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Medical Writings |

“Memes” as Infectious Agents in Psychosomatic Illness

Stephen E. Ross, MD
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University of Colorado Health Sciences Center; Denver, CO 80262 (Ross)

Acknowledgments: The author thanks John Steiner, MD, and the many other members of the University of Colorado Department of General Internal Medicine who provided helpful comments on the manuscript.

Requests for Reprints: Stephen Ross, MD, University of Colorado Health Sciences Center, Box F414, 4200 East Ninth Avenue, Denver, CO 80262; e-mail, steve.ross@uchsc.edu. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Ann Intern Med. 1999;131(11):867-871. doi:10.7326/0003-4819-131-11-199912070-00019
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Can a mere idea cause medical pathology? Many authors would say yes. It has been claimed, for instance, that fibromyalgia, the irritable bowel syndrome, and the chronic fatigue syndrome are iatrogenic—that these are not simply methods for classifying illness, but that these nosologic constructions actually induce and sustain illness in susceptible persons (1). The contagiousness of eating disorders has also been remarked upon (2). This contagion is not the result of any classic pathogen (a microbe or a toxin)—instead, a socially constructed script of anorexia nervosa or bulimia is transmitted from person to person. Intangible disease constructions also appear to be the communicable pathogens in several contemporary epidemics, from “repetition strain injury” in mid-1980s Australia (34) to instances of “mass psychogenic illness” or “epidemic hysteria” (59), such as the recent outbreak of cola-associated illness in Belgium (1011).

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