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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    taught, for it includes many a chronic case which goes from physician to physician, and in this way counts as a fresh case over and over again, finishing up in a Workhouse Infirmary such as the one where my own studies have been so largely carried on. Moreover, these organic cases are not as fatal as many cases belonging to cardiac, renal, and other specialities; and even for these something can be done by proper management, as I often had occasion to observe in the Paddington Infirmary. We need not dwell farther on this point now, for we shall, I believe, have abundant opportunities of observing that diseases of the nervous system are not so incurable as the casual observer is apt to suppose. Coming to the subject of to-day's lecture, it is often the fashion to select, for meetings such as these, rare conditions which present features of interest, perhaps by reason of their very rarity; but I have thought it best to select the very commonest. Among the great number of persons who daily apply for relief at the out-patient department of this hospital, a large proportion, while apparently free from any discoverable morbid lesion, bitterly complain of a variety of distressing and pecuhar sensations, which though vague and indefinite are obviously most discomforting. Very often they come and say simply that they feel nervous. Now, gentlemen, when you have investigated these patients, in nine cases out of ten you come to the conclusion that the disorder they are suffering from is neurasthenia. Thus it happens that this condition is one of everyday occurrence, and therefore, one of considerable importance. Neverthe- less, strange to say, it is either not referred to at all or is very inadequately dealt with in the text-books in current use. No apology, therefore, is needed for introducing this subject to your notice to-day. It is certainly a drawback that there is rarely anything tangible to show in these cases; physical signs are usually conspicuous by their absence. I can only bring the patients before you, so that they may describe to you the strange and often distressing sensations which they feel. ^ I do not mean to say that every patient who comes complammg of nervousness suffers from neurasthenia. A