NEURASTHENIA, a medical term for weakness of the nervous system. The symptoms may present themselves as f oh lows : general feeling of malaise, combined with a mixed state of excitement and depression; (2) headache, sometimes with the addition of vertigo, deafness and a transitory clouding of con sciousness simulating petit mal or migraine; (3) disturbed and restless, unrefreshing sleep, often troubled with dreams; (4) weakness of memory, especially for recent events; (5) blurring of sight, noises or ringing in the ears; (6) variable disturbances of sensibility, especially scattered analgesia (partial and symmet rical) affecting the backs of the hands especially, and in women the breasts; (7) various troubles of sympathetic origin, notably local ized coldness, particularly in the extremities, morbid heats, flush ings and sweats; (8) various phenomena of nervous depression associated with functional disturbances of organs.
According to the complexity of symptoms, the neurasthenia is more particularly defined as cerebral, spinal, gastric and sexual. The cerebral form is sometimes termed psychasthenia, and is liable to present morbid fears or phobias, e.g., agoraphobia (fright in crowds), monophobia (fright of being alone), claustrophobia (fright of being in a confined place), anthropophobia (fright of society), batophobia (fright of things falling), siderodromophobia (fright of railway travelling). There may also be mental rumina tions, in which there is a continuous flow of connected ideas from which there is no breaking away, often most insistent at night and leading to insomnia. Sometimes there is arithmomania (an im
perative idea to count). Such cases often exhibit a marked emo tionalism and readily manifest joy or sorrow; they may be cynical, pesimistic, introspective and self-centred, only able to talk about themselves or matters of personal interest, yet they frequently possess great intellectual ability, and there is an absence of the insane ideas characteristic of melancholia.
Traumatic neurasthenia is the neurasthenia following shock from injury; it is sometimes termed "railway spine," "railway brain," from the frequency with which it occurs after railway acci dents, especially in people of a nervous temperament. The physi cal injury at the time may be slight, so that the patient is able to resume work, but symptoms develop later which may simulate serious organic disease. As in all forms of neurasthenia, the sub jective symptoms may be numerous and varied, whereas the objective signs are but few and slight. Many difficulties, there fore, present themselves in arriving at a sound opinion as to the future in such cases. "Shell-shock" (q.v.) is a modern variant of neurasthenia occasioned by war conditions. The treatment of neurasthenia is largely psychical and if carried out systematically is often very successful (see PSYCHOTHERAPY). (F. W. Mo.)