Neurasthenia as a model of a disease thought to have disappeared. On an unpublished letter by Jean-Martin Charcot

D. A. Pérez Martínez
Neurosciences and History 2024;12(1):20-29

Type of article: ORIGINAL

AUTHOR

D. A. Pérez Martínez
Neurology Department. Hospital Universitario “12 de octubre,” Madrid, Spain.
Neurology Department. Hospital Universitario La Luz, Madrid, Spain.

ABSTRACT

Introduction. George Miller Beard first described neurasthenia in 1869 as a clinical picture characterised by fatigue, caused by the modern lifestyle of the 19th century. However, patients often also presented sleep disorders, cognitive complaints, digestive disorders, and symptoms of sexual dysfunction. The concept was disseminated internationally from 1880 by Jean-Martin Charcot, and became one of the most frequent diagnoses at the Salpêtrière at the time. However, from the 1930s the entity practically disappeared in the history of Western medicine.

Material and methods. This article reviews the concept of neurasthenia and its historical development. We present a previously unpublished private letter from 1888 by Prof Charcot, which includes real data on his clinical management of neurasthenia.

Results. Charcot followed a similar diagnostic and therapeutic approach to that of Beard. Today, patients with chronic fatigue syndrome, fibromyalgia, and more recently post–COVID-19 syndrome present similar symptoms to those initially described in neurasthenia.

Discussion. The emergence of post–COVID-19 syndrome or “long COVID” has resulted in an epidemic of patients with similar symptoms to those described by Beard in 1869. Nineteenth-century clinicians may already have described this patient profile, suggesting a shared pathophysiological basis.

KEYWORDS

George Miller Beard, Jean-Martin Charcot, long COVID, neurasthenia, chronic fatigue syndrome, post–COVID-19 syndrome

Neurosciences and History 2024;12(1):20-29