Response to Dr. Massey's "Neurasthenia, psychasthenia, CFS, and related matters".
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Results of experiments on animals with ablation of different parts of the brain and analysis of published data suggest that the neurophysiological basis of temperaments, according to Hippocrates, of nervous system types, according to Pavlov, and of extra-introversion consists in individual peculiarities of interaction of four structures: the frontal neocortex, the hippocampus, the amygdala and the hypothalamus. Pathological disturbance of this interaction produces the basic varieties of neuroses: hysteria, neurasthenia, psychasthenia and obsessive states. The significance is discussed of individual features of sets and hierarchy of basal human needs: material-biological, social, ideal (with their variants: retention and development, "for oneself" and "for others") needs of overcoming (will) and of "fitness" - for the formation of individuality.
In the present study the results of a neurological and neurophysiological health examination of 29 aircraft factory workers chronically exposed to jet fuel vapors are presented. The exposed subjects were classified into a heavily exposed and a less heavily exposed group. The examination included a standardized clinical neurological examination, measurements of the conduction velocities in the peripheral nerves, and threshold determinations of vibratory sensations in the extremities. All 13 persons examined in the heavily exposed group and 7 of the 16 in the less heavily exposed group stated that they had repeatedly experienced acute effects (dizziness, respiratory tract symptoms, heart palpitations, a feeling of pressure on the chest, nausea, headache) of the jet fuel vapors in the inhaled air. A high rate of symptoms indicative of neurasthenia and psychasthenia and symptoms and signs indicative of polyneuropathy was observed both in the heavily exposed group and in the two groups combined in comparison with reference groups. Considering the presented facts concerning (a) the acute effects on repeated occasions, (b) the high rates of symptoms indicative of neurasthenia and psychasthenia and symptoms and signs indicative of polyneuropathy, and (c) the differences in the observations made between the two groups with varying degrees of exposure to jet fuel, the authors interpreted the results as indicative of a possible effect of long-term exposure to jet fuel on the nervous system.
The author describes some special traits in accomplishing the modified techniques for a formation of conceptions according to Vigotsky-Sakharov's test in patients with different forms of neuroses (neurasthenia, hysteria, psychasthenia). A study of conceptual thinking in such patients revealed a dissociation between the possibility of a practical mastering of the task and its verbalization on a conceptual level which is characteristic of hysteria.
The challenges of chronic fatigue syndrome (often called myalgic encephalomyelitis, especially in the UK) (CFS/ME) to analytical and medical approaches are connected with our inability to understand its distressing somatic symptoms in terms of a single identifiable and understandable disease entity. The evidence for the roles of viral aetiologies remains inconclusive, as does our understanding of the involvement of the immune system. The history and social context of CFS/ME, and its relation to neurasthenia and psychasthenia are sketched. A symbolic attitude to the condition may need to be rooted in an awareness of psychoid levels of operation, and the expression and spread of CFS/ME may sometimes be aided by the ravages of projective identification. Psychic denial, sometimes violent, in sufferers (especially children and adolescents) and their families may be important in the aetiology of CFS/ME. We draw out common threads from psychodynamic work with five cases, four showing some symptomatic improvement, analytic discussions of three cases being presented elsewhere in this issue of JAP.
Anxiety as a symptom, syndrome and diagnosis is discussed, as well as its overlapping with the concept of neuroses. The original concepts of neuroses, neurasthenia and psychasthenia that have been coined since the eighteenth century are revised, as well as its evolution from Freud to DSM IV and ICD 10.
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