Clinical lectures on neurasthenia.

  • Savill, Thomas Dixon, 1856-1910.
Date:
1902
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Licence: In copyright

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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    PROGNOSIS H5 malady to which their lowered vitality renders them liable. The most frequent of these, perhaps, is a low form of pneumonia. The first and most important question in the prognosis relates to the family history. If this be free from mental disease of any kind, if the ancestors of the patient were long-lived, and moreover if his previous history be free from any illness which leaves damaging effects behind it; and finally, if the age of the patient be moderate at the advent of the disease, a favourable outlook is justified. Cases which come on slowly usually run a prolonged course. If the disease has lasted a considerable time, either for want of treatment or for any other reason, it is generally slow to yield. This is almost an axiom in all varieties of mental disorder, and it certainly comes into operation here; for you know that nerve impulses tend to travel along paths of least resistance, and every time an impulse travels along a certain path, the resistance becomes less, and thus abnormal or vicious paths become established, when the disease has lasted long. If, on the other hand, a patient comes under treatment early, and responds readily to it, the prospect is good, however unfavourable matters may seem. The presence of arterial hyper-myotrophy, or arterial sclerosis, does not appear, if one may judge by the case I narrated and others I have seen, to be such a serious matter as one would think. On the other hand, many of the cases complicated by atheroma which I have met with have drifted on into dementia; though even here one should not hazard an unfavourable prognosis until the powers of assimilation, and the efficacy of treatment, have been ascertained. The treatment of neurasthenic insanity need not detain us very long. All that has been said on the treatment of 11