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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    PATHOLOGY OF HYSTERIA largely regulated by the dilatation and contraction of the splanchnic area. VI.—There is, I beHeve, yet another group of functional disorders of the nervous system which does not fall within any of the preceding, due to an increased reflex irritability, or an increased response to impressions from without, arising either from an inherent irritability of the various reflex centres, or a deficiency of the control normally exer- cised over the lower by the higher centres. This group of functional disorders is, I believe, almost the only one to which the name hysteria may be legitimately applied. Yet, gentlemen, it is sad to find in the present day, how frequently hysterical and functional are used as synonymous and absolutely identical terms. The clinical features we should expect to find here would be:—(1) The occurrence of some of the symptoms in the form of attacks, deter- mined by some external cause ; (2) the disease would tend most often to arise in that sex where, and at a time of life when, the reflex centres are normally most irritable; i.e., in the young about the age of puberty; in females, especially at the time of the menopause. (3) The symptoms would vary from time to time, in degree corresponding with the variations in the irritability of the reflex centres and the normal variations in the control exercised by the higher powers. The best illustrations of this group are, I believe, to be found in the manifestations of hysteria. These, gentlemen, are six different ways in which, I believe, functional disorders of the nervous system—those, namely, unattended with any structural changes discover- able by the present means at our disposal—may possibly be explained. At any rate these are the lines along which our researches should, in my belief, be conducted. These con- siderations are, it is true, largely a matter of hypothesis, legitimate hypothesis I trust; but surely, gentlemen, the time has gone by when everything functional, everything non-structural can be called by the name hysteria. Compound causes.—It must not be thought that these several functional causes are capable always of acting alone.