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)

    65/168 (page 45)
    tion, and he was therefore very considerably alarmed when, at the age of 51 (in 1885) he had a convulsive seizure, for the first time in his Hfe. He went to bed as usual, and was told that he screamed out and struggled ; and he states that he bit his tongue during the night. He says that he was unconscious for six hours next day, and was strange in his head for the next two or three days, not recognising anyone. I did not see him until July 1887, but he was said to have had seven or eight severe fits and seven or eight slighter ones during the ensuing two and a-half years, always at night. The convulsions were mainly, if not entirely, confined to the right side. Fits of this kind, coming on for the first time in a healthy man aged 51, are almost certainly indicative of intracranial syphilis. How- ever, no history of the primary infection, nor of secondary manifestations was obtainable, and there were no symptoms referable to the cranial nerves. Nevertheless, that such was the cause in operation was supported by the improve- ment he made under a mixture of bromide and iodide. From this time forward he remained in a very low- spirited condition ; his memory failed him, he was apt to repeat himself in conversation, and gradually, in the course of the ensuing two years, he drifted into a very typical condition of neurasthenia. I saw him at intervals in 1887, 1888, and 1889, and he presented many of the symptoms of that disorder, complaining of nervousness, bodily enfeeble- ment, insomnia, and numerous disagreeable sensations. Even at that time he was tending to hypochondriasis; he always emphasised the most trifling details of his case,'and spent a small fortune in going from one charlatan to another. The abrupt way I had of reasoning him out of his more purely imaginary ailments apparently recommended itself to him, because some years later he traced me with much trouble to this hospital, where he has been under my care as an out-patient for the last two or three years. During this time he has presented the typical symptoms of hypo- chondriasis. Every fresh symptom, every fresh pain, means, m his mind, some mortal disease. He has suffered a good deal from constipation, which was easily remedied by aperients, but nothing would persuade him that he had