December 14, 1994

The Legitimacy of Neurasthenia-Reply

Author Affiliations

Brigham and Women's Hospital Boston, Mass

JAMA. 1994;272(22):1719. doi:10.1001/jama.1994.03520220013005

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In Reply.  —Dr Trautman and Ms Vielma are quite right to point out that depression has become a widely used diagnostic label nowadays for people experiencing "life on a plane lower than normal," and I appreciate their emendations on the term. The attribution of nervous diseases to people in the upper social ranks has had a tradition in the West that stretches back to the Renaissance, if not earlier, and I think Beard and Love were merely tapping into that. Courtiers and scholars in the 16th and 17th centuries, for instance, were thought to be especially subject to nervous complaints. Laborers and yeoman, on the other hand, were considered by physicians and the educated laity to be less subject to affective distempers because of their simple diet and comparatively coarse bodily fabric. This bodily architectonic in turn rested on Platonic teachings that privileged the head and nerves (and rationality) over

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