Typhoid spine: somatic versus psychosomatic diagnosis in Osler's time.
Semin Arthritis Rheum
; 28(2): 114-23, 1998 Oct.
Article
in En
| MEDLINE
| ID: mdl-9806372
ABSTRACT
OBJECTIVE:
To review the history of typhoidal spondylitis as a paradigm of conflicts between medical and psychiatric diagnoses.METHODS:
Because William Osler was the principal advocate for a psychogenic cause of this disease, all of his relevant writings are reviewed together with pertinent psychiatric concepts of the late 19th century, as well as the relevant bacteriologic and clinical research.RESULTS:
Bacteriologic research had advanced sufficiently by 1903 that "typhoid spine" could be proved an osteomyelitis. Nevertheless, the belief that at least some cases were manifestations of a traumatic neurosis analogous to "railway spine" persisted, the trauma having been the acute typhoid infection. The last vestiges of this concept were represented by Osler's article of 1919.CONCLUSIONS:
Osler's 25 year struggle to understand typhoidal spondylitis is an example of the persistent tendency of physicians to attribute a psychologic cause to a syndrome, often pejoratively, because of the absence of a sufficient pathophysiologic explanation or reluctance to acknowledge a new concept.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psychophysiologic Disorders
/
Spondylitis
/
Typhoid Fever
Type of study:
Diagnostic_studies
Limits:
Humans
Language:
En
Journal:
Semin Arthritis Rheum
Year:
1998
Document type:
Article
Affiliation country:
United States