[A psychosomatic approach to symptoms in surgery of the hand]

The understanding of a symptom, and the discovery of its meaning, if it has any, or at least the discovery of its part in the patient's individual story, can only help the surgeon to comprehend the possible failure, in appreciating the meaning of his intervention at the deepest levels of the patient's personality. In similar situations, why does one patient react neurotically, another one hysterically, a third get sick, and another keep his mental and physical health? The symptom is offered in the body. Which body are we talking about? Parallel to the physical anatomy, one can define the "anatomy of the Imaginary", which is unrelated to the anatomical localisation of the organs and their functional role. From there originate hysterical symptoms. As to the real symptom, it can be overvalued, or fostered by the psychological problems of the patient and the secondary benefits that he draws from it. The organic symptom can also be the last resort of a patient whose psychological defences are overfilled or limited. The physiological reactions and the influence of the psyche, intimately linked, make illusory the distinctions in psychology and surgery.