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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    mentioned as an illustration of this defect that the patient could never make up his mind to get up in the morning, and I thought that there are a great many people who would come under the term mad if that were a definition of it. But this person, he told me, when travelling across a desert where there were many brigands, took off his boots and could not make up his mind to put them on again. But this lack of will-power in neurasthenia differs from true insanity in its being less permanent, and in varying from day to day. Similarly the delusions and hallucinations which sometimes trouble neurasthenic patients are only distinguished from true insanity by being transient and variable from day to day. (10) Those are the main symptoms of neurasthenia referable to the spinal cord and the brain, but there is yet another most important class of symptoms which belong, in my belief, to the Sympathetic System. Long-drawn sighs are extremely characteristic symptoms in these cases; attacks of causeless palpitation, or of general flushing, followed by pallor, shivering, or sweating. These patients frequently suffer from cold hands and feet, or complain that they go numb or dead, or blue, without provocation. The tache cerebrale of Troussau can often be elicited. They may also complain of throbbing, heaviness, bursting of the limbs, or the prickling feeling, or crawling of insects in the extremities (formication), which as I have so frequently before pointed out may be associated with neuro-vascular disorder. (11) The Pulse in neurasthenia may be normal, but it IS far more often unduly rapid, and frequently weak, some- times It is irregular in rhythm ; but the feature which is more characteristic than anything is its excitability. The least thing-any little noise, the presence of a stranger, or any slight excitement—will start the pulse off at a very rapid and often irregular rate. The blood tension in those cases which I have examined for this purpose has been mvanably low. I show you here a well marked illustra- tion of this condition, taken from the first case you saw to-aay. ihe two tracings represent (a) the condition of the pulse when the patient was suffering from neurasthenia,