NEURASTHENIA -11 



When this is said, the question arises, Is there a sharp 

 line between the temporary warping of disposition that 

 we see in the neurasthenic and the irresponsibility of def- 

 inite insanity? A recent writer has set a standard which 

 is an attractive one if we can be wise enough to apply it 

 rightly. It is this: The neurasthenic differs from the 

 psychasthenic, as we may call the graver defective, in the 

 fact that he fabricates nothing, but merely exaggerates and 

 distorts. There is some foundation for all his complaints. 

 He is not insane until he is in touch with things which 

 have no existence for other people. Fortunately, in the 

 vast majority of cases, he is destined to recover his poise 

 and not to cross the sinister boundary. 



There are few things more difficult than to deal 

 humanely and yet firmly and consistently with neuras- 

 thenia. A tolerant and even mind is called for one that 

 shall possess all the temperance and perspective which for 

 the time being are so sadly wanting in the patient. The 

 most cruel anguish which must be endured is in experien- 

 cing the enfeeblement of affection which has overtaken the 

 stricken husband or wife. Cutting words from the once 

 loyal companion, bitterness that would never be exhibited 

 to a stranger, must be borne without remonstrance. The 

 superiority of the sanitarium to the home in most cases 

 may be traced to the usual failure to live up to such exac- 

 tions. In the institution some restraint is imposed upon 

 the patient by the strangeness of his contacts, while the 

 trained attendants maintain a uniform attitude instead of 

 alternating between caresses and angry argument. 



It must not be forgotten that the suffering described by 

 the neurasthenic is as real as any that life brings. It 

 merits sympathy. Yet the free expression of much 

 sympathy sinks the victim in deeper despondency and 

 encourages him to invent new theories to account for his 

 misery. It also makes his future appear darker than ever. 

 Even the most earnestly phrased sympathy will not seem 

 adequate to the pity-consuming neurasthenic. He remains 

 skeptical as to the possibility that anyone can really appre- 



