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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    constant jerkings and twitchings of the limbs. I have just now a patient in my private practice who is absolutely unable to sit in one position for a single second, and who is con- stantly jerking her limbs about. Moreover, these patients have a constant desire to be somewhere else than where they are. These symptoms are doubtless familiar to many an overworked doctor and to others who are unable to take sufficient repose or relaxation. This restlessness may take the form of definite attacks of agitation or tremor; and it is generally combined with exaggeration of all the superficial and deep reflexes, especially the latter. But in very severe cases I have sometimes found the knee-jerks absent; there is no constancy in this respect. (5) Pains in the back and limbs, and general hyperesthesia. —These pains in the back the older authors used to call spinal irritation, or rachialgia. Sometimes a pain pre- dominates and persists in one particular spot, and is sometimes accompanied by tenderness over the corresponding spinous processes. The presence of a fixed pain in one particular place is fairly characteristic of neurasthenia ; but I cannot say that this tenderness on tapping over the spinous process has been at all constant, or even frequent, in my experience. But pain is a generic term used by these patients to describe all their disagreeable sensations, and if you enquire carefully into these spinal pains, you will generally find they are seated chiefly in the ligaments and muscles of the back, and that the tenderness also is generalised. It is a tired aching, and resembles the indescribable weariness felt after a person has sat bolt upright for a long time. This kind of feeling is, indeed, rarely altogether absent, and may prevent the patient from sitting up, or even standing upright. The pains in the limbs also very generally affect the muscles, 4