A common complaint of many persons is constant fatigue. They are always tired or they woke up just as tired as when they went to bed.
There are many causes of this symptom, and a careful overhaul is necessary to rule out physical disorders such as tuberculosis and anemia.
The patient may have been pulled down by a bad bout of influenza, an accident, or a big operation.
However, it is generally recognized that a high percentage of patients who complain of fatigue and tiredness are suffering from emotional disturbances, or what they often call the nerves.
In ordinary life, normal people seldom suffer from genuine exhaustion for long. As a rule recovery from physical fatigue is rapid.
The human body can withstand a good deal. However, people vary a good deal in their makeup and some people are truly exhausted in the physical sense because of what the doctors call a neurosis – a disturbance in their nervous or emotional makeup. Such people often dread getting up and facing the day. They are tired and depressed.
Often the nervous patient complains bitterly of the tired feeling. He feels there must be some physical cause for it.
At the same time he often tells the doctor the tired feeling has been present for years. Often the doctor cannot help noticing how well the patient looks in himself.
In many cases it is obvious that the patient is nervous and over-emotional.
Often there is a story of great anxiety or of depression. Such people are “tired out” after small effort. Even trying to concentrate or read or write is too much for them. Often long spells of rest in bed will not get rid of this form of tiredness.
Many people “wear themselves out” because they do not know how to relax. Others are kept awake at night by their worries. This makes them more tired than ever.
Fatigue is one of the commonest symptoms of patients who are depressed mentally. Their spirits are low, they have lost interest in everything, and life no longer seems worthwhile.
In such cases it is very important to recognize the real cause of fatigue. The mental depression may be relieved in certain cases by electrical shock treatment.
The patient who is always tired often asks “for something to buck him up,” but tiredness is a complaint, not a diagnosis. The doctor must search for the cause.
He must listen to the patient’s story and find out how he lives and works. He must assess his stamina and health. He must find out if the fatigue is due to an emotional problem or due to the constitutional makeup.
Often he will listen to what friends and members of the family will tell him before he decides what is making the patient tired.
Often the persons who are really tired out from overwork do not go near the doctor. They have no time and often little money, and, besides, they know what is the matter with them.
For those who are unduly susceptible to colds, chilling, brought on by wet feet, draughts, or changes of temperature, may turn the scale.
It is known that the chilling of the body causes the blood vessels in the nose and throat to close down. This may interfere with the formation of the protective layer of mucus which covers the lining of the nose and thus open the way to let the virus in.
The symptoms of the common cold are well known, but it should not be forgotten that the early symptoms of other well-known diseases, such as measles, German measles, whooping cough, and even “polio” may be just the same.
The patient feels off-color. The dryness of the throat may be an early sign. Chilliness, mild aches, and sneezing soon follow.
The nose feels stuffy and the sense of smell is lost. The nose begins to run. At first the discharge is watery. Later it becomes thick and yellow. As a rule the temperature is not high.
The first 48 hours are the worst, but usually, the cold runs its course for a week or more. In mild cases of “head cold” the trouble only affects the nose, but all too frequently the inflammation spreads.
Most patients have their own special kind of attack. The cold goes to the chest. Some develop bronchitis or lose the voice; others get sore, red eyes.
The infection may spread to the middle ear cavity, causing deafness or earache. Mild inflammation of the sinus cavities is more or less part of the ordinary cold, but serious sinus trouble may result.
Sufferers from chronic sinus trouble are liable to frequent colds; and a story of frequent colds makes the doctor suspect some underlying disease such as tuberculosis, sinus trouble, or an allergic condition.