The soldier's heart and the effort syndrome / by Thomas Lewis.

  • Lewis, Thomas, Sir, 1881-1945.
Date:
1918
Catalogue details

Licence: In copyright

Credit: The soldier's heart and the effort syndrome / by Thomas Lewis. Source: Wellcome Collection.

    20/164 (page 4)
    flow of air. To these physiological symptoms and signs briefly described as a group I apply the term “ physiological syndrome of effort.” The term is used as a convenient description of the chief changes, subjective or objective, which are manifested by the human body in its reaction to exercise ; and one purpose in introducing it is to emphasise a working hypothesis at which I have arrived, namely, that a large number of patients, especially soldier patients, who come under observation, report sick, or are regarded as sick, because they notice or present such a series of symptoms and signs. When I use the term “ effort syndrome 55 I have in mind the symptoms and signs which follow exercise in health ; but I believe that I recognise the same or a very similar group of symptoms and signs in a large class of patients in ill-health. In patients of this class, if no signs of disease are anywhere discovered, I say that they suffer from the “ effort syndrome.” The difference in symptom¬ atology wrhich exists between health and this form of ill-health is largely a difference in degree ; the gauge is the amount of work which, performed in a given space of time, will provoke the symptoms. Symptoms produced in normal subjects by excessive work are produced in the patients by lesser amounts ; the smaller amount of work required, the more severe the malady. Naturally there is no sharp line of division ; there is in a large group of patients a perfect grading from the healthy man to him who is seriously unwell. We are travelling in the borderland between health and disease. This point of view has its value ; it directs investigation towards the normal reactions of the body to exercise and to the corre¬ sponding reactions in disease ; it brings us to inquire into the reserves of some of the most important bodily functions, and into the manner in which these reserves are reduced. The term “ effort syndrome ” as applied to cases in this book is not equivalent to the term “ irritable heart,”