Re: Dysautonomia:A family of misunderstood disorders

[Guest guest]

The Disappearance of Neurasthenia

By Whitmars

(In answer to Janet 's question " What happened to neurasthenia? " in

the Spring 1998 edition of Emerge)

The answer is somewhat complex but, in short, it fell into disuse.

Beard, a neurologist, had first described- neurasthenia in 1869 and

considered it due to the sufferer's commitments literally over- taxing the

nervous system beyond that individual's capacity to do so without adverse

consequences. Unlike what was to follow, Beard recommended a regimen of rest,

in

bed or even hospital if necessary, nourishing food, general TLC from relatives,

and consideration from employers.

A good description of the historical development of this syndrome can be

found in Sicherman (1977). Wessely (1990) is also worth a look, and a good

description of the treatment of the time can be found in Musser and

(1912).

From the sufferer's point of view the situation was reasonably satisfactory,

as both diagnosis and treatment were available, and even an explanation;

sufferers had exceeded their constitutional limitations. A collection of

psychological and physical symptoms were satisfactorily explained, with no real

stigma attached to the former.

Unfortunately, a number of factors conspired to change this. Firstly,

syndrome began to be seen as over-inclusive; doctors thought there were too

many

symptoms (and therefore probably multiple conditions) being included under the

heading of neurasthenia.

Secondly, of these symptoms a fair number occurred in conditions

classifiable as psychological, and in any case no less an authority than

Sigmund Freud

also considered neurasthenia a neurosis.

Thirdly, during the Great War military personnel were invalided out with

similar symptoms but labelled " battle neurosis " . Unfortunately, this led to

this

particular syndrome to be classified as a form of hysteria, thus

stigmatising its symptoms.

Fourthly, despite the various outbreaks of the syndrome around the world

since then, the laboratory science medicine increasingly relied upon has until

recently failed to find any distinctive signs of a biological cause.

As a consequence of all this, although the term neurasthenia was used into

the twentieth century, it became a hazy concept which largely fell out of use,

having little perceived value as a syndrome after about 1920. But lack of

evidence of biological involvement has allowed the term itself to languish in

the psychiatric domain.

It would be nice to be able to say that biological findings now being made

portend the identification of causes and treatments, but that does not seem to

be the case. Findings of all sorts are written up, queried, often not

confirmed, and not infrequently ignored. Explanations for ME/CFS are put

forward in

terms clearly reflecting the specialisations of the authors and sometimes

with inadequate regard to symptoms, other findings, or even what sufferers say

about their condition. Much of this is par for the course in scientific

research, though the last should not be.

It is irritating, of course, that no-one seems to be attempting an overview

of findings to see what links can be forged between them both to construct a

workable hypothesis and to set aside (but not forget entirely) those which do

not seem to fit. It makes the neurasthenic model seem very attractive,

especially where treatment is concerned, and it is not surprising that many

sufferers turn to unconventional medical and complementary medicine treatments

as

at least attempting to do something other than just " manage " a condition

currently not curable by conventional medicine.

References:

MUSSER, H. & , O.A., (eds.) (1912), 'A Handbook of practical

Treatment " (Meridian Institute's website at

http://pages.prodigy.com/MeridianInstitute/neurasth.htm).

SICHERMAN, Barbara, (1977), " The Uses of a Diagnosis: Doctors, Patients, and

Neurasthenia " , Journal of the History of Medicine, Vol 33-54.

WESSELY, Simon (1990), " Old Wine and New Bottles - Neurasthenia and ME " ,

Psychological Medicine, vol. 20, pp 35-53.

Reprinted from Emerge, Summer 1998

[Guest guest]

Here's a shorter URL:

http://heartdisease.about.com/cs/womensissues/a/dysautonomia.htm

Carl Grimes

Healthy Habitats LLC

-----

> Dysautonomia

> From N. Fogoros, M.D.,

>

> http://searcht.netscape.com/ns/boomframe.jsp?

> query=dysautonomia & page=1 & offset=0 & result_url=redir%3Fsrc%

> 3Dwebsearch%26requestId%3D4aa6c46137fc5a3c%26clickedItemRank%3D8%

> 26userQuery%3Ddysautonomia%26clickedItemURN%3Dhttp%253A%252F%

> 252Fheartdisease.about.com%252Fcs%252Fwomensissues%252Fa%

> 252Fdysautonomia.htm%26invocationType%3D-%26fromPage%3DNSCPResultsT%

> 26amp%3BampTest%3D1 & remove_url=http%3A%2F%2Fheartdisease.about.com%

> 2Fcs%2Fwomensissues%2Fa%2Fdysautonomia.htm

>

>

> A family of misunderstood disorders

> In the 19th and early 20th centuries there used to be a condition

> called neurasthenia. People would find themselves suddenly unable to

> function, due to a host of inexplicable symptoms, often including

> fatigue, weakness, strange pains, dizziness and passing out. Doctors

> would not find anything to explain these symptoms, so they were

> at

[snip]

[Guest guest]

There are still doctors who treat dysautonomia, and a couple of specialty

treatment centers. It makes for an interesting and enlightening read. They know

about the diabetes insipidus, the ehlers-danlos syndrome connection, orthostatic

hypotension, depression, and a lot of other things not mentioned in these

articles. And, they get recognized as non-crackpots (unlike most of us). They

have sub-classed the illness into groups, and some of that would look mighty

familiar to a lot of us.

But here's the thing - they don't get the mycotoxin connection and don't seem

too interested in endocrine disruptors in general. And the guys treating the

mycotoxin exposures don't seem to talk to the dysautonomia people any more than

the environmental docs talk to the other two groups or the rest of the poor

(wonderful) fools who have found themselves trying to understand CFS only

because they happened to be observant enough to discover it in their patients.

Which, again. Blind men. Elephant. Do the math. I don't so much fault them for

it, as I just find it extremely frustrating to see what happens when

specialization supercedes the limits of mental and physical endurance. Remember

that kids' game " If I Had a Million Bazillion Dollars " ? I think I'd pay

professional kidnappers to put the very best of all these people in a big room

together with nothing at all to do, and then not let them out again until they

got so bored they actually started talking to each other. Kind of like the hotel

bar after the conference shuts down for the day, except better snackage and no

booze. We'd let them go when they finally got excited about it and wanted to go

back to work. Yeah. That would be fun.

snk1955@... wrote:

The Disappearance of Neurasthenia

By Whitmars

(In answer to Janet 's question " What happened to neurasthenia? " in

the Spring 1998 edition of Emerge)

The answer is somewhat complex but, in short, it fell into disuse.

Beard, a neurologist, had first described- neurasthenia in 1869 and

considered it due to the sufferer's commitments literally over- taxing the

nervous system beyond that individual's capacity to do so without adverse

consequences. Unlike what was to follow, Beard recommended a regimen of rest,

in

bed or even hospital if necessary, nourishing food, general TLC from relatives,

and consideration from employers.

A good description of the historical development of this syndrome can be

found in Sicherman (1977). Wessely (1990) is also worth a look, and a good

description of the treatment of the time can be found in Musser and

(1912).

From the sufferer's point of view the situation was reasonably satisfactory,

as both diagnosis and treatment were available, and even an explanation;

sufferers had exceeded their constitutional limitations. A collection of

psychological and physical symptoms were satisfactorily explained, with no real

stigma attached to the former.

Unfortunately, a number of factors conspired to change this. Firstly,

syndrome began to be seen as over-inclusive; doctors thought there were too

many

symptoms (and therefore probably multiple conditions) being included under the

heading of neurasthenia.

Secondly, of these symptoms a fair number occurred in conditions

classifiable as psychological, and in any case no less an authority than

Sigmund Freud

also considered neurasthenia a neurosis.

Thirdly, during the Great War military personnel were invalided out with

similar symptoms but labelled " battle neurosis " . Unfortunately, this led to

this

particular syndrome to be classified as a form of hysteria, thus

stigmatising its symptoms.

Fourthly, despite the various outbreaks of the syndrome around the world

since then, the laboratory science medicine increasingly relied upon has until

recently failed to find any distinctive signs of a biological cause.

As a consequence of all this, although the term neurasthenia was used into

the twentieth century, it became a hazy concept which largely fell out of use,

having little perceived value as a syndrome after about 1920. But lack of

evidence of biological involvement has allowed the term itself to languish in

the psychiatric domain.

It would be nice to be able to say that biological findings now being made

portend the identification of causes and treatments, but that does not seem to

be the case. Findings of all sorts are written up, queried, often not

confirmed, and not infrequently ignored. Explanations for ME/CFS are put

forward in

terms clearly reflecting the specialisations of the authors and sometimes

with inadequate regard to symptoms, other findings, or even what sufferers say

about their condition. Much of this is par for the course in scientific

research, though the last should not be.

It is irritating, of course, that no-one seems to be attempting an overview

of findings to see what links can be forged between them both to construct a

workable hypothesis and to set aside (but not forget entirely) those which do

not seem to fit. It makes the neurasthenic model seem very attractive,

especially where treatment is concerned, and it is not surprising that many

sufferers turn to unconventional medical and complementary medicine treatments

as

at least attempting to do something other than just " manage " a condition

currently not curable by conventional medicine.

References:

MUSSER, H. & , O.A., (eds.) (1912), 'A Handbook of practical

Treatment " (Meridian Institute's website at

http://pages.prodigy.com/MeridianInstitute/neurasth.htm).

SICHERMAN, Barbara, (1977), " The Uses of a Diagnosis: Doctors, Patients, and

Neurasthenia " , Journal of the History of Medicine, Vol 33-54.

WESSELY, Simon (1990), " Old Wine and New Bottles - Neurasthenia and ME " ,

Psychological Medicine, vol. 20, pp 35-53.

Reprinted from Emerge, Summer 1998

[Guest guest]

I hope this is some good information for some

http://www.ndrf.org/dysautonomia_clinic_resea.htm

-- In , SERENA EDWARDS <pushcrash@y...>

wrote:

>

> There are still doctors who treat dysautonomia, and a couple of

specialty treatment centers. It makes for an interesting and

enlightening read. They know about the diabetes insipidus, the

ehlers-danlos syndrome connection, orthostatic hypotension,

depression, and a lot of other things not mentioned in these

articles. And, they get recognized as non-crackpots (unlike most of

us). They have sub-classed the illness into groups, and some of that

would look mighty familiar to a lot of us.

>

> But here's the thing - they don't get the mycotoxin connection

and don't seem too interested in endocrine disruptors in general.

And the guys treating the mycotoxin exposures don't seem to talk to

the dysautonomia people any more than the environmental docs talk to

the other two groups or the rest of the poor (wonderful) fools who

have found themselves trying to understand CFS only because they

happened to be observant enough to discover it in their patients.

>

> Which, again. Blind men. Elephant. Do the math. I don't so much

fault them for it, as I just find it extremely frustrating to see

what happens when specialization supercedes the limits of mental and

physical endurance. Remember that kids' game " If I Had a Million

Bazillion Dollars " ? I think I'd pay professional kidnappers to put

the very best of all these people in a big room together with

nothing at all to do, and then not let them out again until they got

so bored they actually started talking to each other. Kind of like

the hotel bar after the conference shuts down for the day, except

better snackage and no booze. We'd let them go when they finally got

excited about it and wanted to go back to work. Yeah. That would be

fun.

>

> snk1955@a... wrote:

> The Disappearance of Neurasthenia

>

> By Whitmars

>

> (In answer to Janet 's question " What happened to

neurasthenia? " in

> the Spring 1998 edition of Emerge)

>

>

> The answer is somewhat complex but, in short, it fell into disuse.

>

> Beard, a neurologist, had first described- neurasthenia in

1869 and

> considered it due to the sufferer's commitments literally over-

taxing the

> nervous system beyond that individual's capacity to do so without

adverse

> consequences. Unlike what was to follow, Beard recommended a

regimen of rest, in

> bed or even hospital if necessary, nourishing food, general TLC

from relatives,

> and consideration from employers.

>

> A good description of the historical development of this syndrome

can be

> found in Sicherman (1977). Wessely (1990) is also worth a look,

and a good

> description of the treatment of the time can be found in Musser

and (1912).

>

> From the sufferer's point of view the situation was reasonably

satisfactory,

> as both diagnosis and treatment were available, and even an

explanation;

> sufferers had exceeded their constitutional limitations. A

collection of

> psychological and physical symptoms were satisfactorily

explained, with no real

> stigma attached to the former.

>

> Unfortunately, a number of factors conspired to change this.

Firstly,

> syndrome began to be seen as over-inclusive; doctors thought

there were too many

> symptoms (and therefore probably multiple conditions) being

included under the

> heading of neurasthenia.

>

> Secondly, of these symptoms a fair number occurred in conditions

> classifiable as psychological, and in any case no less an

authority than Sigmund Freud

> also considered neurasthenia a neurosis.

>

> Thirdly, during the Great War military personnel were invalided

out with

> similar symptoms but labelled " battle neurosis " . Unfortunately,

this led to this

> particular syndrome to be classified as a form of hysteria, thus

> stigmatising its symptoms.

>

> Fourthly, despite the various outbreaks of the syndrome around

the world

> since then, the laboratory science medicine increasingly relied

upon has until

> recently failed to find any distinctive signs of a biological

cause.

>

> As a consequence of all this, although the term neurasthenia was

used into

> the twentieth century, it became a hazy concept which largely fell

out of use,

> having little perceived value as a syndrome after about 1920. But

lack of

> evidence of biological involvement has allowed the term itself to

languish in

> the psychiatric domain.

>

> It would be nice to be able to say that biological findings now

being made

> portend the identification of causes and treatments, but that

does not seem to

> be the case. Findings of all sorts are written up, queried, often

not

> confirmed, and not infrequently ignored. Explanations for ME/CFS

are put forward in

> terms clearly reflecting the specialisations of the authors and

sometimes

> with inadequate regard to symptoms, other findings, or even what

sufferers say

> about their condition. Much of this is par for the course in

scientific

> research, though the last should not be.

>

> It is irritating, of course, that no-one seems to be attempting

an overview

> of findings to see what links can be forged between them both to

construct a

> workable hypothesis and to set aside (but not forget entirely)

those which do

> not seem to fit. It makes the neurasthenic model seem very

attractive,

> especially where treatment is concerned, and it is not surprising

that many

> sufferers turn to unconventional medical and complementary

medicine treatments as

> at least attempting to do something other than just " manage " a

condition

> currently not curable by conventional medicine.

>

> References:

> MUSSER, H. & , O.A., (eds.) (1912), 'A Handbook of

practical

> Treatment " (Meridian Institute's website at

> http://pages.prodigy.com/MeridianInstitute/neurasth.htm).

>

> SICHERMAN, Barbara, (1977), " The Uses of a Diagnosis: Doctors,

Patients, and

> Neurasthenia " , Journal of the History of Medicine, Vol 33-54.

>

> WESSELY, Simon (1990), " Old Wine and New Bottles - Neurasthenia

and ME " ,

> Psychological Medicine, vol. 20, pp 35-53.

>

> Reprinted from Emerge, Summer 1998

>

>

>