History

Hypochondria was used by Hippocrates to refer to the region below the cartilage of the ribs. (34) In the second century, Galen linked it to digestive disorders that he attributed to organs in this area as well as humours and animal spirits. The symptom picture was ill-defined and only gradually took on the characteristics recognized today. From earliest times, the disorder was associated with melancholia, a temperamental disturbance caused by an excess of black bile. In The Anatomy of Melancholy (1621), Burton's description of hypochondriacal melancholy included vague physical symptoms, disturbances of mood, and fears. In the seventeenth century, Sydenham described hypochondria in men as the counterpart of hysteria in women, but the first modern definition was published in 1799 by Sims.

In the eighteenth century, hypochondria became part of a fashionable disturbance that Cheyne attributed to the English way of life and environment. (5) However, as notions of aetiology began to shift under the influence of Cartesian dualism, hypochondria was increasingly seen as a weakness and moral failing. Falret, in 1822, was perhaps the first to identify it as a mental disorder, one of the neuroses. Freud viewed hypochondria as an 'actual neurosis', having a physiological basis and not amenable to psychoanalysis. However, present-day descriptions began with Gillespie (6), who in 1928 defined hypochondriasis as 'a mental preoccupation with a real or supposititious physical or mental disorder'.

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