Nervous exhaustion, melancholy, Weltschmerz, ennui, alienation, neurasthenia, Americanitis, stress, chronic fatigue syndrome, burnout ~ the labels & the socio-cultural context may change yet the symptoms remain the same. We are not referring to issues of faulty brain chemistry here such as clinical depression, mania or psychosis, yet these common & everyday emotions are increasingly being perceived as mental health issues. Should they be? Existential malaise manifests itself in a myriad of symptoms with crucially, no definitive cause ever identified.
A common historical (and current) explanation is that of the socio-cultural, likened to a virus attacking the body but this psychic virus‘inflames’ the psyche (Schaffner, 2014), no more so than during times of rapid social change (Kury, 2012). I do not intend to present a clinical analysis of the ‘condition’ but, whilst acknowledging a consistent trajectory in the occurrence of this individual ‘dis-ease’ with life, focus on the presumptions, treatments and explanations of the times to demonstrate to what extent perceptions of ‘illness’ are influenced by social prejudices and expectations.

One can also consider whether to label such human responses as ‘illnesses’ or ‘abnormal’ may be misguided. We laugh at diagnoses of the past yet some contemporary approaches are no less bizarre. We ‘tut’ at Victorian mill workers dosing their babies with laudanum (opium & alcohol tincture) to get some respite but accept the medicating of children with Ritalin without comment.

In relation to the above, this brief paper will also explore how individuals have always used drugs – be they prescribed, over the counter or illicitly obtained to counter these feelings of ‘dislocation’.
The concept of drug taking out of perceived need or to achieve an altered state is as old as humankind, as is the awareness (often sub-conscious) that the ability to ‘switch off’, ‘turn on’, ‘escape’ or ‘open the doors of perception’ may actually be worth the inherent dangers in order to gain some respite or to keep an often harsh world (physically or psychically) at bay for a time.
Hippocrates and the 2nd century physician Galen identified the existential weariness of the ‘melancholic’ and Galen also identified female hysteria as being rooted in sexual deprivation (a tenacious belief that became significant in late 19th century and early 20th century medical approaches). Medieval men and women too suffered from mental & physical exhaustion which was defined within the religious parameters of the time as ‘spiritual weariness’ &a lack of energy which they termed ‘melancholia’ and ‘acedia’.

It is therefore dangerous to fall into the trap of imagining a simpler, ‘golden age’ where mind, body and spirit were in harmony. This is an aspiration achieved only by the lucky few. Another fallacy is that of pre-industrial society being exhausted in body but healthy in mind; industrial and post-industrial (current day) society being healthy of body and sick in mind. The data does not bear this out.

What does appear to form a Leitmotiv or consistency of sorts is the human inclination towards patterns, routines and order, and its dislike of rapid and precipitous change. It is during times like these that one can observe ‘spikes’ in what one could call ‘existential’ or ‘psychic’ distress with which the society of the times grapples to come to terms. At the same time afflicted individuals reach (and still do reach) for medication in vast numbers.
For the purpose of brevity and also for a trajectory with which one can readily identify, the paper will limit itself to the period from the early 1830s i.e. the start of industrialisation which marks a key period where these recorded symptoms occur with increasing frequency.

The ‘industrial revolution’ as such, started in England as early as 1733 with the first cotton mills but it was the invention of steam trains in the first decades of the 19th century that ushered in a myriad of immediate and wider changes for example, the implications of travelling outside one’s locality, perception of speed, standardization of time (that had hitherto been regional & often based on sun rise and set). Add to this an increasingly rapid urbanisation with its cramped, unsanitary living conditions, noise, close vicinity of thousands of people, long working hours and it is no surprise that these first glimmerings of the ‘modern age’ brought with it accompanying ills that remain with us to this day.

As early as 1832, the German writer Goethe complained: ‘Man in his misguidance has powerfully interfered with nature…. Everywhere the purity of the air is affected by smoke and the like, and the rivers are defiled.’

The pace of change in Germany can be gauged by the fact that even in 1870, the population was still 2/3 rural but 30 years later in 1900 it had become 2/3 urban. These changes represented a total break with continuity, established communities and the past, allied to a progressive Establishment culture of capitalism, individualism and the pursuit of profit ~ again elements we can readily identify with today. This accelerated rate of change dovetailed with exponential research and production of powerful, synthesized drugs and patent medicines.
The toxic fallout from the new and the consumption of drugs and narcotics to counter it cannot be seen as mutually exclusive developments. It might be informative to examine some of the main intoxicants developed and consumed during the 19th century to appreciate how widespread their use was and how little individuals, their anxieties and problems have really changed in the past 150 years.
There were no laws for recreational/non-prescription drug use until the 20th century and powerful drugs had been used locally for centuries, often in the guise of ‘herbal’ medicines but often for recreational use. The Fen district (covering Cambridgeshire/ Norfolk) had grown its own opium poppies for centuries and more opium was sold in Ely for example, than any other drug.

Arsenic eating (‘toxicophagus’), often up to 6 grains daily, was prevalent from the 1820s (especially in south-east Austria) for physical endurance and as a general mood-enhancer. Long term users apparently suffered no ill effects. In the 1850s women used it to enhance their complexions; in the1870s arsenic pills were also prescribed as an aphrodisiac & by the 1880s they were, together with strychnine, cannabis and phosphorus, being used as the Viagra of their day.

In the American southern states during the 1880s, there was a craze amongst teenage girls and boys (known as ‘Dippers’), to dunk arsenic into their coffee as a pick-up mirroring the amphetamine pill craze of the 1950s-60s, ‘speed’ in the 1970s & 80s and cocaine in the 1990s and 2000s.

The intoxicating qualities of mixing sulphuric acid and alcohol had been known as far back as the 13th century but it was named ‘ether’ in 1730. In Georgia (USA) there was a teenage craze in 1842 for inhaling nitrous-oxide ‘laughing gas’ out of bladders which became known as ‘ether frolics’ but it was the observation that the teenagers appeared to feel no pain when high that led to its development as an anaesthetic in the States.
It also became popular as an aid to public speaking (Prime Minister Lord Liverpool used it) and by the 1870s was being prescribed as a ‘marital aid’ to women. It was believed that ‘frigid’ women could be stupefied with ether to enable their husbands to have sex with them. If they became pregnant, the ‘frigidity’ or ‘vaginismus’ would be cured.

 
Ireland experienced a massive consumption of ether from the 1840s through to the 1890s, a result of both a rigorous temperance movement and also the endorsement by priests advocating it as a more ‘innocuous’ habit than alcohol. In 1891, Norman Kerr, writing in the Journal of the American Medical Association, described ether intoxication amongst the youth of Ireland:
Sturdy Irish lads and beautiful Irish lasses, brim-full of Hibernian wit, are slaves to ether drunkenness. The mother may be seen with her daughters and maybe a neighbouring Irishwoman or two at a friendly ether ‘bee.’ The habit has become so general that small shopkeepers treat the children who have been sent to purchase some article, with a small dose of ether, and schoolmasters have detected ether on the breaths of children from 10 to 14 (or even younger) on their arrival at school.

It is interesting to note that, even at the peak of the Irish ether-drinking craze, the possession, sale, and private use of ether remained legal.

 
Turkish opium products (Indian opium was inferior & for export only) were popular in England from the 18th century onwards although opium smoking tended to be a more middle/upper class habit. Drinking laudanum (opium/alcohol tincture) however, was popular across the class divide. The poet Coleridge noted in 1808: ‘the practice of taking opium is dreadfully spread…throughout Lancashire & Yorkshire; it is the common Dram of the lower orders of people.’

By 1811, George IV was addicted to laudanum whilst Prince of Wales & by the time of his succession in 1820 binged on a mixture of cherry brandy & laudanum. As early as 1814 opium (known as ‘the black smoke’, ‘black mud’, ‘la fée brune’ (the brown fairy), or ‘the pernicious article’) was being acknowledged as a social problem, with users being ostracised as lacking moral self-control.

By the 1830s, the belief arose that opium was ‘feminizing’ & appealing to ‘effete’ men (known at the time as ‘dandies’ or ‘fops’). In 1833, Leonard Horner, a Manchester factory inspector reported that: ‘in one street in Manchester alone, there were three druggists who sold five gallons a week of each of these [opiated] drugs: one was called “Godfrey’s Cordial” and the other “Atkinson’s Quietus.”’ Both of these patent medicines were commonly used by factory workers or child-minders to sedate babies.

Over the next 30 years, the number of products containing opium soared: opium soap, pills, lozenges, plasters, enemas, liniment and even ‘vinegar of opium’.

 

The direct link between the moral vacuity of the secular, materialistic modern age and its malign effect on wellbeing however, was raised as early as 1839 by a London periodical which reported:

The society of modern England seems to be governed by two leading feelings: the desire for wealth as the instrument of this world’s pleasures & a fretful, gloomy and desponding uneasiness [my italics] about the path to happiness in the next.

 
The poet Elizabeth Barrett (later Mrs Barrett Browning) bedridden and ‘invalid’ before her marriage was frank about the reasons for her use of opiates in the early 1840s:

I have had restlessness until it almost made me mad…the continual aching sense of weakness …as if one’s life, instead of giving movement to the body, were imprisoned undiminished within it & beating & fluttering impotently to get out at all the doors and windows. So the medical people gave me opium – a preparation of it called morphine and ether and ever since I have been calling it my elixir as the tranquilising power of it is so wonderful.

It is an early indication of the dilemma of intelligent middle class women of this time who were not allowed into formal education, had servants to undertake most household tasks and had little meaningful activity with which to fill the endless hours. The parallels with the 1950s and ‘mother’s little helper’ (the tranquilizer Valium) are clear. Establishment medical attitudes did not help. One of the most notorious was those of Paul Moebius who investigated female hysteria and pathological sexuality in 1900 and declared: ‘instinct makes women animal-like….high intelligence in women is degenerate’ (cit. Porter, 2002, p.151).
 

 
The writer Wilkie Collins who himself always had a silver flask of laudanum with him, kept a decanter of it at home and occasionally injected morphine, presciently observed the dilemma of the middle class women of his time. He commented on the ‘miserable monotony’ of much middle class life in England and how middle-class women especially were subjugated to husband and home, used opiates to drug themselves in a ‘functional passivity’ or else succumbed to hysteria which (inevitably) also became pathologised and treated with (yet more) opiates.
 

The concept of female hysteria became accepted by the 1870s with a consensus that its origins were sexual – hence the treatment by opiates which famously subdue sexual desire. ‘Hysteria’ had been treated with opium as early as the 1750s – a case study cites a middle class woman, abused by her husband and ‘losing her reason’ who was ‘cured’ by a dose of 4gms of opium. Female hysterics were being treated with ‘water massages’ (aimed at their genitals) as early as 1860.
 

 
There has been some dispute regarding data discussing the extent of male doctors’ use of ‘pelvic massage’ to induce orgasm (‘hysterical paroxysm’) either manually or by the turn of the century using the newly invented ‘vibrators’. In 1880, Dr JM Grancille patented the first mechanical vibrator & in 1902 Hamilton Beach, an American company patented the first electric vibrator for retail sale, making the vibrator the fifth domestic appliance to be electrified after the sewing machine, fan, kettle and toaster and a decade before the vacuum and iron.
 

Chloral was developed in 1831 by German chemist Justus von Liebig out of ether, alcohol and their derivatives out of which chloroform was later produced. Chloral hydrate was used from 1869 as an anaesthetic but it was also prescribed instead of opium for ‘melancholia & general paralysis of insanity’ (tertiary syphilis). Alcoholics started to use chloral as a substitute intoxicant and by 1879 it was being used as a morphine cure (a handkerchief soaked in chloroform was sniffed).
It also became ‘widespread’ as a drug of choice amongst middle class ‘chloral eating’ males such as clerics & doctors due to its soothing & calming effect. Ironically it induced the very side effects that caused its use in the first place; one user in 1877 called it the ‘tyrant custom’ that caused: ‘lassitude, nervous debility and exhaustion’ and chloral addicts (like female opiate addicts) were labelled as weak and ‘morally insane’.
The 10th Duke of Bedford was a chloral addict in the 1870s-80s as was the teenage writer Andre Gidé who was prescribed chloral for insomnia in 1882-3. Insomnia was an increasing problem of the industrialising age & perceived of as a ‘modern’ ailment caused by the stresses of the modern lifestyle. The philosopher Friedrich Nietzsche, who suffered from insomnia after his experiences in the 1870-71 Franco-Prussian war, was prescribed chloral and started to ‘take it immoderately’ thus ‘accelerating his mental ruin’ according to a doctor at the time.

The Pre-Raphaelite artist Dante Gabriel Rossetti’s wife Lizzie took a laudanum overdose in 1862 which caused his insomnia. He took chloral for it, became addicted and suffered paranoid delusions as a result, trying more than once to commit suicide using laudanum. ‘Dr Collis Brown’s Chlorodyne’ is a patent medicine containing both chloroform and morphine that was developed in 1856 and is one of the few of these medicines that is still available to this day & popular with heroin addicts as an emergency substitute when heroin is unavailable.
Sulphonal was also developed in Germany as a cure for the ‘modern’ ill of insomnia in 1886 but it too proved very addictive. Prime Minister Lord Rosebery used both Sulphonal and later cocaine to get him through the strains of office and public speaking. Hashish entered Europe through Napoleon’s occupation of Egypt (1798-1801) and became the ‘exotic’ drug du jour of artists, writers and bohemians.
 

Industrialisation also allowed the mass production of patent medicines and pills which the ‘working classes’ consumed in vast amounts (doctors were expensive). A Leeds surgeon commented in 1845: ‘they shop for pills & drops as regularly as in meat and vegetables….’ Other compounds and drugs that are often regarded as ‘modern’ were patented and used recreationally or medicinally during this period including amyl nitrate in the 1840s which was used by the teenage Marcel Proust (he would inhale two capsules before bed each night to counter his asthma).

The German pharmaceutical company Merck isolated mescaline from the peyote cactus in 1896 and became the major supplier of mescaline sulphate during the interwar years (1918 to early 1930s). It was a popular stimulant in nightclubs across France and Germany during this period.

Drugs had been pushed under the skin as early as the 1830s (one method was to cut the skin & to use a dropper to introduce the drug). Prime Minister Gladstone’s wife Helen used opiates with the help of a needle as early as the 1840s when the belief arose that taking opiates orally caused digestive problems &encouraged craving and that these could be alleviated by injection of the drug.
Morphine was first produced commercially from Turkish opium in London in 1821 by Thomas Morson for local sale although it was the German company Merck who started wholesale commercial production in 1825. It soon created an addiction problem and in 1853 Dr Alexander Wood in Edinburgh developed a syringe along the lines of a bee sting which he believed could cure morphine addiction. Unfortunately Dr Wood & his wife became addicted whilst testing his new morphine delivery method. Wood’s wife became the first woman on record to die of an accidental injected-opiate overdose.

 
The practice of intravenous injection of morphine did not develop until after 1910 when USA prohibition turned opium smokers towards heroin injection. By the latter half of the 19th century, middle class women were being prescribed injections of morphine for period pains, morning sickness & post-natal depression and by the 1870s, the female morphine addict was a recognised ‘type’. Needle addiction was also recognised for the first time; women would inject each other and a cult/fetishization for ‘puncturing’ resulted. Single women were perceived to be particularly prone to uncontrollable erotic thoughts that could result in neuroticism and tendency to moral weakness and addiction.
 

Cocaine was first synthesized in 1860 by the German chemist Albert Niemann but only commercially produced in the early 1880s by Merck (who also produced morphine& mescaline). It only gained recreational popularity after its use by exhausted German soldiers & American sportsmen during this time when it was also used to wean addicts off morphine.
At first injected, by the 1890s ‘cocainists’ were ingesting the ‘burny/Bernice’ by snorting/’burny blowing’ and were being stigmatised. This did not deter the manufacturers of patent medicines however, who from the 1890s increasingly used cocaine for example in nasal sprays that were often 99.9% pure cocaine. It was dispensed as a cure for ‘neurosthenia’ but in England was popular with men as an aid to greater endurance and productivity.
 

It is apparent then that drug consumption, for whatever reason, was a fact of life across all social classes from the onset of the industrial age both in America and Europe. It was however, during the 1840s that the moral aspect of drug addiction appears which remains to this day. The accelerating industrial revolution was also a secularising process with the moral grip of the Church weakening.
Drug use was regarded as incompatible with an industrialising, progressive society where male productivity was becoming an economic compulsion and cultural fetish; the so-called ‘Protestant work ethic’ that the theorist Max Weber later (1904-5) identified as leading to enervation and exhaustion and which Schaffner (2014) also cites as the reason for the contemporary German preoccupation with exhaustion and burnout.

This physical, moral and psychological decline of the people became a cause for concern during the 1840s and the idea of the malign effects of ‘progress’ gained traction. It was mooted that modern capitalism was weakening blood ties and individual purpose; toxic waste from factories was poisoning bodies and creating, fluctuating birth rates; and that the inhuman rationalization of education & medicine was destabilizing individual wellbeing and leading to a decline in overall mental and physical health.

The 30s & 40s were also the era of Parisian ‘bohemianism’ that has clear parallels with the 1960s. Young people and creatives experimented with drugs, rejected attitudes and morals of the past and asserted their individuality. As the writer Flaubert stated in 1846at the age of 25: ‘Don’t force me to do anything & I will do everything. Understand me and don’t criticise me’. He deplored so-called ‘progress’: ‘Civilization that shrivelled runt of human aspirations…that bitch, inventor of prisons, railroads, enema pumps, cream cakes, of royalty and the guillotine’
It was noted that bothmen and women in Europe and North America were struggling with debilitating but mysterious physical symptoms, some being confined to their beds for months. Sufferers included Charles Darwin and Florence Nightingale who were both disabled at various points in their lives by non-specific ‘illnesses’.
It was during the 1880s when urbanization, expansionism and industrialisation reached its peak that a strange atmosphere started to pervade Europe, consequently defined as Fin de siècle anxiety at the impending turn of the century(one also recalls a similar, more recent unease at the turn of the millennium). Germany was especially affected by this sense of mass anxiety (the historian Michael Green called it ‘the iron cage’ of progress) due to the rapidity of its expansion.

By 1910, Germany’s population numbered 56 million and it had as many large cities as the entire rest of Europe. Max Weber called it a period of ‘Entzauberung’ (disenchantment) whilst Freud dubbed it ‘Unbehagen’ (un-ease). The era came to be perceived of as one of ‘decadence’ and moral decline. The ‘type’ was written about and defined as the ‘egoist’ i.e. those who were aesthetes’, ‘flamboyantly individualistic’ and unable to use willpower to control their emotions.
This submission to ‘animal urges’ was labelled ‘degenerate’ (fiction including The Egoist [1879]; the eponymous Dorian Gray [1891] and Dr Jekyll & Mr Hyde [1886] are fictional portrayals of the type).
The acute anxiety and its symptoms of nervous exhaustion, hysteria and ‘neuroticism’ were pathologised through the nascent discipline of psychiatry and psychoanalysis, and it was the American neurologist George Miller Beard who introduced the term ‘neurasthenia’ for a perceived illness that between about 1880-1920 became a highly popular diagnosis in psychiatry.
 

Neurosthenia was especially prevalent as a ‘condition’ in the USA, regarded at the time as the ‘country of the future’ ~ so much so that it came to be known as ‘Americanitis’ and also ‘Future Shock’. It tidily linked the disparate symptoms of fatigue, anxiety, headaches, impotence, insomnia and depression squarely with the pressures and uncertainties of modern, urban life.

Theodore Dreiser addressed the issue in his article ‘Americanitis -Can It Be Cured?’ in The Delineator, (a women’s fashion magazine he edited): ‘The morning paper gives us a daily list of deaths by suicide, apoplexy, and insanity…..men in the prime of life rushing into eternity, desperate because they are left behind in the race, or driven mad by the rush of the business world.
Early neurologists specialising in nervous illnesses avoided the stigma of mental illness & asylums by designating ‘neurosthenia’ as a disorder of the body recommending ‘cures’ such as bed rest, hypnosis and electrotherapy. Health spas proliferated (especially in Germany) offering restorative clay baths, mountain hikes and hydrotherapy.

In Germany however, the increase in benefit claims from working class people around 1900 suffering from nerve-related ailments, ‘proved’ that the working-classes were becoming ‘degenerate’. Doctors therefore created a clear distinction between ‘neurological’ diseases with a clear anatomical basis and ‘neurosis’ that had no clear physical or mental cause.
Neurosthenia was therefore considered to be a draining of mental energy and an affliction mainly of the higher classes who did little physical work but were pressurised on a mental level.

In working people one can therefore surmise a doctor would suspect ‘degeneracy’ rather than mental stress. Indeed, as Schaffner notes: contemporary accounts of neurasthenia contained: ‘a not inconsiderable degree of pride and self-moulding ….in the late nineteenth century: neurasthenia signified refinement, sensibility and an artistic streak’.

The middle class lady suffering ‘a fit of the vapours’ from ‘her nerves’ had indeed become a staple of contemporary fiction. It was thanks to this German distinction between neurological ailments and neuroticism that the terms ‘neurasthenia’, ‘nervous breakdown’ and ‘hysteria’ started to fall out of favour and were replaced by the concept of ‘neurosis’.

However, the physical cause of ‘neurosis’ was also never established and it was the emergent field of psychoanalysis (e.g. Freud) that gave the term clinical credibility by locating its source in unconscious emotional conflict rather than in ‘weak’ nerves. Nervousness and anxiety (as it still is) became established as an issue of the mind not of the body. The First World War was a defining moment in terms of the ‘modern’ sensibility.
It kick-started an accelerated pace of technological development and the ensuing shock and trauma of war created both in Germany and England what James Webb termed: ‘a flight from Reason’ as well as introducing psychological conditions with very clear sources e.g. shell shock. The ‘roaring twenties’ were marked in both England and Europe by a combination of extreme hedonism but also poverty and misery.
Martynkewicz (cited Schaffner, 2014) asserts that the fin de siècle did not just produce exhaustion, but also gave rise to strategies to counter and prevent its effects. He states: ‘in times of weakness and illness…..the longing for salvation and redemption, as well as for saviours, spiritual guides, prophets, trainers and dieticians, multiplies.
’From around the 1870s, these counter-movements proliferated, largely generated by and aimed at the middle classes and aiming to combat the‘sickness of the soul’. By the inter-war years they were massively popular and included the influential ‘life reform’ movement in Germany that advocated naturism, vegetarianism, hydrotherapy and fresh air as antidotes to urban ills.
Youth movements such as the German ‘Wandervogel’ (wandering birds) groups and in England the scouting movement were created to encourage the young into the fresh air and ‘wholesome’ pursuits. English adults had the newly formed Ramblers Society and the Socialist Clarendon Cycling Club, both designed to allow working, urban people a healthy escape from the urban environment. Dress reform (or ‘aesthetic dress’) was advocated in England from the 1880s to free women from the physically enervating constrictions of corsetry and enable them to engage in exercise.Oscar Wilde was probably the most famous advocate of dress reform.
He was an ‘anti-corseter’ and advocate of flowing gowns, Turkish trousers, and low heels or clogs for women; loose coats, cloaks, soft boots, and wide-brimmed hats for men. Norman Kerr founded the first British professional society dedicated to investigating drug and alcohol‘inebriety’ or substance ‘mania’ in the 1880s, claiming that the cause was hereditary.
The term ‘addiction’ was not coined until the First World War indicating a shift of emphasis from a physical issue that could not be helped (hereditary) to a psychological vice caused by a lack of individual willpower. Interestingly the debate around ‘Americanitis’ faded both in the U.S and Europe by the onset of economic depression, unemployment and then the 2nd World War in 1939. The old symptoms do not re-emerge until the 1950s, this time called ‘manager illness’ and sited in Germany during its ‘economic miracle’ (Wirtschaftswunder) period ~ again, another period of extreme change and upheaval.
 

One also thinks of the Existentialist philosophy current at the time with theories on ‘alienation’. It was also a period of post-war conformity when parameters of what constituted ‘normal’ behaviour was increasingly being put into the hands of clinicians. In 1953 for example, 20,000 lobotomies were carried out in America alone (Scull, 2015) and the consumption of prescription tranquilizers ‘for the nerves’ rocketed.

 

Commerce was not slow to jump on the neurasthenia/‘Americanitis’ bandwagon. The media stoked the panic for example, claiming in 1907 that the Chicago meatpacking millionaire Nelson Morris had died of the ‘disease’. Patented medicines & elixirs such as the ‘Americanitis elixir’ were bought by millions who could not afford time off work in bed or expensive spa cures.
Others included ‘Neurosine’ which contained cannabis and claimed to lessen migraines and agitation and ‘Hop bitters’, an alcohol-containing tonic aimed at men who were stressed by work and responsibility. Interestingly the term ‘blues’ was appropriated by an American doctor Albert Abrams in 1903 as a specific idiomatic synonym for neurasthenia which he used in his book The Blues (Splanchnic Neurasthenia): Causes and Cure (1905).
In 1886 John Pemberton created Pemberton’s French Wine Coca with actual cocaine as an ingredient &marketed it as a cure for opium addiction, ‘nerve trouble and nervous irritability’. One advert stated: ‘Americans are the most nervous people in the world’. He removed the alcohol (but not the cocaine) in 1886 realising that temperance reformers could affect sales & rebranded it as Coca-Cola, a‘brain tonic elixir’ that would cure neurasthenia, headaches, relieve exhaustion and calm the nerves.
 

 

The British Medical Journal tested a bottle of this medicine in order to see what it contained. It was mainly sugar water, flavoured with a little alcohol and orange extract & 8.9% potassium bromide.

Bromides were drugs commonly used in asylums of the time to calm patients, but they could cause depression and disorientation if taken regularly for long periods. It also may have contained a trace amount of Pilocarpine, a drug which has a variety of effects on the nervous system, including boosting the production of bothsaliva and sweat.

 
 
 
 

Conclusion

Female ‘hysteria’ is no longer a recognised illness and ‘neurosthenia’ as a clinical condition was dropped from the Diagnostic and Statistical Manual (the ‘bible’ of psychiatry and psychology) in 1980. However, as stated in the introduction: ‘the labels & the socio-cultural context may change yet the symptoms remain the same’.
We now have social anxiety disorder, borderline personality disorder, and temper dysregulation disorder ad infinitum. Chronic Fatigue Symptom however, which presents symptoms very real to its sufferers has, for many years been derided as ‘psychosomatic’. Various theories have been posited to the continuation of existential dissonance and burnout that show no signs of abating.

It is being increasingly posited that the proliferation of new media in the digital age does not allow us to relax properly; cameras track us, blue light emissions keep us awake, young people are stressed and anxious due to the blurring of boundaries between‘real’ and mediated realities and workers are exhausted because they can never ‘switch off’ due to smartphone technology.

Urban changes are so rapid that people feel alienated and like ‘outsiders in their own cities’. So current discourse echoes that of the earliest: ‘modernity’ is to blame for nebulous feelings of being ‘out of sorts’ allied to apocalyptic predictions for the future. Mood enhancers and anti-depressants are massively consumed (prescription mood-enhancers and tranquilizers were worth $64 billion to the global economy in 2010) and the young escape for a while with smart drugs and legal highs.None of the ‘cures’, treatments and ‘life reforms’ etc. have actually solved the underlying cause: to help us make sense of what it means to be human in a world that will never remain static.
We live in an age where every human trait is pathologised as an ‘issue’ to be analysed, treated and medicated. The first edition of the Diagnostic & Statistical Manual of the American Psychiatric Association (1952) contained 100 pages, the 2000 edition however, ran to 943 pages. That speaks for itself. The medical establishment appears to have done an ‘about-turn’ from regarding bio-chemical dysfunctions as ‘moral/spiritual/emotional’ lapses to these same moral/spiritual/emotional issues being assessed and treated as bio-medical ‘conditions’.
In her review of recent German literature on the subject of exhaustion and burnout (a condition currently very prevalent in that country), Schaffner (2014) concludes that instead of pathologising these symptoms as ‘abnormal’ and problematic it might be time that we accepted that exhaustion is actually part of what we are, that we need to accept our limitations and also that the worry over our very limitations are what makes us ‘human’ in the first place.

Scull (2015) neatly puts the blame back where, as we have seen, it inevitably goes: on the pressures of ‘modern’ life. He notes: ‘If we are not mad, modern life has made us so….quite simply madness is civilization.’ So all we can do is live with it as best we can. We are fallible, we are flawed, we are human ~ end of.

 

• Good Health in 1909: a hydrotherapy body compress at the Swiss Lebendige Kraft sanatorium
• References/Recommended Reading
• Daugherty, G. (2015): ‘The Brief History of “Americanitis”’, online at Smithsonian.com at: http://www.smithsonianmag.com/history/brief-history-americanitis-180954739/?no-ist
• Davenport-Hines, R. (2001): The Pursuit of Oblivion: a social history of drugs.(London: Phoenix).
• Gijswijt-Hofstra [Edt]; Porter, R. [Edt.] (2014): Cultures of Neurasthenia: From Beard to the First World War. (Clio Medica 63)
• MacIvor Thompson, L. (2013): ‘The Contested Space of the Victorian Vagina: The Myth of Vibrators and Hysteria Therapy’. Online at: https://tropicsofmeta.wordpress.com/2013/02/20/the-contested-space-of-the-victorian-vagina-the-myth-of-vibrators-and-hysteria-therapy/
• Martynkewicz, W. (2013): Das Zeitalter der Erschöpfung: Die Überforderung des Menschen durch die Moderne. Berlin: Aufbau.
• Porter, R. (2002): Madness: A Brief History (Oxford: Oxford University Press).
• Schaffner, A.K. (2014): ‘German Burnout’ in: The Times Literary Supplement. 12th February 2014.
• Schuster, D. (2011): Neurasthenic Nation: America’s Search for Health, Happiness, and Comfort, 1869-1920 (Critical Issues in Health and Medicine).
• Scull, A. Madness in Civilisation (London: Thames & Hudson)
• ‘The History of Mental Health’ online at: http://historyofmentalhealth.com/tag/americanitis/
• University of Virginia (2015): ‘Neurosthenia and the Cult of Nervous Exhaustion’ online at:http://exhibits.hsl.virginia.edu/nerves/
• A 1919 U.S editorial cartoon by Oliver Herford (1863–1935) on the blight of drugs in America