nds and feet,
which are sometimes mottled bluish-red, a loss of appetite and zest in
life, and a mental instability characterized by an indecision, and a
tendency to worry, a weepishness upon the slightest provocation.

A certain number of the temporary breakdowns or nervous prostrations,
which seem to be growing more common or fashionable, may be sometimes
traced to such a deficiency of normal response to the needs of
everyday conflict by the adrenal gland. In some, mental and physical
elasticity are totally lost, and even the slightest exertion in
either field often causes so much weariness and exhaustion as to be
prohibited. Depression and even melancholia are associated with the
fear of not being able to accomplish good work hitherto easy and
enjoyed. Sometimes they are obsessed with the thought that they have
lost their nerve completely, and so dread to commit themselves in even
the most trivial of situations. The vacillating frame of mind is so
distressing at times as to arouse thoughts of suicide. When these
symptoms concur in the type of personality whom I shall describe
as the unstable adrenal-centered individual, there is evidence for
explaining the process as the effect of an insufficiency of secretion
by the adrenal gland.

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 worrie