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Phthisical Insanity

G. E. Berrios

Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital (Box 189), Hills Road, Cambridge, CB2 2QQ, UK. geb11{at}cam.ac.uk

The history of the relationship between tuberculosis and insanity has been neglected. This is surprising, for during the nineteenth century it was subject to an important medical and cultural debate and gave rise to a style of analysis which has been used ever since to study the clinical phenomenon of ‘disease-coexistence’ (rebaptized ‘comorbidity’ during the 1970s). Triggered by a perceived increase in the prevalence of tuberculosis and insanity, the debate centred around the meaning and mechanisms of disease-coexistence, techniques which may be used to rule out fortuitous associations, the comparative relevance of epidemiological, congenital, genetic and environmental factors, and the clinical effects that the members of the disease pair may have on each other. The Classic Text reprinted below provides an adequate introduction to the main issues listed above.

Key Words: Clouston • comorbidity • consumption • disease-coexistence • disease-co-occurrence • history • insanity • mental disorder • phthisis • psychiatry • tuberculosis

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