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 anaemic people which I shall by and by speak of more fully.
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.