Weird histories involving concussion. Da Costa syndrome first appeared in the American civil war. It was thought to be some kind of heart disease that caused fatigue. But many soldiers with this were executed for malingering and being cowards. Then it became a psychiatric condition in the 20th century and people were locked up in institutions, lobotomies were used to treat the depressive effects, electric shock treatment was used up into the 1980's along with mind bending medication that reduced people to having the minds of children. In the 1990's it was realized that most of the symptoms were related to head injury and concussion.
At the same time in the US another condition was described, 'Railway Spine' it came in two forms one from the workers building railways where after a head injury they became fatigued and were sacked for making it up and malingering. The second came from the survivors of train crashes who reported fatigue and problems with the mind. Arguments about this suggested it was caused by physical damage to the brain and spine, but these 'strange' ideas were discarded in favor of psychological problems and people just trying it on to claim compensation from the railways.
Da costa syndrome is not used in a serious medical context anymore but oddly it is used in the legal system by medical experts and insurance companies to prevent compensation claims.
The argument about the symptoms of head injury and concussion has not really changed in 180 years.
No, but I've been seriously struggling with chest pain and shortness of breath after any exercise, even walking a few steps, in the last month or so (not so bad at the beginning). Originally thought it was chest infections given I have a poor immune system (and I was getting this before the TBI); then suspected pericarditis but chest x-ray and ECG both clear. I'm now at a loss and still having the chest pain (including today when I've only walked from one room to the other).
Anyway, be interested in any possible effects of TBI on chest or heart - so hard to separate what's TBI and what's Long COVID et al.
Hard to separate all of it, shared symptomology all round. Da Costa syndrome was an all round catch all diagnosis, eg if something could not be explained it was Da Costa syndrome.
Concussion is still not taken seriously, as you say 180 years on. Employers don't understand and still see it as being awkward They don't understand that your brain can't process and the confusion that brings to the person.
Indeed, its astonishing, we are told that with all the technology and expertise in neuroscience we as a human society know so much about the brain. But the simple fact remains that if society can't tell the difference between psychological, physiological and neurological symptoms then in practice we don't really know much at all. Iain McGilchrist the neuropsychiatrist explains it like this, neuroimaging produces lots of pretty pictures, there are so many expert theories about what they mean, but in practice when dealing with brain injured people none of the theories make any sense.
The arguments have not changed in over 100 years even with all the modern brain technology.
Really interesting. Have you read Antinio Damasio on the story of another railroad worker? Also about brain injury, and subsequent behaviours. Descartes' error. His wife Hannah worked with him.
Not hard to believe that not much is known about what the pictures mean. Consulting radiology is big business - and there are disagreements about how to interpret the images. Conferences in Chicago every year on how to read pictures.
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Changes after head injury
Fatigue after head injury
recovery from a mild brain injury, post concussion syndrome and lapses
