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Updated: October 28, 2025


This is a remarkable showing when we consider the strain of the strange, long, dark winter campaign, and of these fourteen cases six were mental deficiency that were not detected by the experts at time of enlistment and induction, three were hysteria, two neurasthenia, and three psychasthenia. Here let us add that there was only one case of suicide and one case of attempted suicide.

Yet the fact that the patient himself really does not will the effect at which he is aiming separates, mostly without difficulty, the diagnosis of psychasthenia from that of insanity. Quite nearly related to it are the manifold variations of abnormal and perverse sexual tendencies.

For the purpose of this discussion, it is not important whether psychasthenia arises purely from degeneration of structure, or from faults in the chemistry of the plasma which bathes the nerve structures, or whether it is a purely psychopathological condition to which the physical phenomena are secondary, as some would have us believe.

I went to see a stomach specialist who looked me over and gravely informed me that I had psychasthenia anorexia. This was a new one on me. For all I knew about the term, it may have been obsolete swearing. I did not realize then that a little medical learning to a layman is a dangerous thing. This doctor prescribed exercise, as had all the others whom I had ever consulted.

Various ways of procedure might appear in order and the most natural one would be, of course, to pass down from disease to disease and sketch special cases from diagnosis to cure. We might go through the various stages of neurasthenia and then through psychasthenia and then through hysteria and so on.

We have seen that the work of the psychotherapist is of very unequal value in different parts of the field; in some, as in neurasthenia, in psychasthenia, in hysteria and similar regions most effective, in others like paresis or paranoia reduced to an almost insignificant factor. Where it can help and where not we recognize as a mere question of experience.

By the term psychasthenia is understood a group of conditions in which the bodily symptoms, such as fatigue, sleeplessness, loss of appetite, etc., are either not so marked as in neurasthenia, or else are overshadowed by other, more distinctly mental symptoms. These mental symptoms are of three main types.

One might compare the psychoneuroses to a watch which needed oiling or cleaning, or merely a winding up, as against one in which a vital part was broken. The most important of the psychoneuroses, in so far as the housewife is concerned, is the condition called neurasthenia, although two other diseases, psychasthenia and hysteria, are of importance.

If we classify symptoms, we may separate from it that which we nowadays are inclined to call psychasthenia. An abnormal suggestibility for autosuggestions stands in the foreground. Fixed ideas and fixed emotions, especially fears, trouble the patient. He may pick up his obsession by any chance experience and no good-will liberates him from the intrusion perhaps for years.

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