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February 24, 1900


JAMA. 1900;XXXIV(8):503. doi:10.1001/jama.1900.02460080055018

Although neurasthenia is known as a modern disorder, and is sometimes designated the "American disease," it is probable that it has existed throughout all time. Its most characteristic phenomenon is undue readiness of recuperation, and of this its protean symptomatology represents but innumerable variations. It is customary to speak of the disorder as a "functional" one, from a failure to discover definite anatomic or histologic changes capable of explaining its manifestations, but it is difficult to conceive of derangement of function without alteration in structure, although this may elude the action of stain and the scrutiny of microscope. One is therefore constrained to believe that certain insidious and elusive nutritive, chemic or toxic influences are operated in the etiology of neurasthenia. What is perhaps scarcely less important, however, is the susceptibility, the predisposition of the individual nervous system to the specific influences responsible for the development of the disorder. Here