their efforts to calm themselves, and only at an early hour in the morning
do they sleep again. Other patients go to bed with the conviction they will
not sleep, and are kept awake by incessant cogitation, their minds being
harassed by a rapid flow of images, ideas and memories. In some cases the
person is calm, his mind is at rest, yet he cannot sleep.

6. Circulatory Disturbances. More blood flows to an organ at work than to
one at rest. In health we do not notice these changes, but in neurasthenia
these internal tides are exaggerated as rushes of blood to the head,
flushings of various parts, and coldness of hands and feet.

Heart palpitation is alarming but not dangerous, and the distended
blood-vessels of the ears may set up vibrations in the drum, so that at
night when the head is on the pillow, every beat of the heart is heard as a
thump, which banishes sleep, and works the victim into a state of high
tension. A pain in the chest, arms and elbows is often felt, limbs may
swell (shown by the tightness of rings, collars, etc.) while the hands and
feet are usually moist and clammy. The patient may have to empty the
bladder every half-hour. Disorders of menstruation are common.

7. Mental Fatigue. Hundreds of pages would be needed to describe all the
symptoms due to mental fatigue, the morbid belief that the victim has a
fatal disease being very common, though his "disease" rarely makes him lie
up; in the day he works, at night describes his symptoms to the home
circle.

The inability of most men to apply themselves steadfastly to any one set of
ideas is seen in the immense popularity of music halls, cinemas, and
short-story magazines, which offer a change of interest every few minutes.