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November 3, 1923


JAMA. 1923;81(18):1526. doi:10.1001/jama.1923.02650180044019

Definitions of the term traumatic neurosis always contain the condition that organic lesions are absent. Nevertheless, ever since 1866, when Erichsen published his book "On Railway and Other Injuries of the Nervous System," opinion as to the nature of these disorders has been divided into two schools, emotional and commotional. Charcot and many others demonstrated that, in the great majority of cases at least, the symptoms are due to the mental attitude of the patient toward the whole situation in which he finds himself; the trauma is only the occasion or excuse for escaping from the situation, and the disorder is primarily emotional. The other school, in which Oppenheim was a prominent leader, maintains that, while many cases are emotional in origin, others, in spite of the absence of evidences of gross injury, must have some structural lesion, probably minute and as yet unrecognized. Great impetus was given to this