18 THE TONER LECTURES. 



Americans in all walks of life, among women as often, or perhaps 

 oftener, than men. These neurasthenics are commonly individuals 

 who are careful rather than careless in their habits of living and 

 W'orkiug, although sometimes the reverse is the case. They may be, 

 and frequently are, of the nervous diathesis. If men, they are 

 not those who come to the front in politics and in the professions, 

 and who form the sul^ject of our study. They may be statesmen, 

 or physicians, or lawyers, or journalists, but they do not represent 

 the aggressive and successful elements in such careers. They are 

 men who, having wet their feet in the ripples of endeavor, imagine 

 that they have buffeted with great waves. 



Those who form the subject of this lecture, on the other hand, are, 

 as a rule, men of great natural vigor, who have worked with more 

 energy than discretion. They are the swift and strong, the fit in- 

 tended to survive. Sadly enough the}' often live only to teach the 

 truth that the race is not always to the swift, nor the battle to the 

 strong. While scarcely ever belonging to the class of chronic 

 neurasthenics, these men are sometimes the victims of a nervous pros- 

 tration, which comes on acutely, or so insidiously that its early 

 warnings are overlooked or brushed aside. This condition may be 

 followed quickly by some serious organic disease, or, under fortu- 

 nate circumstances, it may be recovered from by rest and proper 

 treatment. The cases classed as acute neurasthenia were of this 

 character. 



The condition of half-gout, or suppressed gout, named lithccmia 

 by Murchison\ and also sometimes spoken of as lithuria or lithiasis, 

 has attracted much attention during the last few years. In addi- 

 tion to Murchison, the nervous symjjtoms of lithsemia have been 

 ably discussed by Draper^ Russell Reynolds^ Dyce Duckworth^ 



1 The Croonian Lectures on Functional Derangements of the Liver. By 

 Charles Murchison, 31. D., LL. D., etc. 



* Series of American Clinical Lectures, edited by E.G. Seguin, M. D., 

 1875, and New York Medical Eecord, February 24, 1883 



* British Medical Journal, December 15, 1877. 

 ♦Brain, April, 1880. 



