In ancient times, phrenitis was considered a persistent fever delirium, which the medicine of the time understood as a form of mental illness. Today the disease is described as inflammation of the diaphragm, which is treated with the administration of antibiotics. The disease is mostly caused by bacteria.


What is phrenitis?

The clinical picture of phrenitis dates back to antiquity and has been handed down to the Middle Ages. At the time, the illness was described as persistent delirium with fever. The Corpus Hippocraticum wrote down phrenitis. This made the clinical picture a recognized disease during antiquity, and numerous typesetters tried to describe it. In modern medicine, phrenitis no longer exists in its original form of fever delirium. See dictionaryforall for Ego Syntony in Dictionary.

Today, doctors are more likely to diagnose diaphragmatic inflammation, whereas in ancient times phrenitis would have been diagnosed. The previously described fever delirium can, but does not necessarily have to be one of the symptoms of diaphragmatic inflammation. As a symptom, fever delirium is rather unspecific and can occur in the context of various diseases.


In ancient times, inflammation of the diaphragm was considered to be the cause of phrenitis. According to ancient belief, the diaphragm was the seat of the soul and mind. Because the symptoms of the disease seemed more indicative of insanity, authors like Galen sometimes included the brain and its membranes as damaged areas of the body. In this area, too, an inflammatory, i.e. inflammatory cause was assumed at the time.

This view of phrenitis was passed on to the Middle Ages via Byzantine and Arabic texts. The medicine of the Middle Ages demarcated the clinical picture from mania and melancholy. Michael Ettmüller described the disease in contrast to the other two terms as a feverish inflammation of the brain. When psychiatry developed in the 19th century, the classification of phrenitis as a mental illness was rejected because the symptom fever did not fit into this category. Physicians of the 19th century therefore understood phrenitis more as a form of meningitis, which is known to be associated with fever, disturbances of consciousness and convulsions. According to current opinion, phrenitis is an infectious or psychologically caused inflammation of the diaphragm.

Symptoms, Ailments & Signs

In ancient writings, chills, delusions and fear are described as the main symptoms of phrenitis. The confusional states of the disease are believed to be due to a high fever, which can also trigger seizures, hallucinations, eye rolling, tremors, and intermittent loss of consciousness.

According to the current state of research, inflammatory molecules, so-called cytokines, can disrupt the release of neurotransmitters. Such a disrupted release of neuronal messenger substances triggers hallucinatory and delirious conditions, as described in ancient writings in the context of phrenitis. Fever delirium can occur primarily in the case of systemic inflammation.

Such systemic inflammations usually appear in the form of large infections, as can be found in the diaphragm. Today, however, the accompanying symptoms of diaphragmatic inflammation are completely different than they were in ancient times. In particular , hiccups, breathing problems or pain and pressure on the costal arch are now considered the main symptoms.

Diagnosis & course of disease

During antiquity, the diagnosis of phrenitis was made by sight and confirmed by examination methods such as palpation. Today, the doctor makes the diagnosis of diaphragmatic inflammation based on the anamnesis in combination with a blood test and possibly a chest x-ray. The blood test can reveal the extent of the inflammation.

Accompanying hiccups can give the doctor an indication of trichinella infestation as the trigger of the inflammation. In the present, phrenitis is still painful, but delusional symptoms are rare. As a rule, the disease is not fatal today. In ancient times, however, most patients died from the inflammation.


Phrenitis causes various symptoms in patients. First and foremost, those affected suffer from a high fever and also from chills. There is also inner restlessness and feelings of anxiety or panic attacks. The disease can also cause insane speech. Those affected continue to suffer from hallucinations or seizures.

The hands tremble and it can also lead to a complete loss of consciousness, in which the patient can possibly injure himself. Furthermore, phrenitis can also lead to various inflammations and other infections, since the immune system itself is significantly weakened by the disease. Those affected also suffer from breathing difficulties and permanent hiccups.

In most cases, phrenitis can be treated relatively well and easily with the help of antibiotics. There are no further complications. In some cases, however, those affected also need psychological treatment. Life expectancy is usually not negatively affected. Likewise, bed rest has a very positive effect on this disease.

When should you go to the doctor?

If you experience symptoms such as fever, chills, or anxiety and panic attacks, there may be an underlying infection. A doctor should be consulted if the symptoms do not go away on their own after a few days. Phrenitis is a disease that no longer exists today, which is why a specific medical investigation is not necessary. Nevertheless, typical fever symptoms must be examined, since a comparable condition may be the cause. Persistent delirium with fever can occur, which can have different causes.

If the symptoms described occur, it is best to consult your family doctor. People suffering from a chronic infectious disease or an immune deficiency are particularly at risk. Pregnant women, children and older people are also among the risk groups and should consult a doctor if typical fever signs and changes in consciousness are noticed. In addition to the general practitioner, one can visit the internist. The treatment is drug-based and can usually take place on an outpatient basis. In the case of severe fever attacks, inpatient therapy in a specialist clinic is necessary.

Treatment & Therapy

In ancient times, patients with phrenitis were usually tied to the bed so that they would not hurt themselves or others in their delirium. Bloodletting was usually initiated to treat the symptoms, which was then understood to be the most important means of curing most diseases. However, even this treatment method contained a high risk of infection, since medicine was not yet sterile at the time. In addition, dietary regimens and rubbings with oil for ancient patients of phrenitis were believed to initiate healing processes.

As a rule, these treatments could not heal the mostly infectious inflammation of the diaphragm. Normally, therefore, only patients with an extremely strong immune system survived. In most cases, the untreated inflammation spread further and further, which in many cases caused the delusional symptoms in the first place. Bacterial inflammation of the diaphragm in particular is now treated with antibiotics.

In the case of antibiotic resistance, the doctor usually gives enzymes as an alternative. Painkillers are often prescribed to relieve the pain. Cough drops relieve any cough symptoms. If there is a psychosomatic cause instead of an infectious cause, the doctor will advise his patient to undergo accompanying psychotherapy.

Outlook & Forecast

As a rule, phrenitis can be cured relatively well if it is recognized early and treated immediately. Complications are very rare and only occur if the phrenitis is not treated at all. For this reason, the person affected should ideally consult a doctor very early on and also initiate treatment in order to prevent the occurrence of further symptoms. Self-healing is also not possible, so that in the case of phrenitis, it is always necessary to take medication in order to completely heal the disease.

By taking antibiotics, the symptoms usually disappear within a few weeks and the disease heals completely. Further follow-up care is usually not necessary. However, if the disease is not treated, the infection can spread and, in the worst case, lead to the death of the person concerned. Since the disease can also occur as a result of a psychological illness in some cases, the treatment proves to be relatively difficult. Those affected may also fall ill again after a complete cure, since no immunity against phrenitis can be built up.


Bacterial phrenitis cannot be completely prevented. Diaphragm inflammation with psychosomatic causes, on the other hand, can be prevented with psychotherapeutic treatment. During this treatment, the patient usually learns stress management strategies that prevent the onset of psychosomatic illnesses.


Phrenitis is a medical diagnosis that is no longer used today. In the Middle Ages, aftercare for phrenitis mainly included talking to clergymen or doctors. Since a mental illness was suspected behind the symptoms, the sufferers were often referred to closed facilities or socially excluded. In particular, the typical mania and the pronounced melancholy were seen in the Middle Ages as a sign of a serious mental illness or even obsession and were treated insufficiently or not at all.

Nowadays, phrenitis is often equated with meningitis. Meningitis follow-up includes regular visits to the doctor and other measures that depend on the severity of the disease and other factors. In principle, patients should take it easy and observe the symptoms carefully. The doctor should be consulted every one to two weeks so that the course of the disease can be closely monitored.

In the case of unusual symptoms such as fever or body aches, the doctor must be informed immediately. In the event of circulatory problems, the emergency services should be contacted. Those affected may need first aid, as the symptoms of the disease can lead to a circulatory collapse or sometimes to a heart attack. The meningitis or phrenitis aftercare is carried out by the general practitioner or an internist.

You can do that yourself

Phrenitis is an ancient disease. It is therefore very unlikely that it will still appear today. Those affected who show symptoms of phrenitis should strictly observe immediate bed rest. The exchange with the doctor is vital for survival and must be intensively maintained. Rest, sleep and rest are necessary. Disturbing factors, ambient noise or other influences are to be reduced to a minimum. Everyday professional and private obligations must be reorganized immediately.

People from the social environment or nursing staff should take care of all the necessary errands during the time of the illness. Sufficient fluids should be supplied to the body. A healthy and balanced diet is also important. The immune system must be supported and stabilized. This requires vitamins, nutrients and trace elements.

Sleep hygiene needs to be checked for optimal recovery. The mattress and the bedding should be neither too warm nor too cold. A sufficient supply of fresh air is necessary so that the patient receives enough oxygen. The lowering of the fever can be supported with fresh wraps or bandages. Since the affected person adheres to aggressive behavior, he must be adequately protected from himself and others. Measures to reduce the risk of injury must therefore be taken.