NEURASTHENIA 205 



ance of stimulation. They are talkative and demonstra- 

 tive. They laugh easily and with abandon. Their state 

 suggests a mild intoxication. It may be that the condi- 

 tion is more like an intoxication than we should be in- 

 clined to think. We account for the garrulity of banquet- 

 ers by saying that the alcohol has acted as a narcotic, 

 selecting the inhibitory centers for its primary action and 

 so giving the outward and subjective signs of stimulation. 

 The influence of the fatigue substances upon the brain 

 may be much like this. Whether the secret of the in- 

 fluence consists in a general stimulation or in the with- 

 drawal of desirable inhibitions, the obvious result is aug- 

 mented activity. 



Once before we have alluded to the fact that the tired 

 nervous system craves employment, though it needs 

 repose. Many people will appreciate the following in- 

 stance cited by J. J. Putnam: An overwrought woman 

 had appealed to an old physician for advice. He had told 

 her that she must rest. Her reply was that she did not 

 feel tired and could not bring herself to be still. "Madam," 

 said the doctor, "you will have to lie down until you are 

 tired and then rest." A hyperexcitability like this is un- 

 happily common in children, who nowadays have less 

 training in the exercise of inhibition than fell to the lot 

 of earlier generations. We may now go on to see how con- 

 sistently the neurasthenic exemplifies this heightened 

 nervous activity in every department of his organization. 

 It is easy to recognize that a vicious cycle is involved, 

 the overaction intensifying the fatigue and yet failing to 

 bring automatic relaxation. 



Guided by Courtney, we shall consider the signs of 

 neurasthenia as they appear in four realms. These are: 

 (1) The motor mechanism, (2) the sensory equipment, 

 (3) the autonomic or visceral field, and (4) the tempera- 

 ment. The connections of all these are such that dis- 

 turbances in one must be expected to overflow upon the 

 others. The reflex principle makes this inevitable. In 

 order that an organism shall be properly adjusted to 



