Whether neurasthenia be a condition or a disease or whether the term itself be properly or improperly used, the fact of its existence, of its untold mystery and increasing frequency is as certain as is the fact of civilization itself.
In all the fields of nervous maladies none is more widespread in its distribution and perhaps none more preventable than neurasthenia; a disease of unknown character and localization, the exact nature and seat speculative only; partly a morbid psychical asthenia and partly physical asthenia and irritability; so closely allied to hysteria and hypochondriasis that such can only be differentiated by grouping symptoms, by the symptoms-complex; simulating often degenerative diseases as tabes and general paresis1 or incipient tumors; closely allied, often a seemingly transition stage, to the most grave psychic diseases; of no known pathology, except it be the late imperfect pathology of fatigue cells; the only sure known phenomena
ELY TC. NEURASTHENIA AS MODIFIED BY MODERN CONDITIONS; AND THEIR PREVENTION. JAMA. 1906;XLVII(22):1816–1819. doi:10.1001/jama.1906.25210220042001k
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