NEURASTHENIA.

Auckland Star, Volume 55, Issue 152, 28 June 1924, Page 17

NEURASTHENIA.

NATURE AND TREATMENT. (By PERITUSI. Very few healthy poisons arc , attracted liy sickness' in others. Sympathy fur those who suffer is entirely a matter of the spirit and of I lie soul. ' Naturalists tell us of tin- rmolty exhibited hy wild animals Inwards the • sick of their own kind. Bird* will pork a sick companion to death, and it is. pcrliaps. this peculiarity of o\ir animal • ancestors which gives to us our natural dislike of ihe sick room. Where no cruelty or indifference is shown towards ■ the ailing liy healthy persons there is a suppression of the * ancesi nil instinct. just as a desire to kill an enemy (a quite natural desire i is. by most of'us. easily . set aside. The altruistic spirit of unselfishness and service which prompts the minority is not always evident even amongst doctors and'nurses, gome of ■whom act from quite other motives, for it is possible to succeed in work which makes no strong personal appeal. A quack will often succeed when prompted only by greed of gain; he may despise the patients who place in him their faith, even see them die as a result of his ignorance, and experience only regret that he loses in reputation ami profit. .Much sickness is, of course, repulsive, and the kindest relatives will welcome the death of an invalid, telling you it is a "happy release" fur the deceased. This may be so. but press for the truth, ai-il you will lincl that the attendants' sin i in the "happy release" is by no ii' ■' ::■•' n-iderablc " ■ ' • ■ mis. however, that indifference, lii'jtlut, and modified cruelty are the portion of the afflicted, who are in no sense repulsive. Now und aiain they are "pecked to death." 1 refer to men and women who sutler from neurasthenia. The physical discomfort and mental distress of neurasthenics are very real. The minrl is almost wholly occupied in forcing an exhausted body to continue living. Jf there is any actual physical pain (neuralgia, for instance), it is home only with an effort altogether disproportionate to its nature and severity. Vet such patients experience the cruelty of neglect and indifference. Neurasthenia implies "nerve exhaustion." a clumsy expression for lack of mental and physical vitality, a condition as difficult to rind a word for as it is to lind one word to define flat champagne. The champagne remains but the "life" and sparkle are gone. Dr. Playfair used to say that "no accurate description of such cases (neurasthenic) can be given, as the symptoms vary so much. Many cases occur in clever, emotional, but not fanciful people, who would give all they possess to be well. So, you see, there is no relation here to another common condition tabbed with the inappropriate name "hysteria."' Neurasthenia is indicated by such symptoms as excessive and unaccountable fatigue, sleeplessness, a gradual but sure loss of interest in everything, dyspeptic disorders, loss of weight (sometimes there is instead a deposit of flabby unhealthy fat), there may be great restlessness or exhaustion too great for movement, loss of appetite, and such "nervous" symptoms as palpitation and breathlessness without obvious cause. The condition can be produced by mental shock, prolonged mental strain. domestic or business worry or anxiety, "love affairs" —particularly misplaced affection or disappointment—and other sexual causes. 1 told you in a previous? article of the young woman who would always sleep upon a bare mattress upon the stair landing, and another who refused to wear any dress I>ut of one exceptional make and colour. Both these were neurasthenic cases which had drifted into what the public politely call "slightly mental."' As the disease is a combination of mental and physical exhaustion the rational treatment is to rest both systems, and at the same time restore energy and function. The treatment is the exact opposite of Upton Sinclair's exercise and starvation, for it consists of passive exercise (graduated massage) and graduated forced feeding. Unfortunately such treatment is not possible at small expense, and I know of no reliable "home" substitute. It involves removal from normal surroundings, absolute confinement to bed, daily passive exercise, and feeding pressed and continued to a point of over feeding. This last is the most important part of I the "cure.'' From a pint of milk daily jto two quarts in twenty-four hours (no ' other food), the patient is milk fed for ten days or so, and then other food is added, until in a few weeks three good solid meals are taken oac-h day beside, and perhaps a cup of strong soup twice daily after the massage. This heavy feeding is continued for six weeks, and then lessened, and the. patient permitted to get up. The weight will rise rapidly, and the flesh gain firmness, and the skin become clear and of good colour. All invalid habits disappear, and there is a general restoration to health. Neurasthenia is not amenable to drug treatment, which can only conceal or j suppress symptoms, and gives no lasting or real benefit. Delicate men and women need great care and watchfulness, but those of coarser type, whose trouble nevertheless is quite as severe in proportion, are sometimes restored by enforced regularity of life —during a period of imprisonment for instance, although I am not recommending this— I and at the same time removal from I all sources of worry. "My lady had the vapours."' is a not uncommon entry in diaries of long past days. It was the neurasthenia induced by late hours and social engagements which howled her ladyship over, but nowadays cases come from desk and counter, bench and platform, pulpit and kitchen, for each year we are "speeded up" by some iiew thing. It is time someone preached the gospel of "go slow' , with longer flours' of work where and when necessary, for there is no doubt that in a I country like ours there should be fewer cases of nervous diseases, and an almost bovine tranquillity of temperament is preferable to the haste and excitement which lead to nerve exhaustion, and "nervous breakdown.' . When in any family there is a "Lazy Mary" or a "Weary Willie."' the parents or responsible guardians should, before apportioning any blame, satisfy themselves that they have not with them a case of early neurasthenia. School life will produce this condition in quite young children, for nerve exhaustion is not entirely confined to adults. The fact that old restraints have been abandoned and our young people are permitted to keep late hours and often round off a day of study and school games by attendances at picture shows and other entertainments, causes the city child to lose much sleep, and as it has now been definitely proved that a change of occupation is not necessarily a rest, it is well to set a limit to nervous output.