considered a hypochondriac not only by the numerous specialists he consulted during his lifetime but also by every literary critic who ventured an opinion on his health, among them several clinicians. However, Proust's voluminous correspondence, as detailed in its attention to his every symptom as his novel, provides valuable clues to Proust's real, organic, and rare illness. Proust, in fact, was not only genuinely ill but far sicker than he even he believed, most likely suffering from the vascular subtype of Ehlers-Danlos Syndrome. Ironically, Proust's own doctors and his clinician-critics replicated the same kinds of diagnostic errors clinicians still routinely make today, shedding light on the plight of patients with rare illnesses.

[Chateaubriand and contemporary medicine]. / Chateaubriand et la médecine de son temps.

The author reviews the situation of medicine in the time of Chateaubriand, then his attitude toward this art and its practitioners, then his own pathology, psychological as well as somatic.

Cullen, a cautionary tale.

Some ideas return after the briefest of exiles: reductionism is back in vogue. Existential questions - about who we are, about our origins and future, about what is valuable - no longer require difficult soul searching, especially when straightforward answers are expected from the neurosciences. History is being rewritten with the brain as its centrepiece; the search for great men and big ideas of the past begins again. William Cullen (1710-90), whose work on neurosis was once part of the history of psychoanalysis, is now well placed to become part of such a neuro-history. This article attempts to subvert this process, by rebuilding the original meaning of neurosis through Cullen's physiological and medical works, in comparison with his predecessor, Robert Whytt (1714-66), and illustrating this meaning using one particular neurosis: hypochondriasis. The result is a more complicated version of neurosis which, importantly, carries significant insights into the nature and practice of medicine. Moreover, this article examines how Cullen's standing fell in the 1820s as British physicians and surgeons turned to an idea which promised to reform medicine: pathological anatomy. When these hopes faded, Cullen became a figure obsessed with the nerves. This image has survived to the present, a blank canvas onto which any theory can be projected. It also values precisely what Cullen warned against: simplistic explanations of the body and disease, and unthinking confidence in the next big idea or silver bullet. Neurosis was not simply a nervous ailment, but it is a warning against reductionism in history making.

Dubois d'amiens e a sua concepção sistemática da hipocondria e da histeria na França / Dubois d'amiens and his systematic conception of hypochondria and hysteria in France / Dubois d'amiens et sa conception systématique de l'hypocondrie et de l'hystérie en France / Dubois d'amiens y su concepción sistemática de la hipocondría y de la histeria en Francia

Frédéric Dubois d'Amiens foi o vencedor do concurso da Sociedade Real de Medicina de Bordeaux em 1830, graças à apresentação da sua tese intitulada "História filosófica da hipocondria e da histeria". De um ponto de vista existencial, sistemático e por meio de um método histórico-filosófico, ele propõe uma descrição inédita da hipocondria, pois descreve passo a passo a constituição do sujeito afetado, revolucionando assim as concepções médicas e psicopatológicas dessa doença. Apesar das diversas críticas que lhe são apontadas, Dubois d'Amiens reconhece à hipocondria, desde 1830, um sofrimento psíquico e físico específico e vê nela uma forma de pensar, enquanto que Freud a classificará mais tarde como uma neurose atual.

In 1830, Frédéric Dubois d'Amiens won a selection process at the Royal Medical Society of Bordeaux with his thesis entitled "Philosophical history of hypochondriasis and hysteria." From an existential and systematic point of view and based on historical-philosophical methodology, the author presents an unpublished description of hypochondriasis by describing, step-by-step, the constitution of the individual suffering from this affection, thus revolutionizing medical and psychopathological conceptions of the disease. Despite severe criticism of his positions, in 1830 Dubois d'Amiens recognized hypochondriasis as a specific psychological and physical disturbance and described it as a way of thinking. Only much later did Freud classify it as an actual neurosis.

En 1830, Frédéric Dubois d'Amiens remporte le concours de la Société Royale de Médecine de Bordeaux en soutenant son Mémoire intitulé "Histoire Philosophique de l'Hypochondrie et de l'Hystérie". Sous l'angle existentiel et systématique et en s'appuyant sur une méthode historico-philosophique, il propose une description inédite de l'hypocondrie en décrivant pas à pas la constitution de l'individu hypocondriaque, révolutionnant ainsi les conceptions médicales et psychopathologiques de cette affection. Malgré les nombreuses critiques qui lui ont été adressées, Dubois d'Amiens reconnaît à l'hypocondrie dès 1830 une souffrance psychique et physique spécifique et voit en elle une manière de penser, tandis que Freud verra en elle des années plus tard une névrose actuelle.

Frédéric Dubois d'Amiens es el ganador de la competencia de la Real Sociedad de Medicina de Burdeos en 1830, con la presentación de su tesis intitulada "Historia filosófica de la hipocondría y de la histeria". Desde un punto de vista existencial, sistemático y a través un método histórico-filosófico, propone una descripción inédita de la hipocondría, pues describe paso a paso la constitución del individuo afectado, revolucionando así las concepciones médicas y psicopatológicas de esa enfermedad. A pesar de las varias críticas que le son apuntadas, Dubois d'Amiens reconoce la hipocondría desde 1830 como un sufrimiento psíquico y físico específico y la ve como una forma de pensar, mientras que Freud la clasificará mas tarde como una neurosis actual.

Dubois d'Amiens e a sua concepção sistemática da hipocondria e da histeria na França / Dubois d'Amiens and his systematic conception of hypochondria and hysteria in France / Dubois d'Amiens et sa conception systématique de l'hypocondrie et de l'hystérie en France / Dubois d'Amiens y su concepción sistemática de la hipocondría y de la histeria en Francia

Frédéric Dubois d'Amiens foi o vencedor do concurso da Sociedade Real de Medicina de Bordeaux em 1830, graças à apresentação da sua tese intitulada "História filosófica da hipocondria e da histeria". De um ponto de vista existencial, sistemático e por meio de um método histórico-filosófico, ele propõe uma descrição inédita da hipocondria, pois descreve passo a passo a constituição do sujeito afetado, revolucionando assim as concepções médicas e psicopatológicas dessa doença. Apesar das diversas críticas que lhe são apontadas, Dubois d'Amiens reconhece à hipocondria, desde 1830, um sofrimento psíquico e físico específico e vê nela uma forma de pensar, enquanto que Freud a classificará mais tarde como uma neurose atual.(AU)

In 1830, Frédéric Dubois d'Amiens won a selection process at the Royal Medical Society of Bordeaux with his thesis entitled "Philosophical history of hypochondriasis and hysteria." From an existential and systematic point of view and based on historical-philosophical methodology, the author presents an unpublished description of hypochondriasis by describing, step-by-step, the constitution of the individual suffering from this affection, thus revolutionizing medical and psychopathological conceptions of the disease. Despite severe criticism of his positions, in 1830 Dubois d'Amiens recognized hypochondriasis as a specific psychological and physical disturbance and described it as a way of thinking. Only much later did Freud classify it as an actual neurosis.(AU)

En 1830, Frédéric Dubois d'Amiens remporte le concours de la Société Royale de Médecine de Bordeaux en soutenant son Mémoire intitulé "Histoire Philosophique de l'Hypochondrie et de l'Hystérie". Sous l'angle existentiel et systématique et en s'appuyant sur une méthode historico-philosophique, il propose une description inédite de l'hypocondrie en décrivant pas à pas la constitution de l'individu hypocondriaque, révolutionnant ainsi les conceptions médicales et psychopathologiques de cette affection. Malgré les nombreuses critiques qui lui ont été adressées, Dubois d'Amiens reconnaît à l'hypocondrie dès 1830 une souffrance psychique et physique spécifique et voit en elle une manière de penser, tandis que Freud verra en elle des années plus tard une névrose actuelle.(AU)

Frédéric Dubois d'Amiens es el ganador de la competencia de la Real Sociedad de Medicina de Burdeos en 1830, con la presentación de su tesis intitulada "Historia filosófica de la hipocondría y de la histeria". Desde un punto de vista existencial, sistemático y a través un método histórico-filosófico, propone una descripción inédita de la hipocondría, pues describe paso a paso la constitución del individuo afectado, revolucionando así las concepciones médicas y psicopatológicas de esa enfermedad. A pesar de las varias críticas que le son apuntadas, Dubois d'Amiens reconoce la hipocondría desde 1830 como un sufrimiento psíquico y físico específico y la ve como una forma de pensar, mientras que Freud la clasificará mas tarde como una neurosis actual.(AU)

Hypochondria as withdrawal and comedy as cure in Dr. Willibald's Der Hypochondrist (1824).

Balthasar von Ammann's comedy Der Hypochondrist, published in 1824 under the pseudonym Dr. Willibald, foregrounds the social, sexual, and political implications of hypochondria. The play engages with early nineteenth-century medical and popular conceptions of hypochondria to co-opt potentially subversive elements and to promote a specific social, sexual, and political agenda. The text promotes literature ­ specifically comedic drama ­ as a cure for hypochondria. Hypochondria functions as a code for withdrawal. The hypochondriac withdraws medically from healthy society, gaining exceptional status. He withdraws sexually from society by remaining a bachelor, possibly engaged in non-normative sexual behaviour. Furthermore, the politically disenfranchised protagonist voices his political frustrations via a coded medical metaphor. The hypochondriac poses a threefold challenge to the social, sexual, and political order, and the play engages with contemporary conceptions of the disease to provide the solution: comedy. The text, presented as a cure for hypochondria, replaces the coded questioning of the social order via hypochondria with the less threatening code of heraldry. A comedy-within-the-comedy uses the hypochondriac's love of heraldry to cure him, resulting in the elimination of his medical problems and exceptional status, in the purification of his bachelorhood from non-normative elements, and in the pre-emption of political frustrations.

Did Herbert Spencer have reading epilepsy?

Herbert Spencer, the nineteenth-century philosopher, has frequently been dismissed as a "fantastical hypochondriac" (as his most recent biographer, Mark Francis, terms him). Yet he left a record in his Autobiography of symptoms that suggest a very different diagnosis. Abruptly at age 35, he found that the activity of reading, previously indulged in without difficulty, triggered paroxysmal episodes of disturbing "head-sensations" including "giddiness" (so Spencer described them); these severely curtailed his ability to carry out his philosophical studies. Of all possible explanations for such episodes, none seems as likely as reading epilepsy. Enduring preconceptions about Spencer's presumed neurosesmay have kept modern historians from appreciating that Spencer suffered from a legitimate, if esoteric, neurological malady.

[Frederic Dubois D'Amiens, physician-philosopher. An example of the thought of the Royal Society of Medicine of Bordeaux in 1830]. / Frederic dubois d'Amiens, médecin-philosophe. L'exemple de la question de la Société Royale de Médecine de Bordeaux de 1830.

Frédéric Dubois d'Amiens (1799-1873) was perpetual secretary of the Academy of Medicine between 1847 and 1873. He remained famous in the history of the medicine for his Praises as well as for his criticism of the animal magnetism. But people often do not know that he won in 1830 the competition of the Royal Society of Medicine of Bordeaux concerning the distinction of hypochondria and hysteria. Nevertheless, the winning report, published in 1833 under the title A Philosophical history of hypochondria and hysteria, is the most accomplished work of Dubois d'Amiens, both by the development of an unexpected historical and philosophical method and by the new description which he gives of hypochondria. It is from this work that we wish to pay tribute to Dubois d'Amiens.

Acerca del delirio hipocondríaco en las Parafrenias: una revisión historiográfica y clínica / Hypochondriacal delusions in paraphrenias: a historiographical and clinical review

Las ideas delirantes hipocondríacas constituyen un síntoma de eventual aparición en las psicosis crónicas. Algunos autores han planteado la existencia de un cuadro delirante crónico, la Parafrenia Hipocondríaca, en el que este tipo de ideación delirante constituye el síntoma cardinal. En el presente trabajo se evalúa la validez nosológica de la Parafrenia Hipocondríaca y su independencia de las demás formas de Parafrenias. Para esto, se realizó una revisión histórica de la posición de la sintomatología delirante hipocondríaca desde las definiciones originales de Laségue y Griesinger hasta la descripción de la Parafrenia Hipocondríaca por Karl Leonhard. Se presentan tres casos de pacientes con el diagnóstico de Parafrenia Hipocondríaca. Concluimos que la Parafrenia Hipocondríaca representa un constructo teórico válido y útil en la discriminación de los diferentes estados delirantes crónicos.

Hypochondriacal delusions may eventually appear in chronic psychosis. Some authors have proposed the existence of a chronic delusional disease named Hypochondriacal Paraphrenia in which these delusions constitute its main feature. In the present article we discuss the nosological validity of the Hypochondriacal Paraphrenia and its independence from other subtypes of Paraphrenias. With this aim, an historical review of the position of the hypochondriacal symptomatology was performed form the original definitions of Lasegue and Griesinger to the description of the Hypochondriacal Paraphrenia by Karl Leonhard. Then, three cases of patients with the diagnosis of Hypochondriacal Paraphrenia are presented. We conclude that the Hypochondriacal Paraphrenia is a valid and useful nosological construct.