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April 3, 1978

Hyperventilation. The Vapors. Effort Syndrome. Neurasthenia: Anxiety by Any Other Name Is Just as Disturbing

Author Affiliations

Scripps Clinic and Research Foundation La Jolla, Calif
From the Division of Neurology, Psychiatry, and Psychology, Scripps Clinic and Research Foundation, La Jolla, Calif.

JAMA. 1978;239(14):1401-1402. doi:10.1001/jama.1978.03280410043015

WHEN Shelley wrote these lines, was he, in fact, hyperventilating? The question is moot: he would not have recognized the term in any case. The concept of hyperventilation, something of a great gooney bird, is only the latest attempt to subsume some diverse symptoms of anxiety in a word.

Shelley would probably have called his affliction "the vapours." The term "vapors" is difficult for modern physicians to comprehend, since our understanding of it is that of the primary definition of the dictionary, signifying steam, gas, or visible exhalation. However, in the 19th century, the pleural of the term had a far broader meaning: to wit, a disease of nervous debility, in which a variety of strange images float in the consciousness appearing as if real—hence, hypochondriacal affections, depressions of spirit, dejection, spleen, the blues, or, to escalate again to contemporary terminology, a chronic anxiety reaction.

The vapors also described a