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Practitioner 2011; 255(1736): 28

100 years ago: Traumatic neurasthenia

16 Dec 2010Registered users

The train of symptoms which may follow various accidents, in which the patients may or may not have received a serious injury (now known as traumatic neurasthenia) was formerly ascribed to concussion of the spine, inflammation of the meninges and spinal cord, haemorrhages into the meninges and surface of the brain and cord, etc., and since greater public attention has been devoted to those occurring after railway accidents, the condition has been called "railway spine" and "railway brain". There can be no general rule of treatment applicable to all cases; each case must be separately studied. Where the original nerve shock has been great, and the symptoms of palpitation, headache, nervousness, and loss of memory are prominent features, the best treatment undoubtedly is a "rest-cure" for six weeks. Complete rest in bed is essential for the first two weeks at least, and isolation from relatives and friends and correspondence, with massage and overfeeding. General electrification by means of the faradic or sinusoidal current bath is usually the most efficacious means of applying electricity in these cases, the patient being immersed up to the neck in a warm bath, with two large flat electrodes applied, one to the back, the other to the feet, connected to the secondary coil of a faradic battery or sinusoidal current transformer.

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