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An Early Nineteenth-Century View of Functional vs. Organic Disease

Arch Intern Med. 1961;108(3):502-506. doi:10.1001/archinte.1961.03620090174019.
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Like the antithesis between mind and body, that between structure and function has occupied the attention of medical and biological theoreticians for a very long time. The familiar distinction of functional from organic disease is related to both antitheses. When a physician says that a patient has an organic disease he means that a morphological lesion is present. When he says that the disease is functional the matter is not quite so simple. He may mean that the patient is suffering from the effects of a disturbance of physiological or biochemical equilibrium unaccounted for by a structural alteration or unassociated with any such alteration. Or he may mean that the patient's difficulties are of psychogenic origin. Putting to one side the question of psychogenic causation and directing our attention solely to the remaining aspects of the antithesis, it is plain that we are confronted by a potentially sharp cleavage of


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