manifestations predominate, and which are then called hysterical,
whether or not they exhibit ovarian or uterine disorders.

Nothing is more common in practice than to see a young woman who falls
below the health-standard, loses color and plumpness, is tired all the
time, by and by has a tender spine, and soon or late enacts the whole
varied drama of hysteria. As one or other set of symptoms is prominent
she gets the appropriate label, and sometimes she continues to exhibit
only the single phase of nervous exhaustion or of spinal irritation. Far
more often she runs the gauntlet of nerve-doctors, gynæcologists,
plaster jackets, braces, water-treatment, and all the fantastic variety
of other cures.

It will be worth while to linger here a little and more sharply
delineate the classes of cases I have just named.

I see every week--almost every day--women who when asked what is the
matter reply, "Oh, I have nervous exhaustion." When further questioned,
they answer that everything tires them. Now, it is vain to speak of all
of these cases as hysterical, or as merely mimetic. It is quite sure
that in the graver examples exercise quickens the pulse curiously, the
tire shows in the face, or sometimes diarrhoea or nausea follows
exertion, and though while under excitement or in the presence of some
dominant motive they can do a good deal, the exhaustion which ensues is
out of proportion to the exercise used.

I have rarely seen such a case which was not more or less lacking in
color and which had not lost flesh; the exceptions being those
troublesome instances of fat anæmic people which I shall by and by speak
of more fully.