Persons most commonly affected: Both sexes, but majority in men.
Organ or part of body involved: Nervous System
Symptoms and indications: The symptoms are so varied and complex that it will simplify their narration to group the cases according to the predominance of certain phenomena; thus we have the cerebral, the spinal, the gastro-intestinal, the cardiac, the urinary, and the sexual varieties.
The general symptoms are great irritability, marked despondency, great prostration, both physical and mental, without sufficient cause, and loss of weight. So many are the symptoms that the patient, fearing that some may be forgotten, presents a long list of symptoms carefully written down.
The Cerebral Variety--Headache is a prominent symptom, there frequently being tenderness of the scalp. Insomnia is quite characteristic, and the patient arises unrefreshed; there is more or less despondency; the patient is anxious, worried, and fearful of some impending danger. There is impairment of memory, and reading seems to tire the patient; in fact, a continued tired feeling is generally present.
The Spinal Variety--Great weakness and prostration is a common symptom, the patient complaining of feeling sore and stiff on rising. Backache, with tenderness along the spine, is characteristic, while there is perverted sensibility, manifested by a tingling, crawling, or burning sensation, or certain parts will feel hot or cold; sometimes there will be lightning pains, simulating locomotor ataxia. Ankle clonus is sometimes present, while the reflexes are exaggerated.
Gastro-intestinal Variety--Gastric disturbances, with their attendant symptoms, are the chief characteristics of this form. Hyperacidity, waterbrash, nausea, retching, and vomiting, with more or less headache, are present. The patient sleeps poorly, has unpleasant dreams, and develops an irritable disposition. There is flatulency, rumbling of the bowels, constipation alternated with diarrhea, and a sense of weight or soreness over the abdomen.
The Cardiac Variety--While there is an absence of organic lesions, there is palpitation on slight exertion, precordial distress, and sometimes sharp pain as in angina. Throbbing of the abdominal aorta is a distressing symptom and one that causes much anxiety on the patient\'s part. In some cases a capillary pulse may be detected. This group of symptoms causes the patient to become fearful of a sudden termination of life. Loss of flesh is apt to accompany this form.
Urinary Variety--The quantity of urine voided is usually small, and albuminuria, oxaluria, and glycosuria may be present. The patient becomes irritable, and there is a dull headache.
Sexual Variety--A victim of this variety is often an object of pity. The fear of becoming impotent preys upon the mind, the patient is melancholy, sleeps poorly, has nocturnal emissions, complains of pain or crawling sensations in the testicles, has perverted sexual desires, and frequently masturbates. The patient, worried and distracted, leads a miserable existence.
Fatigue, pain, dysphoria, mental agitation, insomnia, loss of appetite, weakness of the back and spine, and headaches.
Causes and risk factors: Sexual excesses and masturbation exhaust nerve force, and are a fruitful cause of the disease. Unhappy marriages are not an infrequent cause of neurasthenia in both sexes, while fear of infectious diseases may so wear upon the nervous system as to give rise to the disease. Various accidents, especially those occurring on railroads and on the water, may cause the disease, and is known as traumatic neurasthenia.
Prevention: The treatment consists in absolute rest (the worst cases not being allowed to get up to void urine, the feces, or even turn in bed without assistance), passive exercise, massage, diet, and, electricity. As the patient improves, baths are to be added. The treatment is to be continued from one to three months. A favorite diet in the beginning\" is one glass of milk every two hours, gradually increasing the quantity till lie is taking a pint or more at each feeding. After two or three weeks, solids are added, which consist of fruits and vegetables, and finally chops, steak, and roast-beef. The faradic and static currents give the best results.
Where the patient is not very sensitive to shock, cold shower or sponge baths are attended by good results. As the patient grows stronger and takes on flesh, outdoor exercise should be taken, care being exercised not to carry it to exhaustion. Tennis, golf, rowing, and surf-bathing will prove of great benefit in stimulating the appetite, improving digestion, and establishing the excretions.
The patient should have cheerful surroundings, agreeable companions, and his reading should be of a light vein and a humorous style, especially avoiding the tragic and all that tends to excite the mind. In the way of medication, the treatment will be entirely symptomatic, only giving naturals when specially indicated. Avena, passiflora, rhus, and the compound tonic mixture will be frequently called for, while chronic constipation must be corrected by appropriate medication before much relief will be obtained.
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