CHAPTER I

Nervous Diseases

Nervous Debility-How to Cure Sleeplessness-Collapse-Treatment of Neuralgia and Rheumatism-Neuralgia-Remedies for Convulsions-Epilepsy-Unconsciousness-Apoplexy-Delirium Tremens.

NERVOUS EXHAUSTION; NERVOUS DEBILITY (Neurasthenia).-Nervous exhaustion is by far the most frequent of the nervous diseases, especially in the United States, on which account it has been called the American Disease. The condition was first described and named by Beard of New York in 1879. He defined it as a state in which there is a deficiency of nerve force, shown by undue sensitiveness (and reaction) to external impressions. Mental impressions are greatly exaggerated. What would be but a molehill to the robust, becomes magnified so that it appears as a mountain; a nervous strain, borne without trouble by the strong, results in nervous collapse; slight muscular effort occasions fatigue out of all proportion to the cause.

Causes. No case is found, as a rule, to be due to any one cause. Usually several causes are conjoined. Heredity plays an important part. Weakness and instability of the nervous apparatus, what is called a

neurotic temperament, is frequently inherited from parents, themselves the victims of nervous or mental troubles, or addicted to excesses of some kind. It may be due to faulty development and nutrition of the child while yet unborn. Individuals with the neurotic temperament may be healthy if no continuous strain be sustained by them, but they have no reserve capital of nerve force, and easily succumb. Persons not born with weak nervous systems may acquire nervous exhaustion through mental and physical overwork, prolonged emotional excitement, care, anxiety, or grief. Worry is both a cause and an effect of nervous prostration.

Certain occupations are more favorable to the development of the disease. Thus, teachers, brokers, bankers, journalists, business men, and women fretted by manifold household cares are especially prone to nervous prostration. Poisons produce the condition, so that alcoholics and tobacco in some, morphine and the poisons of grippe, typhoid fever, and syphilis in others, are not infrequent causes. Sexual excesses, prolonged sexual excitement, and abuse of the sexual organs in the young (see Health and Purity, consult p. 205) occasion nervous debility, although the dread of the consequences is often a more potent factor than the damage done in the case of the latter misfortune. The strong emotional excitement induced by the longings, doubts, fears, and hopes of love and religion is also responsible for its share of neurasthenia. Diseases of

special organs may so exhaust the nervous system as to cause general prostration. When such can be cured, the nervous prostration is likewise relieved. Injuries to the head and back not at all uncommonly give rise to nervous exhaustion, even in the strongest persons. Trepidation over suits, or claims for damages, increases neurasthenia.

Symptoms.-Nervous exhaustion occurs more frequently between the ages of twenty and forty. Both sexes are subject to it. Patients are usually of a spare figure, but occasionally are very stout.

The symptoms are more numerous and varied than in any other disorder known, while the actual alteration in the anatomy or structure of the nervous system, if any, is unknown. Among the most frequent symptoms are: a feeling of pressure and fatigue in the top and back of the head; pain in the lower part of the spine and back of the neck; muscular weakness, as in walking; numbness, and creepy or crawling sensations in the skin; or feelings of heat or cold, imaginary feverishness, or general chilliness; and, again, burning, hot flashes, sweating and flushing of the surface. Tender spots along the spine, usually in more than one locality, and morbid introspection, or self-analysis of symptoms are very common. There is often despondency, confusion of the mind, and inability to fix the attention, so that it becomes almost impossible for the patient to add a column of figures or dictate a letter. The emotions are under poor control, and pa

tients may weep on the slightest cause. The temper is apt to be irritable or moody, and the subject forever fearful and anxious about himself. He imagines he is becoming insane, is afraid to ride on the cars, to go among crowds, to be alone, fears tall buildings will fall on him, dreads fatal disease, thunder and lightning, etc. The sleep is variable; there is commonly sleeplessness, occasionally the opposite condition. The digestion usually suffers; the symptoms of special digestive diseases may be present (see Nervous Dyspepsia, p. 462). Constipation is frequent.

Pain and distress in the region of the heart, and violent, rapid, and irregular heart action are frequent causes for complaint. Disorders of the sexual organs are the rule; in women, disordered menstruation and pain in the ovaries; in men, inability to perform the sexual act, or great exhaustion after it, or premature discharge from the sexual organ. Muscular weakness is shown at times, in severe cases, by unsteady, uncertain, and trembling gait; sometimes by difficulty in enunciating and in writing. Pain may be felt anywhere -in the skin, head, neck, muscles, joints, or some internal organ. While all the symptoms enumerated never attack the same patient at any one time, they are apt to be more or less troublesome at different times; some being prominent in some persons, others in other individuals. Occasionally only one symptom is at all salient, and in that case the determination of the causes is difficult.