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JAMA 100 Years Ago
March 24/31, 2004


Author Affiliations

JAMA 100 Years Ago Section Editor: Jennifer Reiling, Assistant Editor.

JAMA. 2004;291(12):1512. doi:10.1001/jama.291.12.1512

In his recent volume of lectures on diseases of the nervous system, in the course of his description of a case that he found labeled on the bed card of his clinic "simple neurasthenia," though on the gums of the patient he found a conspicuous lead line, Sir William Gowers has something to say of the word neurasthenia and of other words that may cover symptom-complexes, for which it would be much better if the physician should find more definite terms. He says:

The concise and concrete character of the word neurasthenia gives it a satisfying definiteness. This depends to a large extent on its clinical and somewhat graceful sound. Not only is it graceful to the ear, but it is grateful to the mind of the patient who suffers and longs to know from what, who longs to have a name for that which he, or more often she, feels must be a more definite malady than is suggested by the common-place designation of nervous weakness. But its use has extended far beyond the needs of the patient and indeed did so from the first. It has firmly established itself in current clinical terminology. Men are apt to rest on it as they would not on its English equivalent. If they do not actually think that they have found the malady from which the patient is suffering an influence is often exerted on them (of which they are unconscious) which lessens the tendency to go further in the search for the whole morbid state. The Royal College of Physicians of London could not include it in their nomenclature of disease. And yet it is now one of the most common of medical words in every language.