Welcome to our exploration of neurasthenia as the word and the mental condition itself is unknown to most. Let's start with a case description of a person diagnosed with neurasthenia. The case was described by the American physician, George Beard, a major figure in the study and treatment of neurasthenia during the latter part of the 19th century. The patient was described in an 1869 Medical Science article when he was a young physician and treated that year. Let me read, he was 28 years of age, and for a long time he had been subject to severe and repeated attacks of nervous and sick headaches. To use his own expression, he had been quote, living on a lower plane than was normal, end quote. Over work and long confinement had reduced him to a condition of serious exhaustion. And when he called upon us in September he could not walk two miles without fatigue. Although 5 feet tall, 9.5 inches height, he weighed but 112 pounds and for many months there had been no sign of any increase. Beard diagnosed this young man as suffering from neurasthenia just find as the morbid state that is commonly indicated by the indefinite phrase nervous exhaustion. Neurasthenia was, and is an intriguing and oftentimes confusing diagnosis, yet it represents a significant change in what we're becoming the psychiatric sciences. It was one of the first major mental disorders that was explained as having both somatic, that is bodily, and psychological causes. Neurasthenia thus was largely presented as a psycho somatic illness. This departed from the fashion to attribute mental disorders to bodily states to the somatic. Series of origin, such as heredity, physical illness and brain injury. And as professional thinking about the disorder evolved, neurasthenia eventually also came to be seen as a psychological disease in its origin as a psychogenic disorder as you would say. Neurasthenia then illustrates what some call a diagnostic drift in which the diagnosis falls out of use yet the symptom complex persists, but it has given other names. It also illuminates the ways in which cultural conditions influence the symptoms displayed, the detection of those symptoms, the explanations and the treatments of that disorder. In fact, at times, neurasthenia was presented as a culture bound disorder. Let's first examine the discovery of neurasthenia and the scientific explanations that the physicians reported. Beard was not alone in urging recognition of neurasthenia as a serious disorder on the cluster of symptoms that he said were expressed by neurasthenics. In the same year, EH an Houston, also an American physician, encouraged the use of the term. Van Houston asked a mirrored Beard appraisal of this melody as and I quote, a very important and increasingly frequent condition of the system. These doctors shared not only a name, but also a long list of symptoms. These can be divided into the somatic, those symptoms that were bodily, and the functional or psychological. Here is the list, as you can see it's a long list and it's not even a fully comprehensive list. Beard, Van Houston, and other experts deemed as symptoms to include both somatic and functional psychological conditions. Their explanation of the causes, the ideology of neurasthenia also contained an admixture of the somatic, the bodily, and the function of the psychological conditions. We are able to look at this once prominent mental disorder from the vantage point of history. Our distance look enables us to discern the cultural and moral assumptions that were built into the science of neurasthenia. It contained assumptions about how to live well and how not to live well. As one expert wrote in the 1905, and I quote, it is a disease of bright intellectuals, its victims are leaders and masters of men, each one captain of industry, end quote. As this doctor's statement illustrates neurasthenia was inflicted with beliefs often anxious beliefs about class, race, and gender. Beard's 1881 book American Nervousness, its Causes and Consequences, the introduction of which is one of our assigned reading. That book registers many of these assumptions about race, class, and gender just as it offers a plethora of symptoms and causes. American Nervousness emphasized how neurasthenia frequency is due to the conditions of modern civilization, to economic, political, and cultural conditions. These dangers of civilization included steam power, the periodical press, the Telegraph Science, mental activity of women, civil liberties, religious liberties, business, personal habits of consumption, and so on. In all societal progress was to blame for the disease. The Beard did note climate to be a factor, these risk factors mostly affected. Beard believed, the affluent classes of men who are the brain workers and women who endure hothouse education and social expectations. Here then, is a clear example of the classist and racist temper of the scientific theory of neurasthenia. And I quote from that book, the barbarian cares nothing for the great problems of life, seeks no solution, thinks no solution of the mysteries of nature. And after the manner of many reasoners in modern delusions, dismisses what he cannot once comprehend as supernatural and leaves it unsatisfactorily solved for himself, for others, and for all time. The curiosity the Yankee, which went harness, trained and held in check, becomes the purity of invention, science, and ideas. Inquiring into everything with eagerness, unrest, impatient palpitating anxiety and breathlessness, draw heavily on the units of his nerve-force, end quote. You can see clearly hear race and class and gender inflections. The history of the discovery of neurasthenia richly illustrates some central factors in the emergence of science of mental illness. Its progenitors claimed that the causes of mental distress can be at once somatic and psychological, psychosomatic, and perhaps even at times psychogenic. Expert physicians identified environmental conditions that increase the likelihood of a person's developing a disorder. Today we call these factors risk factors of mental disorder. Among the risks writers under neurasthenia emphasized are becoming overly involved with modern civilization. With its rapid development of technologies and its new ways of living at home and at work. Our next section takes a closer look at the experience of person suffering from or persons diagnosed to be suffering from neurasthenia.
