'Neurasthenia gastrica' revisited: perceptions of nerve-gut interactions in nervous exhaustion, 1880-1920.

Kristine Lillestøl

doi:10.1080/16512235.2018.1553438

Abstract

ABSTRACTIn this paper, some of the medical literature on the historical disease-concept of ‘neurasthenia gastrica’ is reviewed. Neurasthenia gastrica was defined as a sub-unit of the wider category of neurasthenia, also referred to as nervous exhaustion or nervous weakness. Neurasthenia was a commonly used diagnostic label at the end of the nineteenth century and a few decades onwards, and was used to describe a wide variety of symptoms for which no ‘organic’ basis could be found. In neurasthenia gastrica, however, the gastrointestinal symptoms predominated, and there was considerable debate as to how the gut interacted with the central nervous system in the development of these ailments. Some of these discussions may be seen as historical precedents for the current debates on the brain–gut–microbiota axis, particularly in relation to the so-called functional gastrointestinal disorders.

Highlights

Neurasthenia was a widely used diagnostic label in America and most European countries at the end of the nineteenth century
Beard was a New York neurologist, attending to the upper middle class patients of the city [4]. When he presented his reflections on ”Neurasthenia, or Nervous Exhaustion” for the first time, in a lecture to the New York Medical Journal Association in 1869, he opened by stating that neurasthenia, literally meaning ‘want of strength in the nerve’, was one of the most common causes and effects of disease at the time
The general clinical examinations did, rarely reveal any pathological findings [5]. When it came to etiological factors of the condition, Beard was of the opinion that ‘Neurasthenia may result from any causes that exhaust the nervous system’

Summary

Kristine Lillestøl

MICROBIAL ECOLOGY IN HEALTH AND DISEASE 2018, VOL. Kristine Lillestøla,b aSection for Medical Anthropology and Medical History, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway; bDepartment of Medical Genetics, Oslo University Hospital, Oslo, Norway

The origins of neurasthenia gastrica

Clinical descriptions

Treatment for the nervous gut

Findings

The end of neurasthenia gastrica?