In 1879, the idea that a physical problem was responsible for the symptoms was challenged by Rigler, who suggested that the cause of the persisting symptoms was actually "compensation neurosis": the railroad's practice of compensating workers who had been injured was bringing about the complaints.
I 1879 blev ideen om at det var et fysisk problem der var ansvarlig, udfordret af Rigler, der foreslog at årsagen til de vedvarende symptomer faktisk var "kompensationsneuroser": jernbanens praksis med at kompenserer arbejdere der var blev skadet fik flere klager frem.