JAMA. 1954;154(16):1352-1353. doi:10.1001/jama.1954.02940500032014.
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From 1900 to 1925 all subjective symptoms had to be explained by the presence of organic defects. Two world wars have demonstrated that many symptoms arise from fear, anxiety, and feelings of guilt, hostility, or inferiority, especially if present over a long period.1 Such diseases as duodenal ulcer, hypertension, rheumatoid arthritis, some allergic conditions, and dysmenorrhea are now known to be related to emotional disturbances. It is a serious error to always assume that a patient's complaint is necessarily an indication of a physical disorder. Such an attitude in the past led too often to a rigid, static, and mechanical treatment of the patient's supposed disease rather than to a flexible and skillful management of the whole patient.

Failure to recognize emotional factors and single-minded pursuit of an organic cause for a patient's symptoms may convince the patient that he has a serious organic disease. This may tend to


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