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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    TOXIC CONDITION OF BLOOD lately necessary, since the toxic products of digestion may have a specifically poisonous effect on nerve structures. This suggestion is rendered more probable by the frequent occur- rence of prostration and other nervous symptoms with all derangements of the alimentary canal. I am not prepared to say that malnutrition, also a result of the derangement of digestion, does not play a contributory part ; but this does not appear to me sufficient to explain all the clinical phenomena, and especially the exacerbations after meals. In support of the toxic theory there are two important series of facts. The first is this, that the leading and most constant symptoms of neurasthenia correspond with symptoms known to be due to toxic conditions of the blood. A moment's thought will show that this is so, and that the headache (which so frequently accompanies pyrexia and other toxic conditions), the disturbed sleep, the restlessness, nervous- ness and prostration, the hypereesthesia and pains, the irritable temper, the readiness with which they are startled and become tired, the defective memory and lack of atten- tion (which are among the first faculties of the mind to disappear in all exhausted states), may all be found in other morbid conditions known to be due to blood disorders, such as pyrexia, lithaemia, gout, rheumatism, acute and chronic alcoholism, and the like. Secondly, that the diseases which most closely resemble neurasthenia in their clinical features are known to be due to an altered blood state. Take lithmmia for instance, one of the commonest of toxic blood states. Many of the symptoms of neurasthenia have so strong a resemblance to those of lithaemia, that there is sometimes considerable difficulty in the diagnosis between the two conditions. Influenza is another blood disorder, and one which the profession has had ample opportunity of studying of late years. Sometimes it attacks mainly the lungs, at other times mainly the ahmentary canal; and as you are well aware, one of the commonest forms of the disease is that in which it attacks the nervous system. Now it is in such cases one meets with one of the most complete examples of neurasthenia that it is possible to find. Here you get the