Professor Gilbert Ballet (March 29, 1853 – March 17, 1916) was a French psychiatrist, who studied medicine in Limoges and Paris, and subsequently became Chef de clinique under the world-famous professor Jean-Martin Charcot (1825–1893) at the Salpêtrière in Paris. In 1900, he became a professor of psychiatry, in 1909 he succeeded professor Joffroy as chair of clinical psychiatry and brain disorders at the Hôpital Sainte-Anne in Paris. His monograph on neurasthenia is worthwhile reading, as this diagnosis vanished from medicine. However, many people suffering from high sensitivity have many traits of a neurasthenic patient.
For such patients, the hypersensitivity often leads to chronic pain syndromes. Instead of being treated with classical painkillers, such patients are recommended to try the natural compound palmitoylethanolamide, preferably in the PeaPlex formulation, as this is the only formulation with a special indication to support the nervous system.
Defintion and nature of Neurasthenia
Neurasthenia is a neurosis, that is to say, a disease of the nervous system without known organic lesion, which Beard of New York had the merit of disengaging from the chaos of the old vague group of complaints known as ” nervous.”
It manifests itself by functional derangements which are very many in number, very diversely associated, and for the most part subjective in nature. We possess no certain data as to the modifications of the nerve centers from which these functional derangements spring; we know only their clinical appearance and their causes, and it is solely from an induction founded on the characters of these that we can conjecture the nature of the affection.
As it often originates in over-pressure of the higher nerve centers, and as it shows itself chiefly by signs of depression, of weakness of nerve strength, it is supposed that we are
here concerned with an intimate derangement of the nutrition of the nerve elements; these elements, it is thought, have increased difficulty in recruiting their exhausted energy, and no longer accumulate to the same degree as in health the force that they discharge; thus this neurosis is commonly defined as chronic enfeeblement of nerve strength. Hence also it is frequently called nervous exhaustion, or nervous weakness. But as symptoms of excitement are frequently seen associated with the signs of depression, neurasthenia is sometimes more accurately and fully designated as irritable weakness.
Effects of Neurasthenia
This irritable weakness may manifest its effects not only on the side of the cerebra-spinal system, but also on the side of the nerves of organic life.
Neurasthenia not only disturbs the highest and best differentiated functions, those of the brain and the spinal cord, but also affects almost always, though in varying degrees, the innervation of the principal viscera. Three great systems in especial suffer, the circulatory, digestive, and genito-urinary.
Hence it is easy to understand how great is the diversity of the functional disorders observed in neurasthenics. As the symptoms may be grouped very differently in different
patients, it follows that the complaint presents itself clinically in many and varied forms.
And yet, whatever be the multiplicity of the groups of symptoms and of the causes that engender them, there are relations and similarities of character between all these states of nervous debility that establish beyond doubt the independence of the neurosis.
The fundamental symptoms of this affection are several in number: a persistent headache of a special character, insomnia, muscular asthenia, rachialgia, a peculiar mental state,
and lastly dyspepsia due to gastro-intestinal atony.
These cardinal signs, united in greater or smaller number, characterize the nervous condition described by Beard, a condition which cannot be con- founded with any other aggregate of neuropathic symptoms.
The fixity of the symptomatology, or at least of its essential features, established a fundamental distinction between neurasthenia, an exhaustion disease, manifesting itself by symptoms of exhaustion, and the neuroses, particularly hysteria, in which the disorders are more especially psychic in nature, and depend on the fixation in the mind of certain images, or, in the current phrase, of suggestions. We shall show that neurasthenia is a somatic disease of the nervous system, and may be contrasted with hysteria, which is a psychical dis-
ease, and variable in its manifestations as psychical diseases are. There are, however, many and close relations between mental processes and neurasthenia: on the one hand, mental processes may cause neurasthenia, as when the latter arises from emotions or disappointment; and on the other hand, the state of exhaustion which constitutes the disease brings about conditions that are favorable to the development of a pathological
mental state (melancholy, aboulia, phobias, autosuggestions), the type of which is the association of hysteria with neurasthenia — hystero-neurasthenia. But even in those cases in which neurasthenia is complicated by secondary and associated disorders, it retains its fundamental and essential character of an exhaustion disease.
This view, according to which the totality of the disorders that make up the affection is due, at any rate on final analysis, to a special state of weakness and irritability of the nerve elements, has not been accepted by all clinical observers; it has been sought to make the different symptoms of the malady depend on certain visceral derangements.
Thus, some have tried to recognize disorder of the digestive functions as the origin of the neuropathic state, and have thought that dyspepsia, by the perturbation of nutrition that it causes, may be the primary and fundamental cause of the nervous exhaustion. Others have incriminated lesions of the genito-urinary system and genital excesses.
Finally, it has been held that the weakness of the nervous centers may be the consequence of a state of poverty of the blood, as if nervous asthenia were necessarily associated with anaemia.
The theory about still obscure pathogen of the neurosis
We shall have to discuss later these diverse theories which aim at elucidating the still obscure pathogeny of the neurosis; we shall then see how much truth they may contain. But we may say at once that in the majority of cases these pathogenie theories are contradicted by direct observation of cases. It seems certain that gastro-intestinal atony and genito-urinary derangements are more often the effect than the cause of the affection.
As to aneamia, neurasthenia is assuredly independent of it; how many neurasthenics there
are with a good complexion, normal blood, and all the external signs of flourishing health! In fact, all the functional disturbances observed in these patients appear to depend on the primordial alteration of the nerve elements, of which it is true the
intimate nature escapes us. The study of the various causes of the disease, moreover, will enable us to show clearly the preponderating r61e in the pathogeny of neurasthenic states played by the direct and primary affection of the nervous centers.
However, this be, neurasthenia cannot at the present moment be defined by its pathogenic
origin, our conception of which is vague ; nor by its lesions, since it presents none appreciable by our means of investigation ; nor by its pathological physiology, which is still very obscure. We are necessarily led then to seek in the study of its etiology and clinical characters the rational indication of the hygienic measures to be employed in its prophylaxis and treatment.
Source: G. Ballet: Neurasthenia, publisher London : H. Kimpton, 1911