J.H. Pons on ‘Sympathetic insanity’

Abstract

The ancient concept of ‘sympathy’ originally referred to a putative affinity or force that linked all natural objects together. This notion was later used to explain the manner in which human beings related and felt for each other. A large literature exists on both the physical and psychological definitions of sympathy. Until the nineteenth century the conceptual apparatus of medicine preserved the view that the organs of the human body had a sympathetic affinity for each other. In addition to these ‘physiological’ (normal) sympathies there were morbid ones which explained the existence of various diseases. A morbid sympathy link also explained the fact that insanity followed the development of pathological changes in the liver, spleen, stomach and other bodily organs. These cases were classified as ‘sympathetic insanities’. After the 1880s, the sympathy narrative was gradually replaced by physiological, endocrinological and psychodynamic explanations. The clinical states involved, however, are often observed in hospital practice and constitute the metier of ‘consultation-liaison psychiatry’. Hence, it is surprising that historical work on the development of this discipline has persistently ignored the concept of ‘sympathetic insanity’.