Shock, collapse, heart failure and sudden death following abnormal emotion, like an attack of rage, or the terrors of a railroad accident, or bad news, or excessive exertion like running a long race or climbing a high mountain when in poor general health, as the phrase goes, or in the terminal stages of infections like epidemic influenza or Asiatic cholera, have been put down to an acute insufficiency of the adrenal gland.  A lowered temperature, blood pressure, and blood vessel tone, exhibited in tests of the response of the skin to stroking, are present in all of these and point the same moral.

In the second half of the 19th century, an American physician, Beard, described Neurasthenia, a general disturbance of the body and mind, not properly classifiable as a disease, but serious enough to incapacitate or at least greatly limit the sufferer.  The neurasthenic is to be recognized by the fact that the most painstaking objective examination of his organs reveals nothing the matter with them.  Yet, according to his complaint, everything is the matter with him.  He cannot sleep when he lies down, he cannot keep awake when he stands up.  He cannot concentrate, but still he is pitifully worried about his life.  The slightest irritant causes him to go off the handle.  As he works himself up into his hysterical state as a reaction to a disagreeable person or problem, irregular blotches may appear on his face and neck.  Generally, his hands and feet are clammy and perspiring, his face is abnormally flushed or pallid, the eyes are worried or starey, unwonted wandering sensations involving now this area of the body, or now that obsess him.  As the blood pressure is too low for the age, the circulation is nearly always inadequate and palpitation of the heart is a frequent complaint.  So frequent, that attention is often centered upon the heart, a diagnosis of heart disease is made, and the unfortunate is doomed for life—­to brood over horrible possibilities.  The brooding over themselves and their troubles is one of the distinctive features of the whole complex.  Neurasthenia may masquerade as any organic disease.  An individual with a soil for a neurasthenic reaction to life will become neurasthenic when confronted by any stone wall, including a serious ailment within himself.

Beard’s Neurasthenia leaped at once into the limelight.  It was seized upon and applauded in Europe as a good new name for an old condition, observed particularly in Americans abroad to rest from the fatigues of the get-rich-quick games of industrial speculators.  In fact, the name of the American Disease was given to it.  Various theories about the effects of climate, sunlight per square inch and unit of time, oxygen content of the air, and so on, were offered up upon the altar of scientific explanation.  Sir Arbuthnot Lane, famous protagonist of Lane’s intestinal kink, said that all Americans were neurasthenic.  Neurasthenia became one of the most popular of diagnoses, and remains so today.