. Medical diagnosis for the student and practitioner. kable case of cardiovascular syphilis with aneurysm and an enormousheart presenting typical neurasthenic symptoms. No murmurs were present. such as occur also individually or collectively in a great number of organic dis-eases and known constitutional defects. Whether the syndrome ever exists as a primary and independent conditionor as a concrete and definite symptom-complex is, at present, doubtful. Preliminary Comment.—To deal satisfactorily with a condition totallylacking demonstrable specific pathology and presenting only a melange of N
. Medical diagnosis for the student and practitioner. kable case of cardiovascular syphilis with aneurysm and an enormousheart presenting typical neurasthenic symptoms. No murmurs were present. such as occur also individually or collectively in a great number of organic dis-eases and known constitutional defects. Whether the syndrome ever exists as a primary and independent conditionor as a concrete and definite symptom-complex is, at present, doubtful. Preliminary Comment.—To deal satisfactorily with a condition totallylacking demonstrable specific pathology and presenting only a melange of NEURASTHENIA 1177 symptoms, individually and collectively such as may represent the commonestand most logical results of a great number of chronic and acute diseases,would seem to be, and undoubtedly is, a hopeless undertaking. Like those archaic terms heart trouble, stomach trouble, andliver trouble, the term neurasthenia has not only served as a cloak forour own diagnostic insufficiency, but as a standing invitation to loose methods a euphemism t. Fig. 585.—A case of cardiorenal disease cardiac enlargement and decidedhypertension. No murmurs were present. The symptoms of neurasthenia had provenmost misleading. in diagnosis, offering a too ready relief from some of the most vexing problemsencountered in medicine. If it were only on this ground it would seem thatthe term should either be dropped wholly, restricted to the few cases whichmay possibly be entitled to such a designation, or strictly limited as to itsuse to the description of true psychasthenia, using that term in its literalsense. Greatly Attenuated by Modern Diagnostic Methods.—To the author itwould appear that if we were to deduct from the cases of so-called neurasthenia 117S MEDICAL DIAGNOSIS those proving under thorough and scientific methods of investigation to be ex-amples of organic disease of the heart, kidneys and nervous system, chroniccryptogenic septic infection, chronic anemia, drug-hab
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