Traumatic Neurasthenia

ALTHOUGH much has been said and written on traumatic neurasthenia, I judge that considerably more remains to be said before the last word can by any means be declared. It was quite natural to anticipate that this diagnosis would become much more prominent after the adoption of the Workmen's Compensation Act; and whilst it may be stated that only a small number of these cases are the subject of damages inside the courts, it will not, I think, be contested that outside they often give rise to trouble and annoyance to the parties concerned. For some years I was engaged in a busy practice in the heavy woollen district of the West Riding of Yorks, and, as medical officer to several manufactories, ironworkers, and miners, I had perhaps unusual facilities for witnessing the operation of the Workmen's Compensation Act from various points of view. It is in the light of that experience, and after a dozen years' working of the Acts, that it seems to me several questions might very profitably be discussed relating to this diagnosis. Permit me to indicate at once that the term traumatic neurasthenia has come to be used very loosely and irregularly-judges, doctors, and lawyers being all more or less guilty. I am well aware of the difficulty in attempting to enunciate any precise and limited definition for the various functional neuroses, as the symptoms presented are well known to run the one into the