Treatment of Effort Syndrome, Mill Hill Emergency Hospital, The Ridgeway, Mill Hill, Barnet, Greater London
Patients suffering from Effort Syndrome receiving tuition from a carpentry instructor at Mill Hill Emergency Hospital. Effort Syndrome was first described during the American Civil War and later by doctor Jacob Mendes Da Costa in 1871, and was thereafter also known as Da Costa’s syndrome. The condition presents symptoms including shortness of breath, palpitations, fatigue, and dizziness – namely symptoms which limit a patient’s “capacity for effort”. During WWI, approximately 60,000 cases of “effort syndrome” were reported amongst British Forces. Treatment varied: some prescribed complete bed rest, while others argued that hospital stays should be kept short, as these were seen as redundant or even harmful due to the lack of discipline and its effect on a soldier’s morale. Switching to lighter responsibilities and occupational therapy was also recommended, and physical fitness was promoted through drills and games. Now, Da Costa’s syndrome is considered to be a manifestation of an anxiety disorder, and treatment is largely behavioural.