Vagotonia; a clinical study in vegetative neurology / by Hans Eppinger and Leo Hess. Authorized translation by Walter Max Kraus and Smith Ely Jelliffe.

  • Eppinger, Hans, 1846-1916.
Date:
1917
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Licence: Public Domain Mark

Credit: Vagotonia; a clinical study in vegetative neurology / by Hans Eppinger and Leo Hess. Authorized translation by Walter Max Kraus and Smith Ely Jelliffe. Source: Wellcome Collection.

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    some light upon the condition known as neurasthenia, one which is often very variable and very difficult to circumscribe and diagnose. V. Noorden has described a symptom-complex which he has called—the hysterical vagusneurosis. His cases are in many ways similar to those we have described as vagotonic. Since in his cases certain stigmata could be regarded as of hyster- ical origin, and were generally included among the symptoms coming under the caption hysteria, it is natural that the emphasis should have been laid more on the side of that disease than on that of vagotonia. Typical of all his cases was the lack of the pharyngeal reflex. This symptom is, however, so frequent a finding in vagotonics, without any hysterical stigmata, that we are inclined to reject hysteria: as the cause of it in these cases. On physiologic grounds, this symptom cannot be brought into relationship with vatogonia, since the region which is anesthetic when the pharyngeal reflex is lacking is supplied by the glosso- pharyngeal and trigeminal nerves, Another symptom frequently found in vagotonics is moist hands and feet. Here also a physiologic explanation is difficult. It is relatively easy to account for sweating, but to account for the localization is not so easy, and all that may be said is that there is a localized stimulation of autonomic fibers. The erythe- matous appearance of these areas [extremities] is usually regarded as vasomotor in origin. But the relationship existing between vasomotor and visceral nerves is not yet entirely clear, though there is much evidence to prove that the vasodilators are supplied by the autonomic nervous system. From this point of view cyanotic, moist hands are signs of vagotonia. Hands so affected are often large and the fingers long and thin. The same applies to the feet, which, in addition, may be flat. We shall attempt no explanation of myopia, a frequent finding among vagotonics. Enteroptosis is often found combined with the general nervous state of these people. Long, chest, costal fluctuantes, cor mobile, even cardioptosis, palpable kidneys, and even prolapsed uteri are also frequent findings. Both men and women may show some signs of enteroptosis. The abdomen is often small above, wide below, while the abdominal wall is lax and poor in muscle. Not infrequently the women have both a masculine form and a masculine distribution of hair. The pubic hair is not horizontally delimited, but extends upwards towards