To the neurologist many cases are referred with the diagnosis of neurasthenia. Many of these are psychologic, being in reality a fixed idea of incapacity derived from the suggestions of medical men or friends, or, perhaps, because of some internal mental conflict which makes the motives for invalidism paramount over those for normal active life. Such patients often actually do become weak, either from mere inaction, or from the malassimilation induced thereby and the worries they permit themselves; this is a familiar picture in a traumatic neurosis,1 so-called. But among those labeled neurasthenics, there is a certain proportion of patients in whom hysteria is not the factor at all; I do not here refer to psychasthenic patients, in whom anxiety and other features of psychic genesis dominate the picture; nor do I include the formes frustes of such psychoses as cyclothymia (manic depressive insanity), hebephrenia, etc. I refer to
WILLIAMS TA. THE SYNDROME OF ADRENAL INSUFFICIENCY. JAMA. 1914;LXIII(25):2203–2207. doi:10.1001/jama.1914.02570250033009
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