University of Oulu

Hyrkäs, E. (2021). ‘A transverse scar on the neck’ – psychosomatic approach in the differential diagnosis and surgical treatment of hyperthyroidism in post-war Finland. Medical History, 65(2), 140-156. doi:10.1017/mdh.2021.4

‘A transverse scar on the neck’ : psychosomatic approach in the differential diagnosis and surgical treatment of hyperthyroidism in post-war Finland

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Author: Hyrkäs, Eve-Riina1
Organizations: 1History of Sciences and Ideas, University of Oulu, P.O. Box 1000, FIN-90014, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Cambridge University Press, 2021
Publish Date: 2021-04-21


In the Finnish medical discussion during the middle decades of the twentieth century, the challenging differential diagnostics between hyperthyroidism and various neuroses was perceived to yield a risk of unnecessary surgical interventions of psychiatric patients. In 1963, the Finnish surgeon Erkki Saarenmaa claimed that ‘the most significant mark of a neurotic was a transverse scar on the neck’, a result of an unnecessary thyroid surgery. The utterance was connected to the complex nature of thyroid diseases, which seemed to be to ‘a great extent psychosomatic’. Setting forth from this statement, the article aims to decipher the connection between hyperthyroidism, unnecessary surgical treatment and the psychosomatic approach in Finnish medicine. Utilising a wide variety of published medical research and discussion in specialist journals, the article examines the theoretical debate around troublesome diagnostics of functional complaints. It focuses on the introduction of new medical ideas, namely the concepts of ‘psychosomatics’ and ‘stress’. In the process, the article aims to unveil a definition of psychosomatic illness that places it on a continuum between psychological and somatic illness. That psychosomatic approach creates a space with interpretative potential can be applied to the historiography of psychosomatic phenomena more generally. Further inquiry into the intersections of surgery and psychosomatics would enrich both historiographies. It is also argued that the historical study of psychosomatic syndromes may become skewed, if the term ‘psychosomatic’ is from the outset taken to signify something that is all in the mind.

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Series: Medical history
ISSN: 0025-7273
ISSN-E: 2048-8343
ISSN-L: 0025-7273
Volume: 65
Issue: 2
Pages: 140 - 156
DOI: 10.1017/mdh.2021.4
Type of Publication: A1 Journal article – refereed
Field of Science: 615 History and archaeology
Funding: This study has been conducted as a part of the PROFI-3 (Fibrosis Diseasome) research project, supported by the Academy of Finland and the University of Oulu.
Copyright information: This article has been published in a revised form in Medical History This version is free to view and download for private research and study only. Not for re-distribution or re-use. © The Author, 2021. Published by Cambridge University Press.