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Saul, L.J. (1938). Psychogenic Factors in the Etiology of the Common Cold and Related Symptoms. Int. J. Psycho-Anal., 19:451-470.

(1938). International Journal of Psycho-Analysis, 19:451-470

Psychogenic Factors in the Etiology of the Common Cold and Related Symptoms

Leon J. Saul

SUMMARY

1. Evidence is presented which confirms the observation that emotional factors may be of prime importance in certain cases of the 'common cold' (including sore throat and laryngitis), i.e. the 'cold' may be essentially a neurotic symptom.

2. That psychogenic factors may be of appreciable frequency and importance in the etiology of colds is indicated by a brief statistical survey of the practices of six psycho-analysts: every one of fifteen patients who had repeated colds before analysis, had few or none after analysis (average years of follow up, three).

3. In the nine patients reported, colds occurred regularly in situations of frustration of strong, mostly unconscious, receptive demands with more or less repressed rage. In the opinion of the author, the evidence in these cases shews that the relationship is causal This observation in no way implies that all emotional states of receptive thwarting result in colds, nor obviously that this etiology is in any sense exclusive. The emotional factor is only one of several (infectious agents, irritants, allergins, temperature changes, etc.), operating separately or in combination, and may be of greater or lesser importance or prominence in any individual case. Nor are the emotions and mechanisms here described necessarily the only ones which can produce the picture of the cold. In the cases reported in which the emotional

factors played a prominent rôle, the symptoms seemed more closely related to allergic than to infectious conditions, although nothing positive can be concluded on this point.

4. The emotional impulses stimulate physiological activities in other regions of the body. These result in the other symptoms which frequently accompany colds: gastro-intestinal disturbances (anorexia, nausea, diarrhoea, colitis, constipation), headache, and in women, leucorrhoea. The fatigue, malaise, etc., are often, at least in part, manifestations of mild depression. Fever, apparently truly psychogenic, occurred in two cases. The whole condition is utilized in the services of masochism, passive indulgence, secondary elaboration and various other secondary gains.

5. Some incidental observations are made on psychogenic factors in catarrhal vaginitis and leucorrhoea.

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