FATIGUE

The Lancet: "Fatigue
Richard Barnett a
True fatigue and what, for want of a better word, must be called tiredness are plainly different. This, from a 1966 Lancet editorial, embodies the history of fatigue. Fatigue is more than tiredness - pathological exhaustion, perhaps - and in its medical sense it has been associated with modernity, with fear of the new.
- Fatigue first appears in the 16th century as a description of tedious duty; a sense that has persisted in such military terms as fatigue-dress. In the early 19th century, its usage began to shift. Within urban society the preindustrial aristocratic body refined, delicate, and easily exhausted was supplanted by the bourgeois body hardworking, disciplined, imbued with the Protestant work ethic. Modern life was fast and exhilarating, and its technologies notably the railways provoked excitement and fear in equal measure.
Medical interest in railway travel was at first limited. In 1857, the French physician E A Duschene identified the joint pains reported by train drivers as maladie des mecaniciens arthritis caused by the vibrations of unsprung locomotives. In 1862, The Lancet adopted Duschene's notion of fatigue in its pamphlet The Influence of Railway Travelling on Public Health. Travellers' bodies could not cope with hours of clattering: muscles tired, sensory organs wore out. New interest in the diagnosis of railway fatigue was sparked when the British railway companies became legally responsible for the safety of their passengers in 1864. The wider problem of 19th-century psychiatry the absence of physical lesions to account for mental symptoms was particularly acute in railway fatigue: some physicians posited microscopic deteriorations in the spinal cord as the cause of "railway spine".
But fatig"