Clinical lectures on Neurasthenia.

  • Savill, Thomas Dixon, 1856-1910.
Date:
1899
Catalogue details

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)

    104/168 (page 84)
    understand it, is not such a frequent symptom as one would imagine, for the term pain is most vaguely used by patients to describe any feeling of discomfort. This more often takes the form of tingling, prickling, formication, and the like • symptoms which I have on many occasions pointed out to you are generally associated with local vaso-motor disturbances. Even when actual pain is complained ot, it is found very often to consist of a dull weary achmg like that met with in over fatigued muscles, which may probably be explained somewhat after the same fashion. As regards the sensorial troubles, the hypertEsthesia, contracted fields, &c., these are readily accounted for either by the increased sensitiveness, or the fatigue of their centres owing to the irregular blood supply, and in toxic neurasthema, to the altered quahty of the blood. In short, gentlemen, as regards the bulk of the symp- toms, there is nothing which explains all the symptoms so well as vaso-motor and sympathetic disturbance; and nothing which affords so satisfactory an explanation of the variations from time to time, and day to day m the degree and character of the manifestations. For the tmth of this theory it is not necessary to show that all patients complain of flushings of the surface, because different tissues and organs may be affected in different individuals. In one it may be the brain, and then mental symptoms predommate ; in another the cord, and then restlessness and neuro- muscular irritability are more pronounced, and so on. In all probabihty the same vascular irregularities occur in all the other physiological systems, and hence the endless variety of the symptoms and sensations; and he feehng. Is more than one patient has put it as though his whole Me was in a whiri, the inabiUty to thmk for two seconds together,-and the general want of harmony and co-ordination in the economy. The next question we have to consider is how the sympathetic and vaso-motor systems t^J'^^/^-^ef ahke by such different conditions as toxic blood states malnutrition, over-functioning and emotional shock? It will be best for us to consider these seriatim.