Outwitting Our Nerves | Page 4

the fat-sheath is not wanting, there is no

inflammation, there is nothing lacking in the cell itself, and there is no
accumulation of fatigue products. Paradoxical as it may sound, there is
nothing the matter with a nervous person's nerves. The faithful
messengers have borne the blame for so long that their name has gotten
itself woven into the very language as symbolic of disease. When we
speak of nervous prostration, neurasthenia, neuroses, nervousness, and
"nerves" we mean that body and mind are behaving badly because of
functional disorder. These terms are good enough as figures of speech,
so long as we are not fooled by them; but accepting them in their literal
sense has been a costly procedure.
Thanks to the investigations of physiologist and psychologist, usually
combined in the person of a physician, "nervousness" has been found to
be not an organic disease but a functional one. This is a very important
distinction, for an organic disease implies impairment of the tissues of
the organ, while a functional disorder means only a disturbance of its
action. In a purely nervous disorder there seems to be no trouble with
what the nerves and organs are, but only with what they do; it is
behavior and not tissue that is at fault. Of course, in real life, things are
seldom as clear-cut as they are in books, and so it happens that often
there is a combination of organic and functional disease that is puzzling
even to a skilled diagnostician. The first essential is a diagnosis as to
whether it be an organic disease, with accompanying nervous
symptoms, or a functional disturbance complicated by some minor
organic trouble. If the main cause is organic, only physical means can
cure it, but if the trouble is functional, no amount of medicine or
surgery, diet or rest, will touch it; yet the symptoms are so similar and
the dividing line is so elusive, that great skill is sometimes required to
determine whether a given symptom points to a disturbance of physical
tissue or only to behavior.
If the physician is sometimes fooled, how much more the sufferer
himself! Nausea from a healthy stomach is just as sickening as nausea
from a diseased one. A fainting-spell is equally uncomfortable, whether
it come from an impaired heart or simply from one that is behaving
badly for the moment. It must be remembered that in functional
nervousness the trouble is very real. The organs are really "acting up."

Sometimes it is the brain that misbehaves instead of the stomach or
heart. In that case it often reports all kinds of pains that have no origin
outside of the brain. Pain, of course, is perceived only by the brain. Cut
the telegraph wire, the nerve, and no amount of injury to the finger can
cause pain. It is equally true that a misbehaving brain can report
sensations that have no external cause, that have not come in through
the regular channel along the nerve. The pain feels just the same, is
every bit as uncomfortable as though its cause were external.
Sometimes, instead of reporting false pains, the brain misbehaves in
other ways. It seems to lose its power to decide, to concentrate, or to
remember. Then the patient is almost sure to fancy himself going
insane. But insanity is a physical disease, implying changes or toxins in
the brain cells. Functional disorders tell another story. Their cause is
different, even though the picture they present is often a close copy of
an organic disease.
=Distorted Pictures.= It should not be thought, however, that the
symptoms of functional and organic troubles are identical. Hysteria and
neurasthenia closely simulate every imaginable physical disease, but
they do not exactly parallel any one of them. It may take a skilled eye
to discover the differences, but differences there are. Functional
troubles usually show a near-picture of organic disease, with just
enough contradictory or inconsistent features to furnish a clue as to
their real nature. For this reason it is important that the treatment of the
disease be solely the province of the physician; for only the carefully
trained in all the requirements of diagnosis can differentiate the pseudo
from the real, the innocuous from the disastrous.
False or nervous neuritis may feel like real neuritis (the result of
poisons in the blood), but it gives itself away when it localizes itself in
parts of the body where there is no nerve trunk. The exhaustion of
neurasthenia sometimes seems extreme enough to be the result of a
dangerous physical condition; but when this exhaustion disappears as if
by magic under the proper kind of treatment, we know that the trouble
cannot be in the body. Let it be said, then, with all the emphasis we can
command, "nerves" are not physical. Laboratory