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more common than in all the world besides, and that the symptoms, behavior, and clinical history are the same in both countries. At the time when my first article on this subject was prepared (1868), I used the general term neurasthenia to cover all forms and types of nervous exhaustion, the symptoms coming from the brain and from the spinal cord being described together and indiscriminately. This imperfection Professor Erb has repeated, and, to that extent, the value of his essay is impaired, since, in strictness, the disease neurasthenia should appear both in the volume on the brain and on the spinal cord, in the former as cerehrasthenia, or exhaustion of the brain, in the latter as fnyelasthenia, or exhaustion of the spinal cord. PREFACE. 9 Many important symptoms he does not mention, and no attempt is made to explain in detail the diagnosis, pathology, or rationale of the disease. CONTENTS. CHAPTER I. Introduction. PAOB Why the Study of Neurasthenia has been neglected.-The Symptoms of a Subjective Character.-Reasoning vs. Observation on.-Less Frequent in Europe.-More Medicine used in America 25-35 CHAPTER n. Symptoms of Nervous Exhaustion. How to Study Cases.-Tenderness of the Scalp.-Cerebral Irritation.-Dilated Pupils.-Sick Headache and Various Forms of Head Pain.-Pain, Pressure, and Heaviness in the Head.-Changes in the Expression of the Eye.-Congestion of the Conjunctiva.-Disturbances of the Nerves of Special Sense.-Neurasthenic Asthenopia.-Muscce. Volitantes.-Noises in the Ears.-Atonic Voice.-Deficient Mentiil Control.-Mental Irritability.-Hopelessness.-Morbid Fears.-Astraphobia or Fear of Lightning.-Topophobia or Fear of Places.-Agoraphobia or Fear of Open Places.-Claustrophobia or Fear of Closed Places.-Anthropophobia or Fear of Society.-Monophobia or Fear of being Alone.-Phobophobia or Fear of Fears.-Mysophobia or Fear of Contamination.-Pantaphobia or Fear of Everj'thing.-Symptomatic Merely.-Morbid Fears Rarely E.xist Alone. Flushing and Fidgetiness.-Frequent Blusbing. »^Sleeplessness.-Bud Dreams.-Insomnia.-Drowsin^s.-Tenderness of the Teeth and Gum.s.-Nervous Dyspepsia (/>y.s;v7)«iV Asth^nujtte).-Deficient Thirst and Citpacity for Assiniiliiling Fluids.-Desire for Stimulants and Narcotics.-Dryness of the Skin.

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