WESTPHAL AGORAPHOBIA

In 1871 Westphal introduced the term "agoraphobia" and published the classic description of the condition. This article presents the first published English translation of Westphal's work, which is a description of four men who had a fear of large open spaces, such as an empty city plaza. The Greek word "agora" was chosen by Westphal to refer to large open spaces such as market places. Westphal appears to have thought of agoraphobia as a simple phobia of large open spaces, some of which were public places, some of which were not. A comparison of his four case histories with the DSM III-R criteria for a diagnosis of agoraphobia indicate that the last three cases fulfill DSM III-R criteria for agoraphobia. In the article Westphal refutes three theories that had been proposed to explain this phobia of open spaces: epilepsy, dizziness, or an optical distortion of the visual image of large open spaces. Westphal was a neurologist with particular expertise in the area of the eyes. All of the patients had symptoms suggestive of panic attacks or limited symptom attacks, but Westphal attached no special significance to the panic attacks. Westphal was unable to explain the etiology of agoraphobia. © 1991.