Let us add the long-continued malarial poisonings, and we have a group of varied origin which is a moderate percentage of cases in which loss of weight and loss of color are noticeable, and in which the usual therapeutic methods do sometimes utterly fail.
For many of these, fresh air, exercise, change of scene, tonics, and stimulants are alike valueless; and for them the combined employment of the tonic influences I shall describe, when used with absolute rest, massage, and electricity, is often of inestimable service.
A portion of the class last referred to is one I have hinted at as the despair of the physician.

It includes that large group of women, especially, said to have nervous exhaustion, or who are defined as having spinal irritation, if that be the prominent symptom.

To it I must add cases in which, besides the wasting and anaemia, emotional 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, gynaecologists, 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.