Perhaps a sketch of one of these cases will be better than any list of
symptoms. A woman, most often between twenty and thirty years of age,
undergoes a season of trial or encounters some prolonged strain. She may
have undertaken the hard task of nursing a relative, and have gone
through this severe duty with the addition of emotional excitement,
swayed by hopes and fears, and forgetful of self and of what every one
needs in the way of air and food and change when attempting this most
trying task. In another set of cases an illness is the cause, and she
never rallies entirely, or else some local uterine trouble starts the
mischief, and, although this is cured, the doctor wonders that his
patient does not get fat and ruddy again.

But, no matter how it comes about, whether from illness, anxiety, or
prolonged physical effort, the woman grows pale and thin, eats little,
or if she eats does not profit by it. Everything wearies her,--to sew,
to write, to read, to walk,--and by and by the sofa or the bed is her
only comfort. Every effort is paid for dearly, and she describes herself
as aching and sore, as sleeping ill and awaking unrefreshed, and as
needing constant stimulus and endless tonics. Then comes the mischievous
role of bromides, opium, chloral, and brandy. If the case did not begin
with uterine troubles, they soon appear, and are usually treated in vain
if the general means employed to build up the bodily health fail, as in
many of these cases they do fail. The same remark applies to the
dyspepsias and constipation which further annoy the patient and
embarrass the treatment. If such a person is by nature emotional she is
sure to become more so, for even the firmest women lose self-control at
last under incessant feebleness. Nor is this less true of men; and I
have many a time seen soldiers who had ridden boldly with Sheridan or
fought gallantly with Grant become, under the influence of painful