Note 218 — LECTURE XIV THE PHYSIOLOGICAL MANIFESTATIONS OF EMOTION

A good example is that of an extreme “neurasthenic,” who had been reduced to a condition of severe inanition from inability to take a proper amount of food because of failure of digestion, nausea, and vomiting. Examined by numerous and able physicians in this country and Europe, none had been able to recognize any organic disease or the true cause of the gastric difficulty which remained a puzzle. As a therapeutic measure her stomach had been continuously and regularly washed out. Yet it was not difficult to recognize, after analyzing the symptoms and the conditions of their occurrence, that the disturbances of the gastric functions were due to complex mental factors, the chief of which, emotion, inhibited the gastric function, as in Cannon’s experiments, and indirectly or directly, induced the nausea and vomiting. The correctness of this diagnosis was recognized by the attending physician and patient. Sometimes a phobia complicates a true organic disease and produces symptoms which mimic the symptoms of the latter—heart disease, for example. In this case it is often difficult to recognize the purely phobic character of the symptoms. O. H. C. was such a case. Though there was severe valvular disease of the heart, compensation was good and there was little if any cardiac disability. The attacks of dyspnœa and other symptoms were unmistakably the physical manifestation of a phobia of the disease. The phobia had been artificially created by overcautious physicians.