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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    diagnosis of the locality we should take the patient's leading symptom, and see what position best explains this and the other symptoms, discussing the several positions which might account for all the symptoms. A knowledge of anatomy and physiology is necessary for this, and it is therefore to be regretted that neurology is generally rele- gated by the medical student to his post-graduate studies. However, the task is not such a formidable one as might be thought, for the prominent symptoms are usually few, and their explanation simple. (6) As regards the nature of the lesion, this is generally a simpler matter, for you may group all lesions into destructive or irritative, and organic or functional, either of which latter may be de- structive or irritative. There are four features which will help us to come to a conclusion on this point. First, the position of the lesion having been decided is some guide, as in cases of hemiplegia for instance, we know that only a few lesions affect the internal capsule. Secondly, the mode of onset of the case is important; circulatory lesions coming on suddenly, degenerative lesions slowly. Thirdly, the character of the symptoms affords important informa- tion, since destructive lesions of the motor tract, for instance, produce paralysis, whereas irritative ones produce convulsions and rigidity of the same parts. Fourthly, the acre of the patient is perhaps as important as any, for, to a very large extent, certain lesions are confined to certain age periods. These are the most important clues that I can give you at the present time. But there is one most satisfactory consideration. In the wards of a general hospital it is hardly possible to employ any one method sufficiently for it to become estabhshed in our minds; whereas here the number of nerve cases is so large that by repeated exercise we can easily and readily come habitually to employ the best and most successful method. Pathologrj of FunctionaV Disorders of the Nervous System. In referring just now to the auatomo-clinical method of research, I pointed out the necessity of employing both