Clinical lectures on Neurasthenia.

  • Savill, Thomas Dixon, 1856-1910.
Date:
1899
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Licence: Public Domain Mark

Credit: Clinical lectures on Neurasthenia. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    The next question before us is—Why should the same symptoms arise from such different causes ? How is it that the same disease arises under such different conditions as gastro-intestiual disorder, malnutrition, over-functioning, emotional strain, and traumatism? Now, gentlemen, I believe the answer to this question is that the nerve structures mainly involved in each case are the same; and that these struc- tures are the vaso-motor and sympathetic systems. It seems to me that this is the part of the nervous system principally and primarily affected, and that all the symptoms, as well as the vague and variable qualities which belong to many of them, can be explained in this way. No doubt the cerebral and spinal structures suffer as well and are directly affected in many instances by the over-functioning, malnutrition, or toxic blood state as the case may be; but it is the disorder of the vaso-motor and sympathetic systems from wbich the most important and constant symptoms and consequences arise. We know so Httle of these most important systems that the matter will merit studying somewhat closely and in detail; and we will ask ourselves, First, What symptoms are directly referable to these systems ? Secondly, Can all the symptoms be explained on the above hypothesis? and Thirdly, How does the sym- pathetic system come to be affected in each of the four pathological groups? Symptoms directly referable to that part of the sym- pathetic system concerned in regulating the circulation are certainly very common, if not the commonest, in neuras- thenia.' Several of the cases shown to you at our last meeting illustrated this; but the matter is so important that I must at the risk of appearing tedious, show you three other cases taken haphazard by way of example, from a large number. Here is a man, George B , aged 42, who came to the ' Board himself points out the prominent part played by the sympathetic system His theory is that the symptoms of neurasthenia are duo primarily to a want of cerebral control. Consequently the vaso-motor centre not bemg under cerebral control becomes very unstable. The cardio-vascular system, having most sympathetic nerves, shows the symptoms most.—Neurasthema, Beard and Rockwell, 1891.