Hysteria and neurasthenia in pre-1914 British medical discourse and in histories of shell-shock

Loughran, Tracey

doi:10.1177/0957154x07077749

Cited by 25 publications

(23 citation statements)

References 33 publications

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“…This trend continued during the war with officers diagnosed as neurasthenic and ranking men as hysterical [7,24]. The hysterical ranking soldier was seen in similar demeaning terms as hysterical females, while the neurasthenic officer was portrayed as closer to an acceptable male ideal [7,25]. However, despite the huge strides that neurologists were making in terms of the functional localization regarding the workings of the nervous system, neurasthenia remained stubbornly considered a 'functional' disorder for which physicians had been unable to find any structural pathology [15].…”

Section: Neurasthenia and Hysteria: Functional Disordersmentioning

confidence: 90%

Section: Neurasthenia and Hysteria: Functional Disordersmentioning

confidence: 97%

“…The symptom picture was extensive, with exhaustion as the main symptom [6]. The most prominent somatic symptoms were in fact listed as nervous exhaustion and fatigue, particularly constant tiredness and general aches and pains which might affect any or several bodily functions (circulation, digestion, sexual activity) [7]. Signs of autonomic nervous dysfunction included dilated pupils, sweaty hands, dry skin and mucous membranes, and generalized pruritus [8].…”

Section: Clinical Picture Of Neurastheniamentioning

confidence: 99%

“…Prior to 1914, hysteria and neurasthenia were considered as separate and opposite categories, in which various dichotomies are attached to each diagnosis: body/mind, female/male, lower/upper class, ancient/modern disease [7]. Charcot was categorical in distinguishing neurasthenia from hysteria, by focusing on the signs of sexual impotency, fatigue, and a tight band of pressure around the head present in patients with neurasthenia.…”

Section: Neurasthenia and Hysteria: Functional Disordersmentioning

confidence: 99%

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The Borderland with Neurasthenia (‘Functional Syndromes')

Paciaroni¹,

Bogousslavsky²

2014

Hysteria: The Rise of an Enigma

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At the end of the 19th century, neurasthenia and hysteria were considered distinct diseases. Specifically, neurasthenia was regarded as a disease of the body, whereas hysteria was regarded as a disease of the psyche. However, immediately before World War I, due to their common characteristics, both hysteria and neurasthenia were thought to be 'functional diseases'. Moreover, it was suggested that heredity and the presence in both of the predisposing condition called 'nervous weakness' were other shared factors. Nervous weakness was considered essential for the definition of neurasthenia, but it was also considered a precondition for the development of hysteria. Because of this, it is still difficult to demarcate a line between neurasthenia and hysteria; therefore, the two diseases should be considered as sharing a common borderland with each other.

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Section: Neurasthenia and Hysteria: Functional Disordersmentioning

confidence: 90%

Section: Neurasthenia and Hysteria: Functional Disordersmentioning

confidence: 97%

Section: Clinical Picture Of Neurastheniamentioning

confidence: 99%

Section: Neurasthenia and Hysteria: Functional Disordersmentioning

confidence: 99%

See 2 more Smart Citations

The Borderland with Neurasthenia (‘Functional Syndromes')

Paciaroni¹,

Bogousslavsky²

2014

Hysteria: The Rise of an Enigma

View full text Add to dashboard Cite

show abstract

“…But his emphasis on how neurasthenia presented differently in Puerto Ricans is suggestive considering the importance medical contemporaries placed on the role of the nervous system in the development of functional disease. 18 If Americans and Puerto Ricans were biologically different, mental illness, by extension, would also differ in cause and appearance.…”

Section: Neurasthenia and Race In The Medical Literaturementioning

confidence: 99%

Neurasthenia at Mengo Hospital, Uganda: A Case Study in Psychiatry and a Diagnosis, 1906–50

Pringle

2016

The Journal of Imperial and Commonwealth History

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This article uses a case-study approach to examine the complex and contradictory nature of diagnoses like neurasthenia in colonial Africa. Drawing on the case notes of European and African patients diagnosed with neurasthenia at the Church Missionary Society's Mengo Hospital, Uganda, it argues that in practice, and outside the colonial asylum in particular, ideas about race and mental illness were more nuanced than histories of psychiatry and empire might imply. At Mengo, the tales of pain and suffering recorded by the doctors remind us that there is more to the history of neurasthenia than colonial anxieties and socio-political control.

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“My Resisting Getting Well”: Neurasthenia and Subconscious Conflict in Patient‐psychiatrist Interactions in Prewar America

Lamb¹

2016

J History Behavioral Science

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This study examines experiences of individual patients and psychiatrists in the Henry Phipps Psychiatric Clinic at Johns Hopkins between 1913 and 1917. The dynamics of these patient-psychiatrist interactions elucidate the well-known conceptual shift in explanations of mental illness during the twentieth century, from somatic models rooted in the logic of "neurasthenia" and damaged nerves to psychodynamic models based on the notion of "subconscious conflict." A qualitative analysis of 336 cases categorized as functional disorders (a catchall term in this period for illnesses that could not be confirmed as organic diseases), shows that patients explained their symptoms and suffering in terms of bodily malfunctions, and, particularly, as a "breakdown" of their nervous apparatus. Psychiatrists at the Phipps Clinic, on the other hand, working under the direction of its prominent director, Adolf Meyer, did not focus their examinations and therapies on the body's nervous system, as patients expected. They theorized that the characteristic symptoms of functional disorders-chronic exhaustion, indigestion, headaches and pain, as well as strange obsessive and compulsive behaviors-resulted from a distinct pathological mechanism: a subconscious conflict between powerful primal and social impulses. Phipps patients were often perplexed when told their physical symptoms were byproducts of an inner psychological struggle; some rejected the notion, while others integrated it with older explanations to reconceptualize their experiences of illness. The new concept also had the potential to alter psychiatrists' perceptions of disorders commonly diagnosed as hysteria, neurasthenia, or psychoneuroses. The Phipps records contain examples of Meyer and his staff transcending the frustration experienced by many doctors who had observed troubling but common behaviors in such cases: morbid introspection, hypochondria, emotionalism, pity-seeking, or malingering. Subconscious conflict recast these behaviors as products of "self-deception," which both absolved the sufferer and established an objective clinical marker by which a trained specialist could recognize functional disorder. Using individual case studies to elucidate the disjunction between patients' and psychiatrists' perspectives on what all agreed were debilitating illnesses, this analysis helps to illuminate the origins of a radical transformation in psychiatric knowledge and popular culture in the twentieth century-from somatic to psychodynamic explanations of mental illness.

show abstract

Hysteria and neurasthenia in pre-1914 British medical discourse and in histories of shell-shock

Cited by 25 publications

References 33 publications

The Borderland with Neurasthenia (‘Functional Syndromes')

The Borderland with Neurasthenia (‘Functional Syndromes')

Neurasthenia at Mengo Hospital, Uganda: A Case Study in Psychiatry and a Diagnosis, 1906–50

“My Resisting Getting Well”: Neurasthenia and Subconscious Conflict in Patient‐psychiatrist Interactions in Prewar America

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