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)

    58/168 (page 38)
    had been married seven years, and the wife had never been free from painful coitus the whole of that time. The third feature is the neurasthenia. Most of the exciting causes bring into operation one or both of two conditions—disturbed nutrition' or over-func- tioning of the nervous system. (1) Overwork is one of the most familiar causes m all of our experiences; too long hours, too close attention to work without a break, and an inordinate desire to finish an aUotted task. One finds it in busy city life, in the keen struggle for existence, and one finds it also most frequently in the autumn months, when men have not been away for some time. Overwork of the mind is what I am chiefly referring to, but physical exertion is also a stram upon the nervous system. (2) Great grief, or emotional stram of any kmd, or bereavement, such as you will remember, had occurred in the female case I showed you this afternoon. The trouble and worry of making both ends meet is a potent factor. (3) Asthenopia, or eye-strain from error of refraction, may alone, though more often in combination with over- work result in neurasthenia, as in the case I narrated to vou ' How the connection is brought about is hard to say but I may remind you that the ciliary muscle is supplied by the sympathetic; and we have Dr. Wood's valuable observation of the dilated pupils in these cases. (4) Traumatism, or severe nerve-shock without actual iniurv may be a cause. I have a man, aged 37, attending among my out-patients at the present time, who received a severe blow on the head, and, as a consequence, suffers from nem-asthenia, which came on suddenly the day after iniurv Sometimes, however, the symptoms do not appear for one or two weeks, or more. This traumatic neurasthenia is sometimes a matter of great importance in a court of law, where perhaps a large sum of money may be nt ^take The absence of any definite physical sign in such cases gives rise to great difficulty and conflict of expert e^Tence. I remember being engaged m such a case where • The reason I use the phrase disturbed nutrition or dystrophy, in preference to mal-nutrition, x.iU be apparent in Lecture IH.