鼻疾患に於ける神経症の研究（前篇）—統計的觀察

　序言

　神経症（Neurose, Neurosis）なるものは臨床各科の疾患比関係が深く，たとえ器質的疾患であつても神経症の傾向が加味される事が少くない。神経症的傾向の全くない純然たる器質的疾患こそ寧ろ少数であろうと云う見解が最近一般にとられる傾向である。近時アメリカで唱道される精神身体医学は正にこの方向を示すものである。

　本研究は昭和17年4月から同19年4月迄の間に慶応義塾大学医学部耳鼻咽喉科の患者100名以上に就いてなされたものであるが，空襲のために資料の一部を焼失したのでその中の95例に就て臨床的観察を試みた。研究対象となつた患者は無選択に集めた鼻疾患者ではなく西端教授が大体直観的に神経質ならんと疑つた患者である。

SAI YOKI investigated the question of ne-urasthenia as an underlying cause of nasal tro-ubles of which the patients complained in 95 consecutive cases. Among this number it was shown that findings of nasal pathology were negative in 33.7 per cent of cases; slightly po-sitive in 42.1 per cent; moderately positive wi-th added symptoms of neurosis in 24.2 per cent. All patients invariably complained of dull heaviness of the head and difficulty of mental concentration; impairment of nasal breathing was comlapined of only in 80 per cent of cases. The author maintains that presence of nasal sy-mptoms will create disturbance in the cranial blood circulation which effects in turn a disor-der in the function of autonomic nervous syste-m and psyche; disturbances so established will be further reinforced by Morita's so-called, "ps-ychic interaction". The outstanding feature of the patients who complain of neurotic sympto-ms is that they are generally highly intelligent but inclined to be tempermentally schizophren-ic in type and might be also highly self-cente-red and obstinate in their mentality. In this way the background in which nasal symptoms appear encompasses psychic disturbances which are manifested by influence of inferiority com-plexes, hypochondriasis, morbid ostentatiousne-ss or desire for perfection the aggregate of wh-ich seem to interact in conflicting force with each other. The nasal troubles, therefore, with which the patient suffer arise out of th-eir own Iiving environment and through their psychic make up. Consequently the treatment thereto should be directed towards reassurance and elimination of morbid anxiety as well as psychic rehabilitation following institution of pschycoanalysis. To these may be added shock and occupational therapies but patients with marked degree of nasal disease should be given an appropriate nasal treatment to be reli-eved of the focus of the disease.