The psychologic aspects of tuberculosis have been a topic of interest to both laymen and physicians over the centuries, from the Hindus as early as 1500 B.C., up to modern times. Berle assays a critical review of the literature on this subject under five headings: tuberculosis and genius, tuberculosis and mental disease, the psychopathology of tuberculosis, the patient-physician relationship, and the relationship between emotional factors and tuberculosis.
Her general thesis is that current as well as ancient notions concerning these relationships are impressionistic, are handed down rather uncritically from one generation to the next, and need to be re-evaluated. Thus, although in many cases the most brilliant imaginative contributions to the treasury of the world's literature were made by people in whom the disease was in an active state, 'evidence substantiating the affirmation that the presence of active tuberculosis in an individual of intellectual or artistic talent exerts a stimulating influence on the quality of his creative output has yet to be presented'. Concerning the association of tuberculosis and mental disease, the bulk of current statistical evidence indicates that 'the prolonged hospitalization in a tuberculous environment of dementia præcox patients rather than a specific lack of resistance of this type of patient to tuberculosis may be considered the dominating epidemiological factor'. The generally accepted prevalence of spes phthisica among patients suffering from tuberculosis is denied. Psychoanalytic studies describe the tuberculous patient as 'childish, selfish, self-centered, irritable, easily angered, easily pleased, capricious with food, dissatisfied and ungrateful'.
Berle recommends increased training of young phthisiologists along psychological lines and a systematic clinical investigation of the possible rôle of bodily reactions and life situations in the development of tuberculosis. The bibliography is impressive, listing sixty-nine articles.
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Rangell, L. (1949). Psychosomatic Medicine. X, 1948. Psychoanal. Q., 18:535