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January 17, 1948


Author Affiliations

Charlottesville, Va.

From the Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, Virginia.

JAMA. 1948;136(3):147-152. doi:10.1001/jama.1948.02890200001001

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Psychosomatic medicine represents an orientation in medical philosophy and practice, a perspective that attempts to evaluate the relation of personality factors and life situations to disease. Psychosomatic diagnosis thus depends on a discipline that requires, in addition to a knowledge of the manifestations of disease, a further understanding of its nature and its significance to the patient in terms of personality security. It is in this specific significance, this utility to the patient, that psychosomatic illnesses primarily differ and in a broad classification may be distinguished from other diseases. Many chronic illnesses produce changes in life situations that require some measure of personality adjustment. In many other diseases personality factors operate to permit a utilization of the illness for secondary gain, with resultant protraction of symptoms and disability. Yet a still broader segment of disease may be considered as primarily psychosomatic in that the structural alterations of the body, and

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